TN 49 (08-08)

DI 11010.040 Field Office (FO) Development and Evaluation of Apparent Technical Denials

Development and evaluation techniques

Develop the evidence necessary to determine whether insured status is met or if the alleged onset of disability was within the prescribed period.

Take extra care to obtain and evaluate all pertinent information about factors involved (e.g., onset date, quarters of coverage, age of claimant, date of prior termination or cessation, or number holder’s (NH's) death in Disabled Widow(er)s Benefits (DWB) cases, etc.). Attempt to resolve conflicts before completing action. It is not necessary to extensively develop and establish factors (e.g., precise date insured status is last met) when it is apparent that it is not material to the determination.

Forward to the Disability Determination Services (DDS) any case in which the facts indicate that the claimant may have been disabled within the insured status period or prescribed period. If the case does not require a disability determination, complete the disallowance action.

In subsequent claims, carefully interview the claimant and screen FO records to fully inform the claimant of the reasons for the prior denial and to update the history of the case. It may be necessary to obtain prior Disability Insurance Benefits (DIB) or DWB official folders if new facts are brought to light that may affect the determination.

If there are no new facts or evidence, which could change the prior determination and the claim, is not excepted from FO handling, effectuate the disallowance action. See Res Judicata - GN 04040.010). For CEF cases, see Processing Field Office (FO) Determinations - DI 81010.140.

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DI 11010.040 - Field Office (FO) Development and Evaluation of Apparent Technical Denials - 08/08/2008
Batch run: 01/11/2019