TN 4 (10-15)

A. Unsuccessful or unproductive attempts to contact

If both telephone and written attempts by the disability determination services (DDS) to contact the individual, payee, or representative are unsuccessful or unproductive (e.g., the individual is unable or refuses to communicate effectively by telephone), the DDS may, as appropriate:

• Request assistance of the field office (FO), or

• Process the case as failure to cooperate (FTC), or

• Process the case as whereabouts unknown (WU).

B. Requesting FO assistance in MINE or MINE-equivalent Cases

The DDS must be alert to situations when FO assistance is needed to contact the disabled individual, obtain completed forms, or gather other information. The DDS may complete an assistance request (AR) to the FO using form SSA-883-U3 (Request for Evidence of Assistance (Disability Case)), or the electronic AR described in DI 81020.100. On the AR:

• Annotate “MINE or MINE-equivalent Case -- Sensitive Handling Required.”

• Indicate DDS actions taken to contact the disabled individual representative, or payee. Request that the FO make further attempts to contact the individual.

• If applicable, indicate the impairment(s) and annotate the questions on the SSA-454-BK (Continuing Disability Review Report) that are relevant to the particular case. In paper cases, attach the SSA-454. Request the FO obtain answers to the annotated questions, being sensitive to the nature of the impairment(s) and the age of the individual. For example, do not request answers to the work-related questions on the SSA-454 if the individual is a Title XVI child under age 15, unless there are indications that the child may be working.

• If applicable, request the FO obtain signature on the SSA-827 (Authorization to Disclose Information to the Social Security Administration).

• Indicate other assistance needed from the FO (e.g., locate requests, third party contacts, etc.).

Request the FO return all documentation to the DDS for processing within 15 days. The DDS should create a diary for 20 days to follow up if the FO has not completed the AR and documentation.

C. WU in a MINE or MINE-equivalent case

WU applies when DDS is unable to locate the disabled person. WU cases (both Title II and Title XVI) are not considered medical cessation cases.

MINE and MINE-equivalent cases require limited medical documentation. Therefore if sufficient documentation exists to continue the case but the disabled individual cannot be located, the DDS must stop development and return the case to the FO as a “no determination”. Inform the FO whether there is sufficient medical documentation to prepare a determination, and whether a call-in letter, or other letter, to the disabled person, payee, and representative was returned as undeliverable.

If the FO is unsuccessful in locating the individual, the FO will prepare a WU cessation determination for Title II claims, or suspend payment of benefits in Title XVI cases in accordance with DI 13015.001 through DI 13015.015.

D. FTC when continuing disability review (CDR) forms are not received in a MINE or MINE-equivalent case

FTC refers to an individual's failure, without good cause, to do what SSA/DDS has asked by a certain date.

If essential forms are not received within 14 calendar days from the date of the confirmatory review notice, follow up with the individual, payee, and representative via telephone and, if necessary, twice at 10-day intervals.

If the CDR forms are still not received:

• Forward an assistance request (AR) to the FO requesting an attempt to contact the individual, payee, or representative.

• Indicate that this is a FTC case; the individual has not returned the forms or refuses to answer the questions.

• Refer the FO to DI 13015.001 through DI 13015.015 for FTC procedures to follow if all FO attempts are unsuccessful.

• Request the FO return all documentation once completed back to the DDS. The DDS will prepare a cessation determination based on FTC per DI 28075.005 when appropriate.

In Title XVI child cases involving noncooperation, make special efforts to identify and contact another adult or agency responsible for the child's care. The general approach in DI 25205.020 and DI 13015.005A.2.a. applies to CDRs as well as to initial claims.

An individual's FTC is a basis for the DDS to make a cessation determination and terminate Title II or Title XVI benefits. FTC cessations are considered medical determinations; therefore, FTC does not apply if there is enough evidence to make a continuance determination. For more information on FTC in a CDR case, see DI 28075.005.

E. Individual contacts the DDS

If the individual or payee contacts the DDS after the case has been referred to the FO:

• Verify current telephone number and address.

• Obtain or verify a third party contact, if needed.

• If possible, conduct the interview at that time.

Document this information (using SSA-5002, claims communication, or other approved method), and provide this to the FO.

F. References

• DI 11005.056 Signature Requirements for Form SSA-827

• DI 25205.020 Failure Issues

• DI 28075.005 Failure to Cooperate (FTC) and Whereabouts Unknown (WU) Cases

• DI 81020.100 Electronic Assistance Requests (AR)

• DI 81020.125 Electronic Case Routing Before Final Determination

• DI 81020.130 Electronic Case Closure

• GN 03360.005 Releasing Information by Telephone