DI 30005.234: Correcting Unsigned or Improperly Signed Determination Forms
Effective Dates: 10/05/2015 - Present
- TN 10 (02-11)
- DI 30005.234 Correcting Unsigned or Improperly Signed Determination Forms
- A. Definition of an unsigned or improperly signed determination technical corrective action
- An unsigned or improperly signed determination form technical corrective action (TCA) exists in any of the following situations:
- * The adjudicating medical consultant (MC) or psychological consultant (PC) has not signed the SSA-831-C3 or SSA-831-U3 (Disability Determination and Transmittal), SSA-832-C3 or SSA-831-U3 (Cessation or Continuance of Disability or Blindness Determination and Transmittal – Title XVI), and SSA-833-C3 or SSA-831-U3 (Cessation or Continuance of Disability or Blindness Determination and Transmittal – Title II) determination form when required, and:
- * The adjudicating component MC or PC did not sign an appropriate medical evaluation document, including the Disability Determination Evaluation in the electronic Claims Analysis Tool (eCAT) (For information on medical assessment and disability determination documents, see DI 26510.090 C);
- * The medical evaluation document does not contain the statement "These findings complete the medical evaluation portion of the disability determination" with a check in the check block; or
- * The adjudicating component disability examiner fails to complete the MC or PC signature block of the disability determination form and enter the appropriate statement; i.e., “See form ____ dated ____.”
NOTE: Some adjudicating components are authorized single decision maker states, and do not require an MC or PC signature in all instances.
- * The disability examiner (DE) did not sign or improperly signed the adjudicating component's determination form.
- * The same DE, MC, or PC who signed the initial determination form adjudicates or signs a reconsideration determination form.
- B. Policy for correcting the determination form
- The review component may either correct the TCA by assuming jurisdiction or return the case to the adjudicating component for correction.
- C. Adjudicating component procedure for improperly signed determination forms
- When the review component returns a case for correction because the determination form is either unsigned or improperly signed:
- * Correct the TCA per the SSA-847-U3 (SSA Request for Case Action);
- * Clear the case to the appropriate component; and
- * Do not return the case to the review component unless they instruct you to do so.
- See Also:
- GN 04440.237, Determination Forms Technical Corrective Action (TCA)
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