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  Accept jurisdiction of the CEF. NOTE: If the CEF was sent to an incorrect site, reject jurisdiction only to the OQR office that sent the return or to a Field Office (FO) or another DDS that is in the same state. Do not reject jurisdiction to an out of state DDS.

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  Receipt the CEF as a return per Returned Cases - SM 06001.208. NOTE: Do not receipt the QR return as a new claim;

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  Assign the QR return;

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  Take the corrective action (refer to Federal Quality Review (QR) - DI 81020.135F.2.b., if the DDS Determination requires correction);

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  Prepare an Assistance Request to the FO for any FO development. Do not transfer the CEF to another component during the review process;

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  Add any additional evidence and documentation to the CEF;

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  If necessary prepare a corrected PRTF and/or RFC assessment form. The original PRTF and/or RFC should remain in file as part of the audit trail. The original should be annotated "Do Not Process" For more information see DI 30005.232 Non-substantive Technical Corrective Actions (TCAs); and

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  Return jurisdiction of the CEF to the OQR review component that performed the review when OQR requests return of the CEF. If a CEF needs to be referred to another component for final action, such as the FO, return the CEF to the OQR review component first.

NOTE: The OQR office that actually reviewed the case may be different than the regional OQR or office shown in NDDSS. The DDS must return the case to the OQR office that is in the EFI download.

When the OQR review component cites a deficiency which requires the DDS to correct the SSA-831, document the CEF appropriately to show that the original SSA-831 has been superseded. The DDS must:

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  Prepare a corrected SSA-831.

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  Notate the corrected SSA-831 in the “Remarks” (Item #34): “Corrected SSA-831 replaces the original SSA-831 dated (mm/dd/yy).”

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  Upload the corrected SSA-831 to the CEF.

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  Upload any additional evidence and documentation (e.g., new evidence, eForms, decision notices) to the CEF.

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  If applicable, move the incorrect PDN to Section C, Current Development/Temporary (Green Section) and upload the corrected PDN notice to the CEF.

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  Retain the original unprocessed SSA-831 image in the Yellow Front Section of the folder. Add the following note in eView: “DO NOT PROCESS the original SSA-831 dated mm/dd/yy.”

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  Verify that the image(s) of the revised document(s), such as the new SSA-831 and PDN, have been updated and added to the CEF.

DDS must route all CEFs to the OQR review component if the controlled return is “Y” regardless of the outcome of the RPC.

If the RPC Resolution rescinds the OQR cited deficiency, the DDS may route the CEF to the OQR review component to ensure OQR updates DICARS and removes the deficiency.

If the RPC Resolution affirms the OQR cited deficiency, the DDS:

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  Completes the corrective action(s);

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  Adds the corrective action documentation to the CEF; and

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  Routes the CEF to the appropriate Field Office (FO).

OQR:

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  Rescinds the original deficiency;

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  Faxes the appropriate documents into the CEF using document type 2070 (REBRESP);

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  Prepares an email notification to the DDS Administrator (with cc’s to the appropriate components); and

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  Clears the CEF case to the next appropriate component (usually the FO for effectuation of the determination).

OQR:

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  Affirms the original deficiency;

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  Faxes the appropriate documents into the CEF using document type 2070 (REBRESP);

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  Prepares an email notification to the DDS Administrator (with cc’s to the appropriate components); and

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  Returns jurisdiction to the DDS for any necessary corrective action.

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  Prepares a letter/memorandum stating their position to not support the DDS’s second-level rebuttal request;

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  Prepares a barcoded cover sheet using document type 2070 (REBRESP), Response to Rebuttal, and faxes the letter/memorandum into the CEF using fax number 866-722-2297. The DDS receives an alert when the CD adds the letter/memorandum to the CEF; and

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  Emails the letter/memorandum to the DDS (with cc’s to the OQR review component).

Upon receipt of the letter/memorandum from the CD, the DDS:

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  Completes the corrective action(s) requested by the OQR review component;

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  Adds all corrective action documentation to the CEF; and

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  Returns the CEF to the OQR review office to code the rebuttal results.

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  A cover letter/memorandum indicating their support of the DDS’s second-level rebuttal request, and emails it to the DDS with cc’s to the appropriate OQR review component that reviews and prepares a response to the rebuttal. OQR email addresses are on the OQR website.

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  A barcoded cover sheet, using document type 0170 (REBUT2), Level 2 Rebuttal, and faxes the cover letter/memorandum and the DDS’s second-level letter/memorandum to the CEF using fax number 866-722-2297.

When the DDS is notified of the CD’s support of the rebuttal request, the DDS transfers jurisdiction of the CEF to the CD. Refer to the following chart for the appropriate Regional Office CD destination codes.

NOTE: The CEF status is “Transferred.”

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  The OQR review component reviews the CEF in eView;

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  Prepares a memorandum resolving the rebuttal and addresses the memorandum to regional CD Director; and

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  Notifies OQR CO via email that the response is ready for review.

The Division Director, DIB Initial, reviews the CEF via eView, makes the final decision to affirm or rescind the deficiency, and signs the final memorandum. The Division Director, DIB Initial is the final arbiter. OQR CO ensures:

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  The final memorandum (using document type 2070 (REBRESP), Response to Rebuttal) and any related documentation (e.g., medical review notes, ODP policy input, etc.) received during the rebuttal resolution process are faxed into the CEF using fax number 866-722-2297; and

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  The appropriate components are notified of the final resolution of the second-level rebuttal.

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  Obtains jurisdiction of the CEF;

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  Updates the CEF;

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  Codes the final rebuttal in DICARS; and

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  Sends the CEF to the appropriate component for action. The CEF is returned to the DDS if corrective action is needed.

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  Takes the corrective action(s) requested by the OQR review component;

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  Adds all corrective action documentation to the CEF; and

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  Returns the CEF to the OQR review office.