TN 11 (06-04)

A. Process - General Responsibilities

1. Disability Process

The disability interview process is based on the following general areas of responsibility (see DI 11005.018B. for details):

a. FO

• Disability Report - Adult (SSA-3368), or Disability Report - Child (SSA-3820)

• Function Report - Child (SSA-3375 through SSA-3379)

• Disability Report - Field Office (SSA-3367).

b. DDS

• Work History Report (SSA-3369)

• Pain Report - Child (SSA-3371)

• Function Report-Adult (SSA-3373)

• Function Report-Adult-Third Party (SSA-3380).

The FO is responsible for the completion of forms described in DI 11005.018A.1.a. However, when the FO has curtailed completion of the forms, the DDS is responsible for obtaining any additional information that is necessary, based on the facts in each case.

2. Variations in the Disability Process

It is recognized that local best practices variations of the current process exist. Except for use of the SSA-3373 and SSA-3380, FOs and DDSs may continue operating under existing best practices agreements.

B. Process - Details General

FO's will send out Starter Kits to claimants in conjunction with the appointment letters. TSC' s will no longer send out Disability Report forms (SSA-3368, SSA-3820) to claimants. TSC' s will only send out Starter Kits if claimants or advocates specifically request one. TSC operators will encourage claimants to use the Internet Disability Reports. The TSC will not mail out a Function Report. The FO will obtain the appropriate Function Report in all child cases.

1. Self-help

The applicant completes a Medical and Job Worksheet-Adult or Medical & School Worksheet-Child and the appropriate Function Report (SSA-3375 through SSA-3379) for children. However, see DI 11005.020 for curtailment situations. If the DDS later decides that other information should be obtained, it recontacts the applicant.

The FO conducts the disability interview and enters the information in the Electronic Disability Collect System (EDCS), prepares an EDCS 3367, prepares an SSA-820 or SSA-821 when there are work issues, and obtains an application and signed, dated, and witnessed SSA-827s.

The FO then sends the case to the DDS.

2. Non-Self-Help

The FO interviewer conducts the disability interview and enters the information in EDCS and completes the appropriate Function Report for children (SSA-3375 through SSA-3379). However, see DI 11005.020 for curtailment situations. In curtailment situations, if the DDS later decides that other information should be obtained, it recontacts the applicant.

The FO interviewer prepares an EDCS 3367, prepares an SSA-820 or SSA-821 when there are work issues, and obtains an application and signed, dated, and witnessed SSA-827s.

When, in the interviewer's judgment, it is probable that FO or DDS recontact with the applicant will be difficult (i.e., is homeless, will be difficult to contact by telephone, or will be unavailable for contact), or if the claimant asks to have the forms completed by an interviewer or demonstrates concern or apprehension about the ability to complete the forms, or the FO interviewer suspects the claimant will be unable to complete the forms properly, the FO interviewer completes an SSA-3373,for adults, and an SSA- 3369 if the claimant had more than one job in the 15-year period before stopping work because of his/her illness, injury or condition. (See DI 11005.025B.1.)

The FO then sends the case to the DDS.

3. DDS Procedures

The DDS will use their own local forms to collect information about pain and other symptom for adults, the SSA-3373 to collect information about the claimant's ability to perform the activities of daily living, and the SSA-3380, which will be used to collect information from third parties familiar with the claimant's ability to function, such as, the claimant's spouse, relatives, neighbors, friends, clergy, teachers, or employers. Neither the SSA-3373 nor the SSA-3380 is mandatory for use in all cases. The DDS will use them if they determine that function development is needed. The DDS will not send an SSA-827 when requesting a third party to complete the SSA-3380, unless the DDS knows from past experience that the source requires it. In the rare instance in which a third party requests an SSA-827, the DDS will effectively black out all but the last four digits of the SSN previously entered on the SSA-827. See DI 11005.055. The DDS may obtain the information detailed on the SSA-3373 or SSA-3380 by telephone and record it on an SSA-5002 in lieu of using the SSA-3373 or SSA-3380. DDSs may supplement the information on the SSA-3373.

The DDS is responsible for obtaining any additional information that is needed when criteria for curtailed completion of the SSA-3368 or SSA-3820 are present and the FO has partially completed the forms. In addition, when the applicant answered “Yes” to question 2C. on the SSA-3368 or 3D. on the SSA-3820 for pain or other symptoms, the DDS is responsible for obtaining information about pain or other symptoms.