Complete the mandatory N20 Checklist to document that all of the required actions are taken before requesting management
approval of an N20 suspension. Sign the technician approval section (electronic signatures
and /s/ signatures are acceptable) and forward to the designated member of management
when requesting management approval of the N20 suspension. Click the PDF file, save
the checklist, and complete it.
Document N20 suspensions on the DROC screen in CCE (MS 04422.010) or on a paper Form SSA-5002 faxed into the NDRed using
Evidence Portal in non-CCE cases using the following format:
SUBJECT: N20 Determination-Claims Specialist/Claims Technical Expert
ACCURATELY DEVELOPED AND DOCUMENTED THE RECORD (Include results of ALL initial written requests, follow-up attempts and steps taken to exhaust all efforts
and the outcomes): Y/N
REASON FOR N20 SUSPENSION:
EFFECTIVE MONTH FOR N20 SUSPENSION: MM/YY
N20 CHECKLIST COMPLETED, SIGNED AND STORED IN EF/NDRed using Evidence Portal: Y/N
DATE N20 CHECKLIST GIVEN TO MANAGEMENT: MM/DD/YY
NAME OF MANAGEMENT OFFICIAL REVIEWING REQUEST:
***CERTIFICATION***
I HAVE DEVELOPED AND DOCUMENTED THE RECORD ACCURATELY AND CONFIRM THE USE OF N20 SUSPENSION
IS APPROPRIATE. I CERTIFY THIS ACTION MEETS THE REQUIREMENTS OF SI 02301.235.