TN 18 (11-18)

DI 23022.050 Making the Determination in Compassionate Allowances (CAL) or Quick Disability Determinations (QDD) Fast-Track Cases

CITATIONS:

20 CFR §§ 404.1619, 416.1019

A. Making the medical determination

After receiving sufficient medical and vocational evidence that indicates the claimant’s impairment(s) meets or equals criteria in the Listing of Impairments or that medical and vocational factors indicate a fully favorable determination, no further development is necessary.

In these cases, submit the evidence to a medical or psychological consultant (MC/PC) to determine the sufficiency of the evidence and to assess the severity of the impairment(s).

In concurrent cases, if there is not at least one fully or partially favorable claim in the case, remove the case from CAL and QDD processing, using as a removal reason, “All Claims in the case are denials”.

NOTE: MCs and PCs must give priority to QDD and CAL cases.

B. Removing the CAL and QDD indicator

Remove the CAL and QDD indicator if any of the following apply:

1. All claims in the case are denials

If all claims in the case are denials, remove the case from CAL and QDD processing, using as a removal reason, “All Claims in the case are denials.”

2. All claims in the case are disability determination services (DDS) "no determination"

Use this removal reason if the DDS returns all claims in the case to the field offices (FO) with no determinations.

3. Non fast-track action or development is required

Use this removal reason if any of the following apply:

  • Class action re-adjudication,

  • Clearly not a CAL case –remove CAL only,

  • Medical deferment,

  • Reactivation or reopening

For more information on removal reasons, see DI 23022.055 Actions on Compassionate Allowances and Disability Determinations Fast-Track Cases.

C. Case routing

When you obtain all necessary evidence and make a medical determination, complete the:

  • processing,

  • disposition, and

  • route the case (For routing instructions see DI 32005.025).

Ensure that the Certified Electronic Folder (CEF) Indicator is correct and that you forward any paper folders associated with the CEF to the next location.

NOTE: If the Office of Quality Review (OQR) selects this case for Federal quality review and the electronic file also has a paper folder, the DDS must mail the folder to the reviewing office.

D. References

  • DI 23022.055 Actions on Compassionate Allowances and Disability Determinations Fast-Track Cases

  • DI 26500.000 Initial Case Processing

  • DI 26510.000 Completion of Form SSA-831-C3/U3 – Title II, Title XVI, and Concurrent Claims


To Link to this section - Use this URL:
http://policy.ssa.gov/poms.nsf/lnx/0423022050
DI 23022.050 - Making the Determination in Compassionate Allowances (CAL) or Quick Disability Determinations (QDD) Fast-Track Cases - 11/19/2018
Batch run: 10/29/2024
Rev:11/19/2018