Effective Dates: 09/01/2022 - Present Previous | Next

TN 26 (09-22)

GN 03910.050 Contacting a Represented Claimant

A. When we may contact a represented claimant directly

Generally, when a claimant has an appointed representative, we will communicate directly with the representative and not the claimant. However, we may contact the claimant directly if:

  • •

    the representative asks us to deal directly with the claimant. See GN 03910.050C;

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    the claimant, who is alleging blindness or a visual impairment, elects to receive notices by first class mail with a follow-up telephone call from us to read the notices to him or her. See NL 01001.000 for the special notice option (SNO);

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    the contact relates to a possible violation of the Rules of Conduct and Standards of Responsibility for Representatives. See GN 03970.010;

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    there is an indication that a representative's appointment may have ended, but the information in our records is unclear or insufficient;

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    there is ambiguity about the scope of representation; or

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    there are multiple representatives appointed and it is not clear who is currently appointed or who is the principal representative.

EXAMPLE: The claimant appointed two representatives at different times and the representatives do not appear to be working together. In this instance, we will contact the claimant directly to clarify the situation.

B. Written communications sent to both claimants and appointed representatives

We send all written communications relating to a pending claim, matter, or issue to the claimant and his or her appointed representative(s), if any. Specifically, we will:

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    in disability claims, send notices or requests for development (i.e., a written request for specific evidence) to the principal representative and a copy to the claimant;

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    send notices of determinations and decisions and notices of awards to the claimant and a copy to the representative or if applicable, the principal representative. See NL 00601.010A for information on award notices; and

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    in communications related to the authorization of representative fees, send the notice(s) to the representative and a copy to the claimant, as appropriate. In fee agreement cases, send notice(s) related to the authorization of fees to the representative or if applicable, the principal representative when there are multiple representatives appointed to a pending claim, matter, or issue. See GN 03940.008C and GN 03940.055A.2 for information on fee agreement notices. In fee petition cases, if the claimant has appointed multiple representatives on a pending claim, matter, or issue, send notice(s) related to the authorization of fees to each representative, as appropriate. See GN 03905.075 for information on fee petition notices.

NOTE: For notices and correspondence specific to the Disability Determination Services (DDS), see DI 31001.010C.7.

C. How we contact a represented claimant

1. Directly contacting a represented claimant about a pending claim, matter, or issue

If the representative requests that we contact the claimant directly about a pending claim, matter, or issue:

  1. a. 

    Document the Report of Contact (RPOC) in Modernized Claims System (MCS) or Report of Contact (DROC) in Modernized SSI Claims System (MSSICS) with language that clearly indicates that the representative wants us to contact the claimant directly.

  2. b. 

    Do an update after transfer (UAT) in Electronic Data Collection System (EDCS) under other updates and provide details to alert DDS or Office of Hearing Operations (OHO) about this information. For electronic cases, fax a copy of SSA Form-5002 (Report of Contact (ROC)) into the electronic folder. For paper cases, forward the ROC to the appropriate component.

  3. c. 

    For electronic cases, add the following message, "Representative Involved - prefers direct contact with the claimant." See DI 81005.040 for information on alerts and messages.

  4. d. 

    Contact the claimant directly in this pending claim, matter or issue and document your contact accordingly.

  5. e. 

    Send copies of written contacts (e.g., ROC) with the claimant to the appointed representative (the principal representative if there are multiple representatives appointed to a pending claim, matter, or issue).

NOTE: If the representative is registered, you may also complete a ROC in the Registration, Appointment and Services for Representatives (RASR) application. If you complete a ROC in RASR, document the appropriate screens in MCS or MSSICS because RASR does not automatically update information in MCS or MSSICS.

2. Contacting a represented claimant directly about post-entitlement (PE) matters

If the representative requests we contact the claimant directly in PE matters:

  1. a. 

    Complete an ROC or document the DROC screen in MSSICS cases indicating that the representative has requested we contact the claimant directly and specify the PE issue the representative is handling.

  2. b. 

    Document the Special Message field of the Master Beneficiary Record (MBR) or Supplemental Security Income Record Display (SSIRD) with language that indicates that the representative wants us to contact the claimant directly and specify the type of PE issue.

  3. c. 

    For electronic cases, fax a copy of the ROC or DROC into the electronic folder. For paper cases, fax a copy of the ROC or DROC into the Non-Disability Repository for Evidentiary Documents (NDRed) using the Evidence Portal (EP), as appropriate.

  4. d. 

    Contact the claimant directly in the PE matter and document your contact accordingly.

  5. e. 

    Send copies of written contacts (e.g., ROC) with the claimant to the appointed representative (the principal representative if there are multiple representatives appointed to a pending claim, matter, or issue).

3. Contacting a claimant to read a notice when the claimant elects SNO

If a represented claimant elects SNO, call him or her directly within five (5) business days of the date of the notice and assist the claimant with any questions he or she may have.

NOTE: Do not initiate requests for information or ask additional questions unless the representative gives us permission to communicate directly with the claimant.

For example, the FO technician calls to read a notice to a claimant because he or she elected SNO. The technician discovers the claimant also needs to submit additional evidence such as proof of wages. The technician must not ask for this additional information during this contact. Instead, the technician must contact the representative to obtain the information or permission to call the claimant directly. Otherwise, the technician must make the request in writing to both the claimant and representative.

D. Communicating with appointed representatives

When communicating with an appointed representative, document all verbal contacts regarding any pending claim, matter, or issue using a ROC.

You must record your documentation regardless of whether the contact was initiated by the appointed representative or us. This requirement for documentation begins with the date we recognized the representative's appointment and continues until the representative's appointment ends. See GN 03910.060B for information on events that end a representative's appointment.

1. Updating the claim file

Update the claim file by:

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    adding any written document we receive from the appointed representative regarding the pending claim, matter, or issue (e.g., a letter, protest, or clarification). For electronic cases, fax the written document into the electronic folder. For paper cases, update the paper file with the original;

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    completing a ROC to document the in-person or telephone contact. For electronic cases, fax the ROC into the electronic folder or do an UAT in EDCS. For paper cases, update the paper file with the original. If you do not have the claim file, send a copy of the ROC or written contact to the component where the claim file is located after faxing the documentation into NDRed using EP; or

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    annotating the claims development screen, if available, with the date and a brief description of the contact (e.g., requested claimant to sign Form SSA-827 (Authorization to Disclose Information to the Social Security Administration)).

2. Updating RASR

Update RASR by recording a ROC to add information from the written document (e.g., an EIN/affiliation clarification or a request for a reprint of Form SSA-1699 (Registration for Appointed Representative Services and Direct Payment)) we receive from the representative.

 

To Link to this section - Use this URL:
http://policy.ssa.gov/poms.nsf/lnx/0203910050
GN 03910.050 - Contacting a Represented Claimant - 09/01/2022
Batch run: 09/16/2022
Rev:09/01/2022