Effective Dates: 12/27/2024 - Present Previous | Next

TN 8 (12-24)

DI 23007.010 A Reasonable Effort to Identify and Involve a Third Party in Claims Involving Failure to Cooperate and Insufficient Evidence

A. When you must make a reasonable effort to identify and involve a third party

Before you stop attempts to get the claimant to comply with your request, you must make a reasonable effort to identify and involve a third party when all of the following apply:

  • •

    The claim falls into a special handling category;

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    The claimant does not have an appointed representative (AR), except when the claimant is under age 18. These claims require special handling even when they have an AR;

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    The claimant has not already identified a third party on the SSA-3368 (Disability Report - Adult), SSA-3441 (Disability Report - Appeal), or SSA-454 (Continuing Disability Review Report);

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    The claimant did not indicate they are unwilling or unable to provide any third party by selecting "No" in Section 2 – "Contacts" on the SSA-3368;

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    The Field Office (FO) has not documented that the claimant refused to provide a third party (or parties) in the Remarks section on the SSA-3368, SSA-3441, or SSA-454; and

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    The claimant has not complied with a follow up request for evidence or action or does not attend or confirm a consultative examination (CE) appointment.

For claims that require special handling, see DI 23007.001A.

For the definition of a third party and where to locate them on the appropriate forms, see DI 23007.001C.

When the claimant does not comply with an initial request for evidence or action, see DI 22505.014.

When the claimant does not comply with the initial notice of a consultative examination (CE) appointment or does not attend a CE appointment, see DI 22510.019.

B. Making a reasonable effort to identify a third party

When the criteria in DI 23007.010A in this section applies, make a reasonable effort to contact the claimant to ask if they intended to omit third party contact information. If that was not their intention, ask them to identify one person we can contact who knows how to reach them if they become unavailable and can assist with their claim.

You may also ask the claimant to identify a third party when you follow up on an initial request for evidence or action, or when you attempt to confirm the claimant's attendance at a scheduled CE appointment (see DI 22510.019).

1. Contacting the claimant by telephone

IMPORTANT: If someone other than the claimant answers the phone, or if you leave a voicemail message, leave only enough information so they know to return the call. Do not disclose any unnecessary personal information about the claimant or their disability claim.

a. When you speak to the claimant

Verify the claimant's identity prior to discussing any details of the case (see DI 39567.210 and GN 00203.020). Ask for the name and contact information of a third party. When the claimant asks for more time to provide this information, give them 10 additional calendar days from the date of your telephone call. Explain that failure to provide the requested information may result in you making a determination based on the evidence in file, which means you may find that the claimant is not disabled.

Document the date and content of your conversation on an SSA-5002 (Report of Contact) or a Case Note in the Disability Case Processing System (DCPS), and “write to” the CDW.

b. When you leave a message for the claimant

You may leave a message on the voicemail recording system of a telephone number in the claim file that is attributable to the claimant. You must also mail the claimant a call-in letter following the instructions in DI 23007.010B.2, in this section.

Include the following in your message:

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    Your contact information and the date you called; and

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    A request that the claimant return your call within 10 calendar days from the date of your message.

Document the date and content of your conversation on an SSA-5002 or a Case Note in DCPS, and “write to” the CDW.

2. Contacting the claimant by letter

Include the following:

  • •

    Your contact information and date of your letter;

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    Request the claimant provide the name and contact information of at least one third party who knows how to reach them and we can contact if they become unavailable;

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    A request that the claimant call you within 10 calendar days from the date of your letter with the requested information; and

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    Explain that failure to provide the requested information may result in you making a determination based on the evidence in the file, which means you may find that the claimant is not disabled.

C. Making a reasonable effort to involve a third party

You make a reasonable effort to involve the third party (or parties) by contacting them by telephone or by letter. This is true even when one or both of the third parties declines to assist the claimant or does not respond to your contact.

When the claimant identified an additional third party, you must also make a reasonable effort to involve the additional third party when your attempt to involve the other third party was not productive (i.e., you are unable to speak to or leave a message for the third party, or they do not respond to a call-in letter). You may attempt to contact both third parties on the same day. You do not need to wait for the initial third party to respond before attempting to contact the additional third party.

How you contact a third party may depend on the information in the file (e.g., contact a third party by telephone when you only have their telephone number or send a letter when you only have their address). Do not attempt to look up a third party’s telephone number or address in a telephone book or online unless the third party is a professional at a particular location (e.g., a social worker at a specific clinic).

1. Contacting the third party by telephone

IMPORTANT: If someone other than the third party answers the phone, or if you leave a voicemail message, leave only enough information so they know to return the call. Do not disclose any unnecessary personal information about the claimant or their disability claim.

a. When you speak to the third party

Do the following during the conversation:

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    Verify the identity of the third party prior to discussing any details of the case (see DI 39567.210 and GN 00203.020);

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    Provide your contact information;

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    Explain that the claimant told you that you could contact them for assistance with the claimant’s disability claim; and

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    Explain that the claimant did not:

    • –

      Comply with your initial request, or follow up request, for evidence or action, or

    • –

      Attend the CE appointment that you scheduled.

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    When the claimant did not comply with your request for evidence or action, identify the evidence or action that you need. When the third party provides a good reason for giving the claimant more time to comply with your request, give the claimant 10 additional days from the date of your telephone call.

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    When the claimant did not attend the CE appointment that you scheduled, explain the CE process and the claimant’s need to attend. When the third party provides a good reason for rescheduling the CE appointment, reschedule the CE.

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    Explain to the third party that if the claimant does not comply with your request(s) for evidence or action, or attend the CE appointment, you may make a determination based on the evidence in file, which means you may find that the claimant is not disabled.

b. When you leave a message for the third party

You may leave a message on the voicemail recording system of a telephone number in the claim file that is attributable to the third party.

Include the following:

  • •

    Your contact information and date that you called;

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    State that you are calling on behalf of the claimant;

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    Request that the third party return your telephone call within 10 calendar days from the date of your message; and

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    Send the third party a call-in letter following the instructions in DI 23007.010C.2, in this section.

2. When you contact the third party by letter

Include the following but do not disclose any unnecessary personal information about the claimant:

  • •

    Your contact information;

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    An explanation that the claimant told you that you could contact the third party for assistance with the claimant’s disability claim;

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    An explanation that the claimant:

    • –

      Did not comply with your initial request or follow up request, for evidence or action, or

    • –

      Did not attend the CE appointment that you scheduled.

  • •

    When you need evidence or action, identify that evidence or action;

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    When you need the claimant to attend or confirm a CE appointment, explain the CE process and the claimant’s need to attend;

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    A request that the third party call you within 10 calendar days from the date of your letter; and

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    An explanation that if the claimant does not comply with your request(s) for evidence or action, or attend the CE appointment, you may make a determination based on the evidence in file, which means you may find that the claimant is not disabled.

To Link to this section - Use this URL:
http://policy.ssa.gov/poms.nsf/lnx/0423007010
DI 23007.010 - A Reasonable Effort to Identify and Involve a Third Party in Claims Involving Failure to Cooperate and Insufficient Evidence - 12/27/2024
Batch run: 12/30/2024
Rev:12/27/2024