TN 14 (02-11)

A. Background

The Social Security Administration (SSA) has tested several disability process initiatives to improve the disability determination process. Some of those tests have been stand-alone tests, while others tested various combinations of modifications to the disability determination procedures. In 1997, we tested the Disability Redesign Full Process Model (FPM). The FPM initially tested four initiatives, the:

1. Single Decisionmaker model,

2. Pre-Decision Interview,

3. Elimination of Reconsideration, and

4. Adjudication Officer model.

See details:

DI 12015.001, Introduction – Disability Redesign Tests.

SSA later:

• combined a test of the elimination of the Appeals Council request for review with the FPM and tested the elimination of the Appeals Council request for review as an adjunct to the FPM test;

• identified the most successful elements of the FPM pilot and used them to create the Disability Redesign Prototype model; and

• began testing the Disability Redesign Prototype model in the Disability Determination Services in 10 States in October 1999.

B. Disability Redesign Prototype Model

The Disability Redesign Prototype model test features include:

1. Single Decisionmaker (SDM) Model

   Disability Examiners with SDM authority complete all disability determination forms and make initial disability determinations in many cases without medical or psychological consultant (MC or PC) signoff.

   EXCEPTION: MC review and signoff is required for all Title XVI childhood disability claims and all Title II and Title XVI less than fully favorable determinations involving a mental impairment.

2. Reconsideration Elimination Model

   There is no reconsideration step of the administrative review process for disability issues. The field office (FO) sends initial determination appeals on disability issues to the Office of Disability Adjudication and Review (ODAR) for a hearing, as the first step in the administrative appeals process.

C. Test States

There are 10 States participating in the Prototype test:

1. Alabama,

2. Alaska,

3. California (Los Angeles North and Los Angeles West Branches),

4. Colorado,

5. Louisiana,

6. Michigan,

7. Missouri,

8. New Hampshire,

9. New York, and

10. Pennsylvania.

NOTE: Testing of the SDM model from the FPM continues in 10 States (known as SDM II States):

1. Florida,

2. Guam,

3. Kansas,

4. Kentucky,

5. Maine,

6. Nevada,

7. North Carolina,

8. Vermont,

9. Washington, and

10. West Virginia.

D. Prototype Operating Instructions Manual

The procedures for processing claims under the prototype test are in the Prototype Operating Instructions Manual. A copy of the manual is available on the Internet at http://www.ssa.gov/disability/Documents/Prototype_Operating_Instructions.doc and on the Office of Disability Determinations intranet website at: http://oddweb.ssahost.ba.ssa.gov/disability-processes/sdm-prototype/default.htm.

NOTE: Some processing instructions in the manual may no longer be current due to electronic disability processing enhancements.

Links to References: Q&A 11-010