DI 28501: Reopenings and Revision of CDR Determinations
TN 1 (12-17)
A. Guidelines for routing a reopening of a prior CDR determination
Use the following routing guidelines when the prior CDR determination is reopened and revised under the rules of administrative finality.
B. Certified electronic folder (CEF)
Route cases based on decision (DEC) codes as follows, unless selected for review by the Office of Quality Review (OQR):
|
Situation |
Destination |
Case Note |
|
DEC = CO | ||
|
Title II – No action necessary |
Processing Center (PC) 1 through 8 |
|
|
Title XVI – No action necessary |
L0(zero)E |
|
|
Concurrent – No action necessary |
PC 1 through 8 |
|
|
Title II, Title XVI, Concurrent – Action necessary |
Field Office (FO) |
Describe the necessary action |
|
DEC = CE | ||
|
Title II, Title XVI, Concurrent |
FO |
|
NOTE: To determine the appropriate destination for PC 1 through 8, see DI 32010.001B.
NOTE: If unsure of the necessary action for the CDR case, route the case to the FO so they can determine the best course of action and proper routing procedure.
C. Modular Disability Folder (MDF)
|
Situation |
Destination |
SSA-408 (Route Slip) Entry |
|
Favorable Reopening | ||
|
Returnable Error |
Office of the Originating Error Return |
Indicate type of case |
|
Title II Only – Additional Evidence |
PC 1 through 6 (Disability Procession Branch (DPB)), or PC 7-8 |
“Title II CDR Favorable Reopening, Attn: Disability Examiner/Disability Processing Specialist” |
|
Title XVI Only –Additional Evidence |
FO |
“Title XVI CDR Favorable Reopening. Effectuation of Payment Required.” |
|
Concurrent (two folders) |
FO |
“Concurrent Title II/XVI CDR Favorable Reopening. Payment effectuation for Title XVI is Required. Upon FO completion of Title XVI payment effectuation, route folder to PC 1 through 6 (DPB) or PC 7 through 8.” Add, “Attn: Disability Examiner/Disability Processing Specialist” |
|
Concurrent (one folder) |
FO |
“Concurrent Title II/XVI CDR Favorable Reopening. Payment effectuation for Title XVI is required. Upon completion, route folder to PC 1 through 6 (DPB) or PC 7 through 8.” Add, “Attn: Disability Examiner/Disability Processing Specialist” |
|
Less than Fully Favorable Reopening | ||
|
Returnable Error |
Office of the Originating Error Return |
Indicate type of case |
|
Title II, Title XVI, or Concurrent |
FO |
Indicate type of case “CDR Adverse Reopening” |
NOTE: Route cases selected for quality assurance (QA) review to OQR.
NOTE: For adverse reopening determinations, an individual may elect to continue receiving benefits through the administrative law judge (ALJ) level. For more information, see DI 28001.070 Benefit Continuation – Policy).
D. If case has an MDF and a CEF
Always send the MDF comparison point decision (CPD) folder to the same office that you transfer the CEF. For both folders, include messages about what action is necessary, if any. Follow the routing instructions as given in DI 28501.030B in this section. If OQR selects a case for review, route as appropriate.
E. References
DI 32010.080 Continuing Disability Review (CDR) Favorable Reopening and Revision Cases – Routing Instructions (Paper Cases Only)
DI 32010.085 Continuing Disability Review (CDR) Adverse Reopening Cases – Routing Instructions (Paper Cases Only)
DI 81020.250 Closing and Routing Electronic Disability Review (eCDR) Cases
DI 81030.090 Certified Electronic Folder (CEF) Alerts, Flags and Messages
GN 04440.201 General Rules for Routing and Correcting Deficient Cases