TN 19 (05-07)

GN 01070.222 Unable To Locate Prior Folder In PC Operations

Apply the following procedure once a review of all systems records determines it is necessary to obtain information contained in a paper record and:

  • The case control system shows the prior claim folder is in PC Operations;

  • Immediate payment is due to the claimant; and

  • The folder has not been found by the PC within 11 calendar days, or by the time of the FO's second follow-up request. Check individual PC web sites for pull times.

A. Open application

1. FO action

  • Partially adjudicate the current claim if the prior claim was adjudicated before 2/79 and the exceptions listed in GN 00204.026 do not apply.

  • Prepare a 60 day diary for PC follow-up.

    Note: If conditions warrant, you may establish a longer diary period.

2. PC action

When the diary matures review the systems records included shared process to determine if all information has been received. If the information necessary is not available determine if a paper folder exists and request the prior folder.

If the folder is available

Review the file for possible open application; and

Prepare an amended award if applicable

If the folder still cannot be located

Follow the “prior folder destroyed” procedure in GN 01070.224.

B. Information needed involves a factor of entitlement

If a factor of entitlement needs verification for someone other than the NH, and benefits are immediately payable to other people on the record, follow the procedure below:

FO action

  • Delay payment to the affected claimant(s) and process the claim(s) for the other applicants.

  • Redevelop the issue in question, and follow the delayed claim procedures in GN 01010.140.

C. Information needed does not involve a factor of entitlement

1. FO action

  • Redevelop the issue in question.

  • Partially adjudicate the claim (GN 01010.110); and

  • Diary for 60 days.

2. Action

When the diary matures:

  • request the prior folder, and

  • prepare an amended award if applicable.

    If the folder still cannot be located, follow the “prior folder destroyed” procedure in GN 01070.224.

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GN 01070.222 - Unable To Locate Prior Folder In PC Operations - 05/21/2007
Batch run: 02/12/2014