Summary of Changes
DI 30005.230 Correcting Decision Basis Code Technical Corrective Actions
The title of this POMS section was revised to Introduction to Technical Corrective Actions (TCAs).
In Subsection A: This section contains the basic definition of TCAs. It further explains that all TCAs fall into two basic categories, substantive and non-substantive.
In Subsection B: We define substantive TCAs and which TCAs are included in these categories. We refer the reader to revised section DI 30005.231 for a detailed definition of substantive TCAs and how they are to be corrected.
In Subsection C: We define non-substantive TCAs and which TCAs are included these categories. For non-substantive TCAs, we modernized some of the categories to reflect technical corrective actions that occur in the electronic environment. We refer the reader to revised section DI 30005.232 for a detailed definition of non-substantive TCAs and how they are to be corrected.
DI 30005.231 Correcting 12-Month Medical Evidence of Record (MER) Technical Corrective Actions (TCA)
The title of this POMS section was revised to Substantive Technical Corrective Actions (TCAs).
In Subsection A: We define substantive TCAs in more detail. In subsection A1, we define the regulation basis code TCA. We have renamed to “regulation basis code” from “decision basis code” to more accurately define the TCA.
In subsection A2, we define the “group I or group II deficiencies in a non-sample case and give an example. We included references to DI 30005.121 and DI 30005.123 for definitions of group I deficiencies and DI 30005.125 and DI 30005.126 for definitions of group II deficiencies.
In Subsection B: Subsection B is titled Correcting Substantive TCAs. We explain that substantive TCAs are corrected by the review component or returned to the adjudicating component based on case type.
In subsection B.1, we explain the steps for correcting a regulation basis code TCA when it occurs in an adverse reopening, a cessation or a reconsideration of an adverse reopening or cessation.
In subsection B.2, we explain the steps for correcting a regulation basis code TCA when it occurs in all other case types. At the end of subsection B.2, we added the exception that if the regulation basis code is due to an obvious typographical error, we can correct without assuming jurisdiction of the case.
In subsection B.3, we explain how to correct incorrect actions in a non-sample case. We explain these are handled the same as a deficiency or TCA in a sample case but no deficiency is coded and the SSS-1774, if required, is labeled “informational”. We refer readers to DI 30005.210 through DI 30005.217 for correcting group I, DI 30005.220 through DI 30005.228 for correcting group II deficiencies and this section and DI 30005.232 for correcting TCAs.
DI 30005.232 General Rules for Correcting Other Technical Corrective Actions
The title of this section was revised to Non-substantive Technical Corrective Actions (TCAs).
In Subsection A: We define non-substantive TCAs in more detail.
In subsection A.1, we define the 12-month medical evidence of record (MER) TCA.
In subsection A.2, we define the diary entry TCA.
In subsection A.3, we define a medical or vocational documentation TCA.
In subsection A.4, we define a Notice TCA.
In subsection A.5, we define a determination form TCA.
In subsection A.6, we define a medical assessment form TCA. We expanded the definition to include all medical assessment forms that are either incorrect, missing, incomplete or not applied to the case to reflect the electronic process.
In subsection A.7, we define an un-imaged disability determination explanation (DDE) TCA. This is a new TCA occurring in the new electronic environment.
In subsection A.8, we define a mental impairment case TCA.
In subsection A.9, we define an unsigned consultative exam (CE) TCA.
In subsection A.10, we define an illegible or missing essential evidence TCA and update the definition to reflect the electronic environment.
In subsection A.11, we define the capability development TCA.
In Subsection B: In subsection B, we title it Correcting Non-substantive TCAs. We explain that non-substantive TCAs are handled in several ways depending on the case type, the type of TCA or both.
In subsection B.1, we explain the steps for correcting a un-imaged DDE, illegible or missing medical evidence or unsigned CE report TCA. We further explain we will contact the designated adjudicating component contact for correction BEFORE completion of the review. We also added a note to explain the review component may still cite a group I or group II deficiency or another TCA after the information is secured.
In subsection B.2, we explain the steps for handling a medical or vocational documentation TCA. We explain that we do not notify the adjudicating component but we do apply probability of reversal and provide a rationale when this occurs. We further explain in the note if the quality reviewer is unable to determine whether missing medical or vocational documentation will change the determination or period of disability, a group I or II documentation deficiency exists.
In subsection B.3, we explain the steps for handling a diary entry, notice, capability development or determination form TCA. We will no longer notify the adjudicating component when these TCAs occur and the review component will make the corrections.
In subsection B.4, we explain the steps for handling a 12-month MER TCA. We will return the case to the adjudicating component, along with an SSA-847-U3, SSA Request For Case Action, for correction.
In subsection B.5, we explain the steps for handling a medical assessment form or mental impairment form TCA. We will assume jurisdiction, correct and notify the adjudicating component without returning the case. We provide a link to GN 04440.244 for instructions on assuming jurisdiction. We include a note at the end of this subsection to remind the reader of the cases where we are unable to assume jurisdiction.
DI 30005.235 Correcting Missing or Incomplete Residual Functional Capacity Assessment or Psychiatric Review Technique Forms
This section is being archived since the information in this section has been incorporated into sections DI 30005.230, DI 30005.231 and DI 30005.232.
DI 30005.236 Correcting Incorrect Psychiatric Review Technique Forms and Residual Functional Capacity Assessment Forms
This section is being archived since the information in this section has been incorporated into sections DI 30005.230, DI
30005.231 and DI 30005.232.