PROGRAM OPERATIONS MANUAL SYSTEMPart DI – Disability InsuranceChapter 435 – Processing Foreign ClaimsSubchapter 20 – Routing and Preparation of FormsTransmittal No. 1, 08/09/2023
Audience
Originating Component
ODP
Effective Date
Upon Receipt
Background
The Office of Disability Policy (ODP) is updating the POMS section for completing the SSA-423 (Request for Services and Reply (Foreign Disability Case)) for consistency with the revised SSA-423. In addition, ODP is archiving several other POMS sections with obsolete instructions.
Summary of Changes
DI 43520.001 SSA-423 Request for Services and Reply (Foreign Disability Case)
We updated this POMS section to provide instructions for the Internal Disability Unit (IDU) to complete the revised SSA-423.
DI 43520.005 SSA-423A-U5 (Follow-up Request to Department of State)
We archived this POMS section because this form is obsolete.
DI 43520.015 SSA-382-U2 (INTPSC Diary/Listing)
DI 43520.020 Optional Form 41
DI 43520.070 Exhibits
We archived this POMS section because ODP plans to update the relevant POMS sections to hyperlink to the current forms in inForm instead.
The International Disability Unit (IDU) uses the SSA-423 (Request for Services and Reply (Foreign Disability Case)) to request development from the Federal Benefits Unit (FBU) in foreign disability cases through an electronic SSA-883 (Request for Evidence or Assistance) as follows (initial and supplemental requests only):
Development of medical evidence.
Development of nonmedical evidence.
Request for verification of a foreign medical source's qualifications,
Assistance to the claimant.
For more information on electronic assistance requests (AR), see DI 81020.100.
The information on the SSA-423 populates from Disability Case Processing System (DCPS). However, individual case facts will require IDU to select or complete certain fields, as described in DI 43520.001B.1 through DI 43520.001B.8 in this section.
Enter the SSA appropriation number applicable to the fiscal year during which the expense actually incurred. The SSA appropriation number for the fiscal year, October 1, 2022, through September 30, 2023, is 283 8704. Each succeeding year the third digit of the SSA appropriation number should be changed to correspond to the final digit of the current fiscal year, (e.g., for fiscal year 2024, the appropriation number will be 284 8704).
Enter the allotment code 5113, followed by the object class code for Contracts for Foreign Claims Services 253P (5113-253P). These numbers do not change with the fiscal year.
Enter the consular code associated with country and FBU.
Select the type of development being requested from FBU as follows:
Medical and nonmedical records
Consultative Examinations
Other
IDU may select more than one type of development on the SSA-423. DCPS will include the barcode specific to the type of evidence requested on the Reply. If there are multiple types of development, DCPS will default to the barcode for MER (001). IDU (or the original requesting office) will ensure the evidence received is separated accordingly and included in the correct section of the certified electronic folder (CEF).
For more information on:
Organization of documents in the CEF, see DI 81001.005E.
Documents types, see DI 81020.040.
Moving documents in the CEF, see DI 81020.065D.
Include the claimant's allegations. The allegations populate from DCPS. IDU should review the allegations for completeness and correct any errors or misspellings.
Include:
The name of each medical and nonmedical source(s) needed.
The type of evidence needed, and dates requested or a statement, "Please provide all evidence from MM/DD/YYYY to MM/DD/YYYY."
The request for a medical opinion, if applicable.
The name of any questionnaire(s) (e.g., Physical Report, Cardiac Questionnaire, Speech and Language Questionnaire, SSA-5665 (Teacher Questionnaire), SSA-5666 (Request for Administrative Information), etc.) for the medical and nonmedical source(s) to complete, if applicable.
The name of any other enclosure(s) (e.g., SSA-827 (Authorization To Disclose Information To The Social Security Administration), etc.).
For more information on development of CEs, see DI 43510.020.
The type of examination and testing needed, as applicable.
The name of any questionnaire(s) (e.g., Range of Motion Chart, Muscle Evaluation, etc.) for the CE provider(s) to complete, if applicable.
The name of any other enclosure(s) (e.g., CE guidelines, SSA-827, etc.).
NOTE: FBU will review the SSA-3368 (Disability Report - Adult), SSA-3820 (Disability Report - Child), SSA-3441 (Disability Report - Appeal), or SSA-454 (Continuing Disability Review Report) in the CEF to obtain the address for each source listed on the SSA-423.
For more information on development of medical evidence, see DI 43510.015.
Include an explanation of other development needed, including, but not limited to:
Questionnaire(s) (e.g., SSA-3369 (Work History Report), SSA-3373 (Function Report - Adult), SSA-3380 (Function Report - Adult - Third Party), SSA-3385 (Report of Adult Functioning - Employer), etc.) for the claimant, parent of a minor child, legal guardian, third party, or employer to complete.
Verification of foreign medical source's qualifications.
Field investigation(s).
FBU will obtain any questionnaires that are available in inForm. Otherwise, IDU will select enclosures for any questionnaire(s) or other documents not available in inForm. DCPS will upload these questionnaires and documents to CEF with the SSA-423.
Examples of enclosures (not available in inForm) for CE development may include:
Copies of medical and nonmedical evidence for background.
Questionnaires for completion by the CE provider(s).
CE guidelines for the type of examination or testing.
SSA-827 signed by or on behalf of the claimant.
Examples of enclosures (not available in inForm) for medical and nonmedical records development may include:
Questionnaires for completion by the medical or nonmedical source(s).
Examples of enclosures (not available in inForm) for other development may include:
Questionnaires for completion by the claimant, parent of a minor child, legal guardian, third party, or employer.
SSA-827 signed by or on behalf of the claimant, if applicable.