Effective Dates: 08/25/2011 - Present Previous | Next

TN 3 (09-19)

DI 33010.001 General Review of Claims Folder and Preparation of In-House Folder in the Disability Hearing Unit (DHU)

A. Pre-hearing (PH) transfers the case to the DHU

When the disability determinations services (DDS) is unable to make a favorable determination after the PH review, the DDS closes the case as a No Determination (ND) with a reason of "PH Transfer to Disability Hearing (DH)." An electronic folder interface (EFI) download changes the claim to "DH" level.

B. Receipt of claims folder in the DHU

Depending on the DHU local business procedures, a technical review of the claims folder will be made to determine if the necessary evidence is included, and to identify existing or potential situations requiring additional action or referral.

1. Receipting the electronic folder (EF)

An EFI download changes the claim level to "DH" after the DDS closes the case at the PH level. To receipt the EF, the DHU will:

  1. a. 

    Review the folder for proper routing. If misrouted, the DHU will send the folder to the appropriate DHU or other component.

  2. b. 

    Receive the EFI download and assign the case to a disability hearing officer. See DI 81020.255 Processing a Reconsideration Appeal of an Electronic Continuing Disability (eCDR) Cessation.

2. Receipting the paper folder

The DHU should receive the paper folder under an SSA-408 Route Slip. The DHU will then:

  1. a. 

    Review the folder for proper routing. If the folder has been misrouted, the DHU will send it to the appropriate DHU or other component.

  2. b. 

    Update the case control system.

  3. c. 

    Date stamp the front of the claims folder copy of the SSA-789 Request for Reconsideration-Disability Cessation Right to Appear or Modernized Supplemental Security Income Claims System (MSSICS) generated printout to show the date the folder was received in the DHU. (This copy will be inside the claims folder.)

NOTE: The MSSICS generated printout is acceptable as an appeal document as it contains the same information as the SSA-789 Request for Reconsideration-Disability Cessation Right to Appear for Title XVI or concurrent cases. Refer to DI 12026.020 and DI 12026.025 for further information on appeals documents.

C. Securing claims folder from another office

1. Different folder needed

The DHU may request a folder from another office if the DHU receives the incorrect folder or the DHU needs an additional folder.

2. Procedure to obtain folder

  1. a. 

    Complete a case control query to determine the folder location. See DI 20505.015 for additional queries that can provide information on folder location.

  2. b. 

    Contact the office where the folder is located and request transfer to the DHU.

3. Follow-up if not received in 10 days

  1. a. 

    Make a follow-up call.

  2. b. 

    Follow regional procedures or telephone the regional office (RO) for assistance if the office where the folder is supposed to be has no record of the case, is unable to locate the folder, or does not provide the folder within 10 days of the follow-up request.

D. Folder documents

1. Documents and review

  1. a. 

    Review the folder for any "alerts" or identifying remarks. These may be found on an SSA-5002 Report of Contact (or SSA-408 Route Slip for paper folders), or in the alerts and message tab of eView.

  2. b. 

    Review the folder for waivers or situations, such as confined individuals, that affect scheduling and take appropriate action as needed.

  3. c. 

    Review SSA-1696 Appointment of Representative, or other written notice of appointment, if applicable. See details in DI 33010.001E.

  4. d. 

    Review the SSA-887 Summary of Evidence, if prepared by the pre-hearing unit, to assure all medical and vocational reports listed are in the folder. See DI 29025.001B for details on the preparation of the SSA-887 Summary of Evidence.

  5. e. 

    Review SSA-789 Request for Reconsideration-Disability Cessation Right to Appear or MSSICS generated printout to determine hearing preference.

  6. f. 

    Ensure field office (FO) work development is complete in extended period of eligibility (EPE) cases. SSA-408 Route Slip should have annotation "EPE Case". SSA-883 SGA determination will be in file for cases without medical improvement expected (MIE) diaries.

  7. g. 

