If the DDS suspects that the prior determination was obtained by FSF:
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Determine if another office (e.g., field office (FO)) documented its findings or observations
in an SSA-5002 (Report of Contact);
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After reviewing the documented findings or observations in the SSA-5002, complete
a potential fraud allegation referral through the Allegation Referral Intake System
(ARIS) to the Office to Inspector General (OIG);
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After a potential fraud allegation is submitted through ARIS to the OIG, the following
situations may occur:
If the OIG accepts the allegation for investigation and completes an investigation
on the fraud allegation, the OIG will complete a report of investigation (ROI), outlining
its findings and will forward the ROI to the requesting office for consideration.
The requesting office will determine if OIG's findings in the ROI indicate fraud and
will reopen the case accordingly, or
If the OIG declines to investigate the allegation or does not find evidence of fraud
during the investigation, the requesting office must evaluate whether the prior determination
or decision was obtained by similar fault. Continue to develop the case by following
guidance in DI 23025.010 Disability Determination Services (DDS) - Handling Potential Fraud or Similar Fault
(FSF) Cases and GN 04020.010B.2.
If there is a Special-F (Possible Fraud or Similar Fault) flag within the case file,
and there is no explanation why the case was flagged for possible FSF:
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Contact the FO staff who flagged the case through an assistance request (AR) for a
brief explanation; see related instructions DI 11006.005 Field Office (FO) - Identifying
Potential Fraud or Similar Fault (FSF) Cases, and
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If the FO staff does not respond to the request for clarification, transfer the case
back to the FO.