POMS Reference

DI 28080: Due Process

TN 3 (04-12)

This section provides instructions for the Disability Determination Services (DDS).

A. Folder documentation

  • Place copies of all pre-determination notices in the official claims folder.

  • Document all subsequent contact with the beneficiary or auxiliary beneficiaries on an SSA-5002, Report of Contact.

  • For electronic processing instructions, see DI 81010.090 and DI 81020.050.

  • Set appropriate diary controls and take action to finalize the determination.

B. Diary controls and final actions

  • Set appropriate diary controls and take action to finalize the determination.

  • Do not process the claim before 15 days (10 days, plus five days for mailing time) expires unless you receive a written statement from the beneficiary stating that he or she will not submit additional evidence.

  • Complete the action if there is no response in 15 days. The DDS does not follow up with a beneficiary who fails to respond to the letter.

  • Transfer electronic folders to the field office (FO) of record.

  • Send paper folders to the Office of Disability Operations (ODO) or the appropriate program service center (PSC). For CDR routing instructions, see DI 32010.000.

C. Beneficiary requests more time

  • If the beneficiary responds with a request for more time to get additional evidence, the DDS may allow an additional 10 days. To verify that the claimant is actively pursuing the evidence in question, ask the claimant for the nature of the evidence, identification of sources, etc.

  • Do not follow up with a beneficiary who fails to respond within the second 10-day period. However, there may be unusual circumstances that require the DDS to extend the response time beyond the second 10-day period.

    NOTE: These instances should be rare and granted only when, in your judgment, reasonable circumstances precluded the beneficiary from obtaining the evidence (e.g., the doctor is out of town for an extended period).

  • If there is no response within the second 10 days, complete the determination on the 25th day after sending the pre-determination notice to the beneficiary.