POMS Reference

GN 03102: Reconsideration (Title II and Entitlement Under Title XVIII)

TN 4 (12-06)

A. Policy

Before transferring the reconsideration ensure all issues are developed.

B. Procedure

Claimant is primarily responsible for submitting all pertinent evidence.

1. Developing evidence

Ask for all the evidence the claimant has or can obtain and fully develop questions raised by the claimant.

Document evidence requested but not obtained on RPOC outlining efforts to obtain that evidence.

Request any prior folder needed via email or administrative message.

Forward reconsideration request with related development to the appropriate office.

For recording evidence electronically, see Related Business Process Information, GN 00301.328.

2. Additional evidence not received

a. From the claimant

Send a letter informing the claimant that unless he or she submits the evidence within 10 days plus 5 days mail time or contacts the FO to explain the delay, we will forward the case to the appropriate office for a determination based on available evidence.

b. From other source

Request claimant to obtain the evidence if other source (e.g., employer, relative) refuses or does not respond within 10 business days of the request.

3. PC, DDS requests for additional evidence

Handle requests promptly and send a status report if the evidence is not sent within 15 business days.

4. Developing other factors of entitlement

Develop if it appears additional development may result in favorable action on contested issue.

5. Special issues

a. Accuracy of earnings record

  • Obtain a copy of the earnings record and review it with the claimant.

  • Provide a thorough explanation of the determination.

  • Obtain a signed statement from the claimant indicating his/her agreement or disagreement with the correctness of the earnings record.

  • Give claimant an SSA-561-U2 to complete if claimant still wishes to file a reconsideration

  • Explore any disagreement and document findings on an RPOC and attach to the SSA-561-U2 .

  • Refer to RM 03870.001 to determine when additional development may be necessary.

b. Federal employment involved

Refer to procedures in RS 01901.340.

c. Railroad Retirement Board (RRB) cases

Send to RRB if annuitant is not entitled to monthly social security benefits.

Railroad Retirement Board
Critical Case and Reconsideration (CCR) Section
844 Rush Street
Chicago, IL 60611

NOTE: A decision to transfer a claim to RRB is not an initial determination and cannot be appealed.

Advise claimants who telephone to contact the RRB. If claimant insists SSA make a determination on his/her application for title II benefits, send request to GLPSC.

d. Veteran's benefits

If SSA was unable to make certification to the Veteran's Administration because the claimant did not meet some title II requirement other than insured status, the claim is disallowed under title II and the claimant has a right to reconsideration.

Follow current reconsideration processing procedures.

e. Reconsideration of support determination when no claim is filed

Send the request for reconsideration to Office of Earnings Operations (OEO) to associate with the proof of support file. OEO will forward to the PC for reconsideration. See RS 01301.000.