POMS Reference

DI 23020: Priority Cases

TN 2 (01-08)

A. Definition

  1. Critical Cases are defined as Title II Cases that involve:

    • dire financial need;

    • the non-receipt or interruption of benefit checks that has caused a hardship; or

    • an adverse public relations potential.

      Critical cases, which are usually identified for the Disability Determination Services (DDS) by the Field Office (FO) or the Office of Disability Operations (ODO), normally involve dire need or adverse public relations potential.

  2. The DDS will receive critical cases or notification that cases already in the DDS have become critical as indicated by the following:

    • Electronic Disability Collect System (EDCS) cases from the FO flagged for expedited processing, or EDCS exclusion cases with a Form SSA-1671-U2 (Request for Expedited Action) attached;

    • Cases from ODO, containing the annotation “Critical Case” on the transmittal;

    • Notification by telephone, fax, or other electronic means, from the FO, ODO, Regional Office (RO); or

    • Through direct contact with the claimant or a third party.

B. DDS Action

When the DDS becomes aware of a critical case situation, complete all actions on the case as soon as possible and:

  • Ensure the case is flagged as a critical case.

  • Expedite all case processing.

  • File administrative messages and reports of contact in the case folder. For EDCS exclusions, attach to the outside of the folder Form SSA-1671-U2 (Request for Expedited Action) this form serves as the transmittal slip.

  • Provide a status report by telephone or Administrative Message, to the component that initiated the critical case process when case processing is not completed in three weeks. Generally, the DDS should supply the status report by telephone or other electronic means. The RO may issue additional guidelines regarding DDS responses based on local needs.

C. Disposition of Critical Cases

Normally, these cases will be forwarded to a FO, ODO, Disability Quality Branch (DQB), or Program Service Center (PSC). Cases forwarded to ODO, unless designated otherwise, should be sent to:

ODO, RECON Branch
P.O. Box 1075
Baltimore, Maryland 21203

All cases, regardless of routing, i.e., to the FO, DQB, ODO, or PSC, should be identified as a “Critical Case” in the remarks portion of the SSA-408 transmittal. Follow the instructions in “Routing – Initial/ Reconsideration/Reopening Cases” (DI 32005.000).