Establish an appropriate FO control and a separate processing center (PC) diary when you adjudicate a claim but some issue(s)
requires further development (e.g., partial adjudication). For diary codes and information,
see GN 01040.010.
-
•
Use internal controls (e.g., Modernized Development Worksheet (MDW)) to establish
and follow up on FO controls.
-
•
Use the MCS DECI screen to establish PC diaries whenever possible. MCS diaries will
interface with the PCACS, establish a diary and generate the subsequent follow up
alert in the PC.
-
•
Annotate the RPOC screen with the related diary evidence Code(s) and a detailed rationale for the issue(s) under development.
-
•
If you process the claim manually, the PC must establish the diary or listing manually
in the PC. Annotate the diary request on the Benefit Continuity Remarks/Notice (BCRN)
screen in the Automated 101 (A101) or the Electronic Form (EF101).
-
•
Use a paper report of contact (RC) only if no RPOC screen or other appropriate electronic
screen is available.
NOTE: Due to the number of technical issues possible for each diary evidence code, procedural
description is necessary, see references in GN 01010.260.
Situations also exist when the interface system between MCS and PCACS does not detect
the information or the evidence code is not included. Diaries without proper clarification
from the adjudicator initiating the development, results in improper subsequent follow
up and may not be clear. You must always annotate the RPOC screen in detail, with
the exact reason(s) for development and the corresponding diary code(s). In addition,
for medical re-examinations, pending WC/PDB development and deferred auxiliary claimant
diaries on DIB claims, see DI 11010.030.
For instructions regarding diaries for end-stage renal disease (ESRD) Medicare claimants
who received successful transplants, see HI 00820.030.