BASIC (01-01)

A. Procedure – when OCO/PSC perform special searches

OCO/PSCs will perform a special search for the folder in these situations:

• The folder is NIF in the Megasite files operation/Caves location; OR

• The folder from a FRC location does not contain the current medical evidence; OR

• The folder received is a temporary folder which contains no current medical evidence; OR

• An FCR does not appear on PCACS; OR

• The folder location on PCACS shows “DESTR DEST DEST”; OR

• The folder is not in the operational location as shown on the PCACS query; OR

• The PCACS query reflects QUES (questionable) in any part of the folder location.

See DI 40525.075 for duplicate folder guidelines in Title II folder(s).

B. Procedure - updating the Disability Control File (DCF)

Once an alert is received in the OCO/PSC module/DRS of jurisdiction for a special folder search, update the DCF file to reflect that the special search procedures are underway.

NOTE: Even though the procedure in the remaining sub-chapters specifies which job disciplines are to perform certain functions, OCO/PSC/DRS management can assign these tasks to any job discipline. The assignments are at the discretion of the local management team.

1. Query – first

DE or DEC in each OCO module and by DRS in the PSC will first query the DCF as follows:

1. Select number 32 (Continuing Disability Review File) from the SSA MAIN MENU and hit the “Enter” key.

2. Key “01” (QUERY) and complete the SSN, only key the BIC if it is other than "A" and hit the “Enter” key.

3. Next is the CDR ENTITLEMENT SCREEN (ECDR). ECDR tells you whether the case is a “TII Direct Release CDR” or a “TII/TXVI Direct Release CDR”, as well as the LAF status on all entitlements. Hit the “Enter” key.

4. Next is the CDR QUERY SCREEN (QCDR). Write down the most recently dated 3-digit “DESTINATION” code found under the EVENT area of the screen. (This will assist you in later steps (2f below) of the update process.) Hit the “Enter” key.

   EXCEPTION: If the “DESTINATION” code is “732” ignore it and use the jurisdictional FO instead. Do not physically transfer the folder to DOORS location #732 because the location is not a storage facility.

5. If there are no remarks, the DCF will bring you back to the initial screen that you completed in "a" above. If you are in "remarks" hit the "enter" key to get back to the initial screen.

2. Update – second

Next the DE or DEC in each OCO module and by DRS in the PSC updates the DCF as follows:

1. Key “03” (PC UPDATE) and complete the SSN, only key the BIC if it is other than "A" and hit the “Enter” key.

2. At the ECDR screen, hit the “Enter” key.

3. At the CDR PC INPUT (IPCA) screen, in the "SELECT EVENT TYPE", key “01” to transfer case.

4. The cursor will MOVE to the "FOLDER RECONSTRUCTION ISSUE" field (which is always pre-filled with "N"). Change the “N” to a “Q” and hit the “Enter” key.

   NOTE: A "Q" entry in the DCF FOLDER RECONSTRUCTION field means the folder was not in the location shown on PCACS and its physical location is in question. A "Q" in the DCF FOLDER RECONSTRUCTION field indicates that the OCO/PSC is still searching for the title II medical CDR folder in other locations.

5. See DI 40525.070C. and the CHART in DI 40525.100 regarding PCACS entries.

6. At the CDR PC INPUT Screen B (IPCB), key the most recent 3-digit Destination code previously noted (see DI 40525.070B.1.d.) and hit the “Enter” key.

7. EXCEPTION: If the “DESTINATION” code is “732” ignore it and use the jurisdictional FO instead. Do not physically transfer the folder to DOORS location #732 because the location is not a storage facility.

8. If you have other cases to update, return to the MCDR screen and take appropriate actions.

9. Once DCF updates are completed, close out and route the direct release CDR alert(s) to the technician responsible for undertaking special search procedures at your site.

C. Procedure – PCACS shows a "QUES" or "TEMP QUES" entry

NOTE: FOs will contact the DRS/Module Manager for any original folder received that has not been updated in PCACS to their location.

If the Initial Pull Period (see DI 40525.060) yields "NO FOLDER", OCO/PSC will change the folder location on PCACS to read "AUXRH QUES QUES", or "AUXRH TEMP QUES", or " CAVES QUES QUES or “PC1-6 QUES QUES". Also see the CHART in DI 40525.100.

NOTE: This process can take up to 120 days from the initial "QUES QUES" entry date to locate the Title II and/or Title II portion of the concurrent TII/TXVI folder(s) in "other" locations.

In PCACS "QUES QUES" or "TEMP QUES" cases, OCO/PSCs updates the FOLDER RECONSTRUCTION field on the DCF to a "Q”. A "Q" entry in the FOLDER RECONSTRUCTION field means the folder was not in the location shown on PCACS and its physical location is in question. A "Q”in the FOLDER RECONSTRUCTION field of the DCF indicates that the OCO/PSC is still searching for the title II medical CDR folder in other locations.

FOs periodically monitor/review both PCACS and the DCF for the changes mentioned above.

