A dire need situation exists when a claimant alleges one or more of the following circumstances:

• •

  Dire financial need, for example, the claimant does not possess sufficient income or resources to address an immediate threat to their health or safety (i.e., lack of food, medicine, medical care, or shelter);

• •

  The non-receipt or interruption of benefit checks that has caused a hardship; or

• •

  Another hardship situation with adverse public relations potential (for example, congressional inquiry, or inquiries from other public officials).

Absent evidence to the contrary, the Field Office (FO) or Disability Determination Services (DDS) should accept a claimant's allegation of their circumstances. If the FO or DDS later determines the claimant's circumstances no longer meet dire need criteria, the dire need designation can be removed.

The FO or the DDS determines whether a case qualifies for special processing as a dire need case. At the DDS, dire need cases are usually already identified by the FO or the Office of Disability Operations (ODO).

The DDS will receive dire need cases or notification that cases already in the DDS have become dire need as indicated by the following:

• •

  Electronic Disability Collect System (EDCS) cases from the FO flagged for expedited processing, or EDCS exclusion cases with a dire need flag attached,

  View In PDF

• •

  Cases from ODO containing the annotation "dire need" on the transmittal;

• •

  Notification by telephone, fax, assistance request (AR) or other electronic means, from the FO, ODO, Regional Office (RO); or

• •

  Through direct contact with the claimant, claimant's representative, or a third party.

Flag dire need cases eligible for EDCS processing for expedited processing using an electronic dire need flag as described in DI 81020.085. Flag EDCS exclusion cases using a paper flag.

Upon receipt of a dire need case, the DDS must do the following:

• •

  Ensure the case has the appropriate dire need flag noted in eView and DCPS, see DI 81020.085. If the case is a paper file, ensure the paper folder has the appropriate flag attached to the front of the paper folder.

  View In PDF

• •

  Expedite assignment of the case for review no later than the next business day.

• •

  For EDCS exclusion cases, hand-carry the dire need case to the assigned disability examiner (DE).

Take the following steps when dire need is identified after transfer from the FO:

• •

  Flag the case as dire need in eView and DCPS, see DI 81020.085. If the case is an EDCS exclusion case, attach a dire need flag to the front of the paper folder.

  View In PDF

• •

  Notify the FO by telephone, AR, or other electronic means to initiate simultaneous development.

The assigned DE must take the following actions:

• •

  Review the case to confirm that the FO applied the dire need flag. If the FO failed to add the dire need flag, add the dire need flag to the case.

• •

  Develop and adjudicate the claim as a priority.

• •

  Handle any development or follow-up actions by telephone, fax, AR, or other electronic means, if possible.

• •

  Expedite Medical Consultant/Psychological Consultant (MC/PC) review.

• •

  Retain the dire need designation throughout the process, unless there is evidence in file which indicates the designation is incorrect. For dire need removal instructions, see DI 23020.030H in this section.

When the DDS processes an allowance on an EDCS exclusion dire need case, the DDS must send the case folder to the FO by priority mail with "Dire Need" designated on the envelope.

DDS may remove the dire need flag whenever there is evidence which establishes the claimant's alleged circumstance(s) does not meet the definition of dire need. The adjudicator must clearly document the reason for removal of the dire need flag in the official case file. When documenting in DCPS, the adjudicator should document the reason for removing the dire need flag in the case notes section of DCPS.