TN 3 (02-01)

A. Policy

The DDS may contact an FO or another DDS for assistance when experiencing difficulty in contacting the claimant or other sources for any needed additional evidence. However, a request for FO assistance in contacting the claimant should be rare.

B. Procedure - Assistance Required

Use the following instructions when developing evidence through an FO or another DDS.

1. FO Role

1. Advise Claimants of DDS Actions

   The FO informs claimants that the DDS:

   • Will request medical evidence of record (MER) and,

   • If appropriate, will make arrangements for a CE.

2. Claimant Responsibilities

   Advise the claimant that he or she need not take any action to request MER except where specifically requested to do so. However, when requested, claimants are required to assist the DDS or the FO in obtaining MER.

   NOTE: Should the claimant later furnish evidence (whether or not he or she has been requested to do so), forward it to the DDS along with any charge being made for it.

3. Payment for MER

   • Advise the claimant that the Government will pay the reasonable costs for needed MER from non-Federal sources.

   • If the FO receives a request for payment from either a medical source, the claimant, or the claimant's representative in a DDS jurisdiction case, forward the request to the DDS.

   • Refer to the DDS any questions that cannot be answered regarding payment for MER.

4. Status Reports

   Provide the DDS with a status report when requested information cannot be obtained in 30 days.

2. Assistance Is Required By DDS

The DDS may require the assistance of:

1. The parallel FO to obtain evidence when the FO has developed effective working relationships with employers, medical institutions, and other sources in its service area. The FO will document the folder to alert the DDS to the special arrangement source.

2. Another DDS to obtain evidence from certain medical sources and to arrange a necessary CE when the claimant is residing out-of-State.

C. Procedure - Method

1. FO Assistance

1. General Requests

   Request FO assistance by telephone (to expedite the development) and confirm  by mail using Form SSA-883-U3 (Request for Evidence or Assistance (Disability Case)). See OS 15020.180 for exhibit.

2. Special Arrangements

   When it has been established that the FO can obtain the evidence from the sources more quickly than the DDS, request the FO to obtain the evidence.

   • Establish appropriate payment procedures for special arrangement medical sources in conjunction with the FO and RO.

   • Inform the claimant, or the source requesting payment, of the delay where there will be an undue delay in making the payment.

2. DDS Assistance

1. Request DDS assistance by SSA-883-U3 (see DI 22505.020C.2.c.).

2. If a personal contact related to medical information is necessary, or if a CE is required, work through the DDS in the State in which the claimant now resides. (See DI 39545.225 instructions when arranging a CE with a medical source in a neighboring state.)

3. When requesting another DDS to obtain a CE:

   • Furnish pertinent background information (e.g., photocopies or summaries).

   • Identify the type of examination and any special laboratory tests that are required.

3. Out-Of-State Claimant

When additional development is needed, but the claimant is now living in another State, contact the claimant directly or through the servicing FO (DI 22505.020B.1.). (See DI 20100.000 ff. for jurisdiction guidelines.)

4. Form To Use (SSA-883-U3)

Use form SSA-883-U3 when requesting FO or other DDS assistance by mail, or confirming a request previously made by telephone.

D. Procedure - Completion of SSA-883-U3

1. Address

Complete “FROM” and “TO” blocks as appropriate. The FO should be the one servicing the person(s) or place(s) to be contacted.

2. Heading

1. Complete the identifying information in the heading.

2. Enter the type of claim filed as shown on the SSA-831-U5, in the space provided for this information.

3. Contact

1. Indicate the address and phone number (if available) of the person to be contacted in the request.

2. When the contact is the claimant or applicant, enter in the block “Name and Address of Person to be Contacted” the word “Claimant” or “Applicant,” as appropriate.

   • Claimant means the disabled individual.

   • Applicant is the person filing the application. (The applicant may be either the claimant or someone who filed on the claimant's behalf, e.g., wife filing for incapable number holder, mother filing for a disabled adult child, etc.)

   • Include the name, address, and phone number of the claimant, or the claimant and applicant.

4. Background

Explain completely enough to permit a full understanding of what is required. To prevent duplication of DDS development by the FO:

• Summarize any actions taken, and

• Identify sources which were contacted in an effort to obtain the needed information.

5. Attachments

1. If certain documents in file may be helpful in obtaining or completing the necessary development, send photocopies of the pertinent material with the request.

2. Check the “Attachments” block. In the rare situation where the case file is attached, check the “Claims Folder Attached” block.

6. Prior Phone Contact

1. When the DDS has requested assistance by telephone to expedite development, check the block provided.

2. Below the address in the “To” block, enter the name of the FO or DDS person contacted by telephone or the appropriate FO or DDS unit indicator to facilitate association of the SSA-883-U3 with the telephone request.

7. Requestor

Enter your name, title, and phone number in the space provided at the bottom of the SSA-883-U3.

8. Copies

a. Original

Send to the FO or other involved DDS. (If the disability file is being transmitted with the request, staple the original copy of the SSA-883-U3 to the outside of the folder jacket and mail to the addressee.)

b. First copy

Destroy, unless the RO has issued instructions requesting that it be sent to the Center for Disability Operations in the RO.

c. Second copy

Keep for control purposes.

9. First Followup

If a reply has not been received within 15 calendar days from the date of the original request, follow up by telephone with the FO or the other DDS.

10. Subsequent Followups

Follow up with the FO or other DDS at 10-calendar-day intervals after the last followup until a response is received from that office.