D. Procedure – document your efforts and findings

Inevitably there will be some cases that cannot be found. Once you have done a thorough job looking for a file — DOCUMENT YOUR EFFORTS. Documentation is for follow-up purposes and to inform the next person/component who handles the case not to spend time repeating the search effort. Use the SSA-5002 (see DI 40525.125) to document your efforts. Circle/highlight pertinent data/information, e.g., on the NUMI circle/highlight any name change. Keep all reports of telephone calls, and other pertinent material and queries in file.

E. Procedure – folders in other than OCO/PSC locations

Successfully locating a folder often requires detective work (see DI 40525.075). By utilizing all resources available, you will avoid time-consuming and costly folder reconstruction by the FO. In the end, we will provide better service to the public and others in SSA.

1. Title XVI

1. If the medical CDR is on a concurrent Title II/XVI claimant, the Title II folder will be retrieved by the PSC of jurisdiction.

2. If the PSC is unable to locate the folder, a duplicate Title II folder (See DI 40525.075) will be forwarded to the FO for possible reconstruction.

3. FOs will obtain any Title XVI folders needed to determine if any current medical information is available in the Title XVI claim.

2. Title II file reading in a field office

a. Medical CDR is in progress

• If a folder is reading to a FO, query the Modernized Development Worksheet (MDW) and the DCF worksheet (see MSOM CDR 001.013) screen(s) to determine why the folder was forwarded.

• If a medical CDR is in progress, fax the alert to the FO. See DI 40525.150 for a copy of the flag to use. Discard the flag after faxing.

• Update the “Remarks” page of the MDW screen that the alert was sent via FAX to the number shown on the DOORS. (For information on how to update the MDW screen – see DI 40525.070F.)

b. Other reasons folder is in FO

• If the folder is in the FO for a different reason (other than a Medical CDR in Progress), add a new “Issue” field, such as TIIMCDR on the MDW screen.

• The “Category" field should include the entry “2560”.

• The “Request Date” field is always the current date and the “Tickle” field should be set for the next working day.

• Include any lengthy remarks as to the medical review and that a fax of the alert has been forwarded in the "Remarks" page.

• If there is no MDW screen available for the alerted SSN, prepare the flag shown in DI 40525.150.

• Fax the completed flag, along with the alert, to the FO as indicated on the medical alert. Discard the flag after faxing.

3. Title II file reading in DDS location

If PCACS shows the folder is in the DDS, take the following actions:

1. Obtain a Disability Determination Services Query (DDSQ) to determine if a medical CDR is being performed on the specific claimant on the alert.

   • If YES, discard the alert.

   • If NO, contact the DDS and inform them of the medical CDR. (This happens, in particular, on Class Action cases).

   NOTE: DDS is responsible for contacting the FO for CDR development, etc.

2. If both the HA and CDB folders are travelling together, but the action is only for one of the claimants, prepare the flag shown in DI 40525.150.

3. Fax the alert and the completed flag, to the DDS making the current determination. Discard the flag after faxing.

4. If necessary, update the DCF [including remarks] to show the transfer of the CDR to the DDS.

5. If DDSQ shows the folder is not in the DDS, search for the folder in the new location reflected on the DDSQ.

F. Procedure - folder in Office of Disability Adjudication and Review (ODAR), the Office of the Inspector General (OIG), or Office of the General Counsel (OGC) locations

If the folder(s) is in ODAR, OIG, or OGC:

1. Obtain a query (e.g., OHAQ) to confirm the folder is still in ODAR, OIG. or OGC.

2. If the case is still active in one of these locations, document on the SSA-5002 (see DI 40525.125).

   • DO NOT REQUEST the return of the folder.

   • Close out the CDR on the DCF. (For example, in TXVI use “SSR/MBR Condition – STOP CDR” and in TII just transfer the CDR to DOORS location #732). DO NOT physically transfer the folder to DOORS location #732 because the location is not a storage facility.

   • Annotate in the remarks of the DCF that the CDR is not being pursued pending return of the folder.

   • Discard the direct release alert.

   • DO NOT tickle for return of the folder. Central Office monitors completion of all CDRs - no additional actions are needed.

3. If the query, i.e., OHAQ, shows the folder is not active in ODAR, OIG, or OGC, search for the folder in the new location reflected on the query.

4. If unable to locate the folder(s), proceed to DI 13015.080.

5. Folder found: See DI 13005.030.

G. Procedure - updating MDW

To update an existing MDW (#24 from the SSA MAIN MENU) screen, take the following steps:

1. Key the SSN; SELECT 2 (Update); SELECT DESIRED FUNCTION 1 (Worksheet);

2. Hit the “Enter” key. If the worksheet is available, the first worksheet page will appear.

3. In the UNIT field, type in the word NEW;

4. In the FO field, type in the District Office Code (DOC);

5. In the “Issue” column, add the new issue if necessary (i.e. T2MEDCDR);

6. If a new issue is added, type in a “Category,” a “Request” Date and a “Tickle” Date;

7. Add any short “Remarks,” if lengthy remarks - type a “Y” to create a “Remarks” page if not already established.

8. Hit the “Enter” key.