Identification Number:
DI 23005 TN 12
Intended Audience:See Transmittal Sheet
Originating Office:ORDP ODP
Title:Whereabouts Unknown
Type:POMS Full Transmittals
Program:All Programs
Link To Reference:
 

PROGRAM OPERATIONS MANUAL SYSTEM

Part DI – Disability Insurance

Chapter 230 – Special Issues

Subchapter 05 – Whereabouts Unknown

Transmittal No. 12, 09/11/2024

Audience

PSC: CS, DE, DEC, DTE, IES;
OCO-OEIO: CR, ERE, FCR, FDE, RECONE;
DQB: DE, PA, PE, TL;
OCO-ODO: DE, DEC, DS, RECONE;
FO: CR, CR TII, CR TXVI, DRT, FR, OA, OS, RR, SR;
ODD-DDS: ADJ, DHU;
RO: CDP;

Originating Component

ODP

Effective Date

Upon Receipt

Background

We are clarifying policy by removing the requirement to mail the SSA-L2001 in certain circumstances.

Summary of Changes

DI 23005.001 Processing Whereabouts Unknown Disability Cases in the Disability Determination Services (DDS)

In subsection C.3, we removed the requirement to send the SSA-L2001 (Postmaster Letter) letter when the claimant does not have an appointed representative, legal guardian, or third party contact, and the FO does not respond to the request for assistance locating the claimant because this letter is not available in the Disability Case Processing System (DCPS),

DI 23005.001 Processing Whereabouts Unknown Disability Cases in the Disability Determination Services (DDS)

A. Definition of whereabouts unknown (WU)

For initial and reconsideration claims, consider a claimant's whereabouts to be unknown when the DDS cannot locate the claimant at their last known address and they cannot be reached by telephone (e.g., their phone number is disconnected).

When a WU situation arises during a medical continuing disability review (CDR), follow the instructions in DI 28075.005.

B. When WU arises in the field office (FO)

The FO must review the claim to determine whether a medical determination is necessary. Before transferring a WU claim to the DDS, the FO must resolve any substantial gainful activity (SGA) issues (DI 10505.000) and provide an accurate potential onset date (POD) (DI 25501.220).

For additional information about FO responsibilities when a WU situation arises, see DI 11055.085.

C. When WU arises at the DDS

When a claimant’s whereabouts become unknown while the case is at the DDS, adjudicators must either attempt to locate the claimant or request FO assistance with locating the claimant. Additionally, when the claimant has an appointed representative (AR) or requires special handling, specific instructions apply.

  • For additional information on represented claimants, see DI 31001.010.

  • For additional information on special handling criteria, see DI 23007.001A.

1. AR involved

When a claimant's whereabouts become unknown and they have an AR, the DDS must make a reasonable effort to involve the AR by following the instructions in DI 23007.005A. When the AR requests more time to locate the claimant, the DDS will allow them a minimum of 10 additional calendar days. Document the case file following the instructions in DI 23005.001C.4., in this section.

If, after involving the AR, the claimant's whereabouts remain unknown, follow the appropriate process to develop the claim, evaluate the evidence, and make a disability determination as set forth in DI 23005.001D, in this section.

NOTE: Although an AR might provide the claimant's updated contact information, the DDS may not change the claimant’s personal information in the Disability Case Processing System (DCPS) without first confirming with the claimant that this is the current mailing address or telephone number where they can be reached (unless the AR is a parent of a minor child or a legal guardian). For more information about the scope of AR authority, see GN 03910.025A.

2. Special handling applies

When a claimant's whereabouts become unknown and special handling applies, the DDS must make a reasonable effort to involve the designated third party contact(s) from the current level of adjudication, following the instructions in DI 23007.010C.

When the claimant designates two individuals who we can contact if the claimant becomes unavailable and the first contact person is not productive, the DDS must make a reasonable effort to involve the other contact person.

When the claimant elected not to designate a third party contact, DDS must take at least one of the actions listed in DI 23005.001C.3. in this section.

The designated third party contact(s) is documented in Section 2 – ‟Contacts” of the Forms SSA-3368-BK and SSA-3441-BK, or a contact person might be documented in the ‟Remarks” section of these forms. Document all efforts to involve the third party, following DI 23005.001C.4 in the section.

3. DDS efforts to locate the claimant

When the claimant does not have an AR and special handling does not apply, the DDS must take at least one of the following actions to attempt to locate a claimant whose whereabouts are unknown.

  • Mail the Form SSA-L2001 (Address Information Request) to the postmaster and allow them 15 calendar days to respond;

  • Make a reasonable effort to involve the third party (or parties) if the claimant provided one, or other appropriate individual(s) (e.g., legal guardian), following the instructions in DI 23005.001C.2. in this section.

  • Send the FO an assistance request through DCPS and allow them 15 calendar days to respond. If the FO does not respond after 15 calendar days have passed, the DDS must send a follow up message and allow the FO 10 calendar days to respond. The DDS must retain full jurisdiction of the case while the FO attempts to locate the claimant.

    If the claimant's whereabouts remain unknown after taking at least one of the listed actions above, there is no need for the DDS to make additional attempts to locate the claimant and they may proceed with making a disability determination, following the instructions in DI 23005.001D in this section.

    IMPORTANT: Subsequent Federal quality reviewers will not cite a deficiency if the DDS does not attempt to locate the claimant and defers to the FO for assistance with locating the claimant, instead. For additional information about Group I documentation deficiencies involving WU, see DI 30005.203A.21.

4. Document efforts to locate the claimant

The DDS must document all efforts to locate the claimant listed in DI 23005.001C.3 in a Case Note in DCPS, or on the Case Development Worksheet (CDW).

D. WU considerations when making a disability determination

Do not make an unfavorable determination solely because a claimant's whereabouts are unknown. When the DDS completes the required action(s) listed in DI 23005.001C but is unsuccessful in locating the claimant, follow the steps of the sequential evaluation process and complete any development that does not require the claimant's involvement.

For additional information on the sequential evaluation process, see DI 22001.001.

Based on the evidence in file, the DDS must:

  1. 1. 

    Determine whether a severe, medically determinable impairment (MDI) exists, as discussed in DI 24505.001;

  2. 2. 

    Determine whether any MDI(s) meets or equals a listing;

  3. 3. 

    Determine the claimant's residual functional capacity (RFC);

  4. 4. 

    Review the vocational evidence, if available, to determine whether the information is sufficient to make a medical-vocational determination;

  5. 5. 

    Determine whether the case evidence is sufficient to allow a closed period of disability, as discussed in DI 25510.001;

  6. 6. 

    Ensure the disability determination explanation (DDE) includes a thorough explanation of how the WU situation affects the disability determination;

  7. 7. 

    Include the following when completing the Form SSA-831 (Disability Determination and Transmittal):

    • The claimant’s last known address in Item 5, Name and Address of Claimant, and

    • “Claimant’s whereabouts unknown” in Item 34, Remarks.

  8. 8. 

    Send the appropriate notice to the claimant at their last known address; and

  9. 9. 

    Transfer the case to the FO or, if selected for Federal review, to the Disability Quality Branch.



DI 23005 TN 12 - Whereabouts Unknown - 9/11/2024