    If foreign documents need to be translated, see instructions in DI 33025.015B.2.

  8. h. 

    Refer any potentially harmful documents to the supervisory hearing officer (SHO). See DI 33010.015 for detailed instructions on adverse effect material.

  9. i. 

    Review the SSA-416 Medical Evaluation, SSA-4734-BK Physical Residual Functional Capacity and SSA-4734-F4-SUP Mental Residual Functional Capacity assessment forms when required. See DI 24501.006, DI 24510.005, DI 24510.060, and DI 28010.145.

  10. j. 

    The SSA-2506-BK Psychiatric Review Technique, signed by a medical consultant, is included in all cases involving a current evaluation of a mental impairment. See DI 24583.005 and DI 28010.140.

  11. k. 

    The SSA-538 Childhood Disability Evaluation Form or Childhood Disability Evaluation Form (CDE) is included in all cases involving childhood disability claims. See DI 25230.001.

NOTE: "ADVISORY" [in bold, upper case letters] will be noted on the following forms in the appropriate sections or in the “Notes” section of eView as outlined in DI 29025.001A.2,:

  • •

    SSA-4734-BK Physical Residual Functional Capacity,

  • •

    SSA-416 Medical Evaluation,

  • •

    SSA-4734-F4-SUP Mental Residual Functional Capacity,

  • •

    SSA-2506-BK Psychiatric Review Technique,

  • •

    SSA-538 Childhood Disability Evaluation Form, or

  • •

    Disability determination explanation (DDE).

E. Appointed representative involvement

If an appointed representative is involved, ensure that:

  1. 1. 

    A form SSA-1696 Appointment of Representative, or other written notice of appointment, is in the claims folder;

  2. 2. 

    In electronic folders, the "Representative Involved" flag is in eView; and

  3. 3. 

    In paper folders, a form SSA-1128 Attorney Representation is attached outside of folder to indicate representative involvement.

Refer to DI 31001.001 and DI 33010.065 for additional details on representation of beneficiaries (or recipients).

F. Interpreter

Review the SSA-789 Request for Reconsideration-Disability Cessation Right to Appear, or MSSICS generated printout, to determine the need for providing an interpreter. See DI 23040.001 and DI 33010.030 for complete instructions on interpreters.

  1. 1. 

    Ensure that the DHU provides an interpreter when needed.

  2. 2. 

    Determine if there is any question regarding the qualifications of an interpreter provided by the beneficiary or recipient, and refer the folder to the SHO if there is a question.

G. Preparation of the in-house DHU folder for paper cases

1. Purpose of the in-house folder

An in-house folder is prepared for every paper case processed in the DHU. The folder allows for orderly retention of all hearing materials. It also acts as a general reference for case processing and post-hearing activities.

2. Content of the folder

The DHU folder retains the following types of documents:

  1. a. 

    Documents related to the processing of the specific case, such as copies of Forms SSA-1204-BK Disability Hearing Officer’s Report of Disability Hearing (DC); SSA-1205-BK Disability Hearing Officer’s Report of Disability Hearing; SSA-887 Summary of Evidence; or SSA-1207 Disability Hearing Officer’s Decision.

  2. b. 

    Copies of congressional inquiries.

  3. c. 

    Post-hearing material. When the original of such material is to be associated with the claims folder, make a copy for the DHU folder. See DI 33020.020 for instructions on trailer material..

  4. d. 

    Copies of any hearing documents normally retained in the claims folder, e.g., correspondence from the beneficiary (or recipient), and medical reports.

3. Retention

Retain the DHU folder for one year from the date of the last action or inquiry that involved the DHU.

To Link to this section - Use this URL:
http://policy.ssa.gov/poms.nsf/lnx/0433010001
DI 33010.001 - General Review of Claims Folder and Preparation of In-House Folder in the Disability Hearing Unit (DHU) - 08/25/2011
Batch run: 09/05/2019
Rev:08/25/2011