GN 04440: Federal Quality Review of Disability Determinations
TN 8 (06-04)
A. Introduction
For group II ending date decisional deficiencies and onset date deficiencies follow the procedure in GN 04440.217B. for changes to the SSA-831-C3/U3.
B. Procedure-review component
1. Correcting the SSA-831-C3/U3
Correct the appropriate blocks on the SSA-831-C3/U3 as follows:
a. Block No. 15 and 28
Enter the correct onset or ending dates.
b. Block No. 34
Enter: Corrected Determination.
Identify your specific review component.
c. Block No. 37 and 38
Ensure that both the quality reviewer and the review medical contractor/psychological contractor (MC/PC) sign and date the corrected SSA-831-C3/U3. See below for exceptions.
Use block 34 if more space is needed.
EXCEPTIONS: The review MC/PC does not have to sign the SSA-831-C3/U3 if:
the onset or ending date change is due to SGA; or
the conditions listed in GN 04440.244E.2. are met; i.e., the physician statement and signature are on an appropriate medical evaluation document in lieu of a MC/PC signature on the SSA-831-C3/U3. See GN 04440.135B.3. and DI 24501.002C.1.
2. Correcting the rationale
Correct SSA-4268-C4/U4 if a rationale is involved, as follows:
make corrections where necessary; or
prepare a new brief rationale, explaining which aspects of the adjudicating component's determination are adopted (i.e., facts, findings and conclusions), if any, and which aspects of the determination are changed;
referral to the SSA-1774-U5 is permitted in lieu of re-recitation of facts, if preparing a new rationale.