Quality Review (QR) requests field office (FO) folders for Stewardship review in limited situations to resolve coding issues, for analytical purposes, and to determine the accuracy of payments (e.g., recipient refuses to cooperate or cannot be located).

QR requests FO folders for Transaction Accuracy Review (TAR) sample cases where the Modernized System Indicator field of the Supplemental Security Record is coded “1” or “4” (indicating the FO established the case or processed a transaction outside of the Modernized SSI Claims System. FOs should forward any paper case file to the appropriate QR field site as shown on the email. Discuss problems in locating or sending the cases with the appropriate QR contact. If the FO is still developing the case, they should photocopy the case file materials needed in the FO and send the originals to QR.

QR makes all requests for FO action through the SSA-93 Quality Review website on an SSA-93 feedback form. There is a block in the response area of the website for each case called “Other” which states “Only Use If Applicable”. When the FO responds to an assistance request from QR for issues like those above, they select “Other” and use the comments area to reply to QR.

When finished, the website sends an automated email reply to QR and moves the case to the completed list. A copy of the SSA-93 is available on the website via a link if needed. Refer to the SSA-93 User Guide for more information.

TAR : When requested, reconstruct initial claims per GN 03105.010 and forward the case file to QR.

TAR : Attach a copy of the email notification to each folder as a transmittal slip and forward the case file to QR. Circle or highlight the name and account number of the folder sent.

Stewardship and TAR : If one of the following criteria applies, do not send the folder. Annotate the email with the criteria met, attach the supporting documentation, and send it to QR.

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  Reconsideration or hearing is pending with no decision. Attach a query showing an appeal is pending or a copy of the SSA-561-U2 or HA-501-U5.

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  An allegation of fraud has been referred to the Office of the Inspector General (OIG) through the Allegation Referral Intake System (ARIS). (Completed fraud allegations and status can be checked on the ARIS home page.)

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  Non-medical denial is input when a medical denial also exists. Attach a copy of Form SSA-831-U5.

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  Disability Quality Branch or Disability Determination Services reverses a medical allowance. Attach a query showing the claim in medical denial status.