Effective Dates: 09/22/2025 - Present Previous | Next

TN 24 (09-25)

DI 33015.005 Beneficiary (or Recipient) and Representative Review of Claims Folder

Citations: 20 CFR 404.916(b)(3), 416.1416(b)(3)

A. Offering opportunity for claims folder review

The regulations provide that a beneficiary (or recipient) and the appointed representative may review the evidence in the claims folder, either on the date of the disability hearing or at an earlier time, at the beneficiary's (or recipient's) or the appointed representative’s request.

  1. 1. 

    The disability hearing officer (DHO) will advise the beneficiary (or recipient) and appointed representative in the hearing notice that if they want to look at the case file before the hearing date, they will need to contact the disability hearing unit (DHU) or Social Security Administration (SSA) office in their area to arrange another time or place to review the file.

  2. 2. 

    For suggested notice language, see DI 33010.080 Language for Disability Hearing Scheduling Notice for Domestic Claims-Exhibit, or for foreign claims see DI 33010.085 Language for Disability Hearing Scheduling Notice for Foreign Claims – Exhibit.

  3. 3. 

    If the beneficiary (or recipient) or appointed representative requests to review the folder prior to the date of the hearing, the DHO will prepare the material as described in DI 33015.005B and send to the individual either electronically via my Social Security (mySSA) account or encrypted email, or via mailing an encrypted compact disc (CD). Annotate this action on an SSA-5002 Report of Contact and include the date the folder was sent. Do not send a CD to an incarcerated individual.

  4. 4. 

    The beneficiary (or recipient) or appointed representative may review the folder at the field office (FO) or the DHO if they request to review the folder prior to the date of the hearing.

  5. 5. 

    See GN 03340.000 Access to SSA Records for additional information.

B. DHO preparation of claims folder for review

1. General preparation for folder review:

  1. a. 

    Only include material relating to the beneficiary (or recipient).

  2. b. 

    Provide a paper copy of the medical evidence contained in the certified electronic folder (CEF) only if there is no means of viewing the evidence electronically or if the beneficiary (or recipient) or appointed representative requests a paper copy.

  3. c. 

    The DHO must include all relevant information from the comparison point decision when preparing the folder.

  4. d. 

    Medical assessment forms (e.g., SSA-416 Medical Evaluation, SSA-4734 Physical Residual Functional Capacity, SSA-2506-BK – Psychiatric Review Technique Form) may be found on the disability determination explanation (DDE) in Section A Payment Documents/Decision (Yellow Front) or in Section F Medical Records (Yellow Back).

  5. e. 

    Handle adverse effect material as set forth in DI 33010.015 Adverse Effect.

2. Preparing electronic claims folder:

When preparing the electronic claims folder, include the evidence used to make the determination. This includes medical assessment forms and any documents in sections E. Disability Related Determination (blue) and F. Medical Records (yellow back) of the electronic folder.

  1. a. 

    Send the claims folder via mySSA. Refer to DI 81001.035G for detailed instructions on how to create a PDF copy of eFolder documents and send to a mySSA account.

  2. b. 

    Send the claims folder via secure email. Refer to DI 81001.035F for detailed instructions on how to encrypt a PDF and send to the individual's personal email.

  3. c. 

    Burn a CD of the claims folder. Refer to DI 81001.035E for detailed instructions on how to create an encrypted CD.

  4. d. 

    Handle adverse effect material as set forth in DI 33010.015 Adverse Effect.

C. Access at the DHU

  1. 1. 

    A DHU or SSA employee must be present during the review and available to answer questions.

  2. 2. 

    Provide an area that affords privacy where the folder can be reviewed. If viewing on a workstation or laptop, ensure the individual only has access to their claims folder.

  3. 3. 

    For information concerning disclosure of medical records to a representative, see GN 03910.025 Authority of Representative, and GN 03305.025 Disclosure to Legal Aid Groups, Private Law Firms, and Appointed Representatives.

  4. 4. 

    The DHO must ensure that any Personally Identifiable Information on a laptop computer, CD, or paper folder is kept secure.

  5. 5. 

    If the beneficiary (or recipient) or representative requests the CD, provide it to them at no charge. See DI 81001.030 Claimant or Representative Requests a Copy of the Claims Folder.

  6. 6. 

    If the beneficiary (or recipient) or appointed representative does not request the CD, destroy the CD. See DI 81020.055E Document Retention and Destruction for instructions on how to destroy the CD and other sensitive materials.

To Link to this section - Use this URL:
http://policy.ssa.gov/poms.nsf/lnx/0433015005
DI 33015.005 - Beneficiary (or Recipient) and Representative Review of Claims Folder - 09/22/2025
Batch run: 09/22/2025
Rev:09/22/2025