BASIC (01-01)

A. Background

The Social Security Administration (SSA) is required by law to periodically review the continuing eligibility of all disability beneficiaries and recipients. In performing this review, the severity of the beneficiary/recipient's medical condition at the time of the most recent favorable medical decision (i.e., comparison point decision (CPD)) is compared to the severity of his/her current medical condition. The CPD is the most recent favorable decision that determined the individual was disabled or continues to be disabled. If there has been no medical improvement (MI), benefits are continued with limited exceptions. The Disability Determination Services (DDS) needs to review the prior folder containing the medical evidence supporting the favorable CPD decision to conduct a CDR in an efficient and timely manner.

B. Policy

The Processing Center (PC) is responsible for obtaining/securing the title II or the title II portion of a concurrent title II/XVI medical folder(s) so the continuing disability review (CDR) can be initiated. The field office (FO) is responsible for obtaining/securing the title XVI medical folder(s).

Studies have shown when every effort is made to find a lost folder, in most cases the folder is found.

The instructions in this subchapter discuss the PC actions in this folder recall process.

C. Process

CDR alerts are produced from the Automated Direct Release (ADR) process or based on the responses to a CDR scannable mailer (form SSA-455-OCR SM) or form SSA-455 mailer. The first step in the alert process is a determination of the most recent PCACS location for the folder. The alert is sent to the location of the most recent PCACS folder reads. Alerts for folders located in the Megasite files operation or Caves folder locations are printed in the Office of Central Operations (OCO) and the Mid-America Program Service Center (MAMPSC) respectively and the folders are pulled and sent directly to the FO.

Alerts for folders in operational components (i.e., Program Service Centers (PSC) Modules, Disability Review Section (DRS), etc.), auxiliary storage locations, or that have been destroyed are produced in the PC of jurisdiction. The PC is responsible for securing the folder and sending it directly to the FO.