If the beneficiary or recipient reports no medical sources, and the diagnosis is not
one of those listed in DI 28040.125B.1. or DI 28040.125B.2. in this section, the DDS must contact any third-party the beneficiary or recipient
believes can verify their statements. When there is no other non-medical third-party,
see DI 28040.125B.4. A signed permission to contact a non-medical third-party is not necessary.
Contact any non-medical third-party that has knowledge of the beneficiary or recipient's
condition and can provide an objective assessment of the condition.
Non-medical third-party contacts may include:
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Sheltered workshop administrators,
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Schools or organizations for persons with the same type of impairment as the individual,
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Social service organizations that provide some form of assistance,
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Explain to the third-party that we are conducting a CDR on the beneficiary or recipient
as required by law. Assure the person that we have permission from the beneficiary
or recipient to contact them. Do not tell the third party any information about the
beneficiary or recipient other than that we are conducting a CDR. Ask the contact
how recently they saw the beneficiary or recipient, and whether the person remains
impaired and unable to work or, in a Title XVI child case, unable to return to normal
activities.
Prepare a summary of the statement (form SSA-795 or other locally approved form) and forward it to the source for review and signature;
include a business reply envelope.
The DDS cannot complete a determination (if the determination is based on the non-medical
third-party statement) prior to receiving the statement back from the non-medical
third-party source. If the third-party statement:
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Verifies the beneficiary or recipient's statements, the DDS may process a continuance.
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Creates a continuing disability issue, the DDS should send the case to the FO for
a full CDR in accordance with DI 28040.215.
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Is not received by 14 calendar days from the date of the cover letter, follow up with
the non-medical third-party contact via telephone. If applicable, return the case
to the FO in accordance with DI 28040.125B.4. in this section, or schedule a consultative examination if possible.
The DDS will include the third-party statement in the folder if it is received prior
to completing the case. When receiving evidence in certified electronic folder (CEF)
cases, see DI 81020.060. The DDS will process statements or other evidence received after the determination
as “trailer material”, see DI 81020.140.