Social Security

Retention Date: 03/31/2026


A. Purpose

This Emergency Message (EM) provides Field Offices (FOs) with clarifying instructions on developing initial claims and properly documenting failure to cooperate (FTC) denials for Title II Disability Insurance (DI) and Title XVI Supplemental Security Income (SSI) claims.

B. Background

In their recent audit entitled “Denied Disability Claims that Required Manual Notifications to Claimants,” the Office of the Inspector General (OIG) found that SSA did not have sufficient controls in place to ensure proper documentation of development actions taken before denying a claim for FTC. Additionally, in a significant number of cases, SSA failed to issue the proper notice to close out these denials or failed to include all required policy-compliant language including appeal rights.

To assist technicians in processing these cases, we are revising DI 11018.005 Failure to Cooperate - Insufficient Evidence Determination in an Initial Disability Claim to clarify documentation and notice instructions.

Technicians must follow the instructions in this EM until the revised DI 11018.005 is published, at which point, this message will be archived.

C. Initial and Follow-up (Closeout) Notice Requirements

To establish eligibility or entitlement for DI or SSI, it is the claimant’s responsibility to inform us about or submit all evidence they know about that relates to whether they are blind or disabled. For guidance on whether special handling applies, or for situations where the claimant requires assistance, refer to DI 11018.005B.

The FO must take all required development steps before a claim can be denied for FTC including requesting assistance from the third-party contact, appointed representative, or representative payee as applicable.

a. Initial Request

The FO must issue a written initial request for information on form SSA-1043 for Title II, and SSA-8003 for Title XVI via the applicable claims system, the Document Processing System (DPS) or the Workload Action Center (WAC). Provide at least 15 calendar days for the claimant to respond. In some cases, it might be appropriate to wait longer than 15 days—depending upon the types and volume of documents requested, the source of the evidence, and whether the claimant is actively trying to obtain the evidence. For example, it might take the claimant longer to obtain a document from a source in another country or in another state.

b. Closeout (follow-up) request

After at least 15 calendar days, if FO has not received the evidence, the FO must issue a written closeout request on form SSA-1045 for Title II or SSA-8009 for Title XVI. The closeout date must be 30 days from date of the initial request. For example, if the initial request was sent on June 30, 2025, the closeout date would be July 30, 2025.

To ensure policy compliance and preservation of mandatory appeal rights, do not make changes to mandatory notice language in DPS. See GN 01010.410C.2 for Title II and SI 00601.120 for Title XVI.

D. Documenting Claims Development Before Pursuing a Failure to Cooperate Denial

Document all development efforts in the applicable claims system as follows:

· Identify the outstanding issue(s) on the development worksheet of the claims processing system, along with the initial request and follow-up request dates.
· Document the dates and results of all development efforts on a Report of Contact within the appropriate SSA claims processing system.
· If a paper folder exists, annotate the same information on a paper SSA-5002 and include in the paper folder.
· Refer to existing instructions in DI 11018.005C for Electronic Disability Collect System (EDCS) documentation requirements, which are unchanged.

E. Manual Notice Requirements

The Modernized Claim System (MCS) does not automatically generate a notice for technical denial codes 0M5 and 0M6, which are used to adjudicate an FTC disallowance. The standardized and policy-approved notices available in DPS provide the required explanation of the reason for denial and grant appeal rights.

Technicians should use the following notices in DPS based on claim type:

· DIB Denial Letter – HA
· DIB Denial Letter – DWB
· DIB Denial Letter – CDB

To ensure policy compliance and preservation of mandatory appeal rights, do not make any manual changes to the notice in DPS.

The SSA-L8030 denial notice for Title XVI is automated in most situations. See NL 00802.020 for situations when a manual SSA-L8030 is required.

Closing paragraph:
Direct all program-related and technical questions to your Regional Office (RO) support staff using vHelp or Program Service Center (PSC) Operations Analysis (OA) staff. RO support staff or PSC OA staff may refer questions, concerns or problems to their Central Office contacts.

Reference:
DI 11018.005 Failure to Cooperate-Insufficient Evidence Determination in an Initial Disability Claim
GN 01010.410 Failure to Submit Essential Evidence
SI 00601.110 Final Request- Failure to Cooperate (N18) Initial Claims
SI 00601.120 SSA-L8009-U3 (Supplemental Security Income, Important Information (IC)) – Notice Instructions
NL 00802.020 Initial Denial Notice — SSA-L8030, SSI Notice of Disapproved Claim