POMS Reference

DI 13015: Special CDR Issues

TN 1 (01-01)

A. Policy

OCO and the PSCs are responsible for retrieving Title II and the Title II portion of the concurrent TII/TXVI folder(s) for CDR direct release alerts and mailing them to the FOs. They are also responsible for preparing a duplicate folder if the folder shown on PCACS cannot be located or has been destroyed. The PSC sends any folder material belonging to the NH located during the search even if it is not the complete medical folder, i.e., contains only post-entitlement material.

OCO and the PSCs can take up to 90 days from the initial ADR Process selection date to locate the Title II and Title II portion of the concurrent TII/TXVI folder(s) for CDR direct release alerts. They have an additional 120 days to perform the “special search” if the folder is not located during the initial pull period or has been destroyed see DI 13015.060B.

B. Process – Special Search in OCO/PSC

1. PCACS Shows a "QUES QUES" or "TEMP QUES" Entry

  • AT THE END OF the initial pull period (not to exceed 90 days), if ODO/PSC is unable to locate the folder, OCO/PSC changes PCACS to read "AUXRH QUES QUES", or "AUXRH TEMP QUES" or " CAVES QUES QUES" or “PC1-6 QUES QUES”. NO FO ACTION NECESSARY: see the Chart in DI 13015.100C.

  • In addition, OCO and the PSCs update the FOLDER RECONSTRUCTION field on the CDR PC Input (IPCA) screen of the Disability Control File (DCF) to read "Q". A "Q"in the FOLDER RECONSTRUCTION field of the DCF indicates that the PSC is still searching for the Title II medical CDR folder in other locations. 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.

2. Special Search – Other Locations and Preparation of a Duplicate/Replacement Folder

  • OCO and the PSCs can take up to 120 days from the initial "QUES QUES" entry date to locate the Title II and Title II portion of the concurrent TII/TXVI folder(s) in "other" locations.

  • If the PCACS query reflects "QUES QUES" or "TEMP QUES" and OCO/PSC"s other location search is unsuccessful (not to exceed 120 days), OCO/PSC updates the DCF IPCA FOLDER RECONSTRUCTION field to "L". Also see the CHART in DI 13015.100C. OCO/PSC enters an "L" in the FOLDER RECONSTRUCTION field of the DCF, which indicates that the medical folder is lost.

  • OCO/PSC prepares a duplicate folder and forwards it to the FO to initiate the CDR (see DI 13015.070).

  • The duplicate folder will usually contain: a FACT, NUMI, copy of the earnings record, the direct release alert, documentation of search efforts (see example SSA-5002 in DI 13015.250), and a SSA-5526-U2-OPS routing form which instructs the FO that folder reconstruction may be necessary.

C. Procedure - FO Actions

1. PCACS Reads "AUXRH QUES QUES", or "AUXRH TEMP QUES" or " CAVES QUES QUES" or “PC1-6 QUES QUES”.

  • NO FO ACTION NECESSARY: see the Chart in DI 13015.100C.

  • DO NOT REQUEST any direct release Title II or concurrent Title II/XVI CDR folders directly from the Megasite or Caves reading "QUES QUES" or "TEMP QUES". The located CDR folder(s) or a duplicate folder will be forwarded automatically to the FO of jurisdiction when OCO/PSC is finished with their search.

  • FO should periodically (about every 30 days) review both PCACS and the DCF for the changes mentioned above. Establish your follow up tickle controls using the DCF worksheet (CDRW) located in MSOM CDR 001.013. A "Q” in the FOLDER RECONSTRUCTION field of the DCF indicates that the PSC is still searching for the Title II medical CDR folder in other locations. 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.

2. FO Actions Awaiting/Pending Receipt of Duplicate Folder

  • Tickle file for 15 working days for receipt of the duplicate folder. (OCO/PSC forwards the duplicate folder to the FO of jurisdiction within 15 working days.) See MSOM CDR 001.013 for establishing tickle controls via the DCF's new CDRW screen.

  • If the duplicate folder is not received, phone OCO/PSC, as appropriate, and obtain the name of your contact.

  • REQUEST status of duplicate folder explaining the reason.

  • Discuss with OCO/PSC contact the appropriate follow up time for receipt of the duplicate folder.

  • TICKLE file for this date.

  • If after second follow-up, duplicate folder is not received, prepare a duplicate folder. The FO duplicate folder should contain a FACT, NUMI, and a copy of the earnings record. Place a copy of your contact with OCO/PSC in the folder as documentation of search efforts.

3. FO Actions On Receipt of Duplicate Folder

  • Determine if there is a concurrent claim on the SSN. If there is, recall the Title XVI folder as the medical evidence may be in that folder. See MSOM CDR 001.014 for the CDRI information screen, which should be used to establish control for receipt of the folder via the “PRIOR FL” field.

  • Carefully document your efforts on the SSA-5002 (see DI 13015.250) to locate the Title XVI folder in concurrent claim situations. This documentation is especially important when the DDS receives a folder without the medical evidence from the most recent prior favorable determination and must decide whether or not to ask the FO to search for this medical evidence.

  • Review the SSA-5002 documentation (see DI 13015.250) to determine what efforts were made to locate the Title II folder/medical evidence.

  • The duplicate folder may contain some material from a temporary folder(s) that was housed in the Megasite/Caves/PSC operations component.

  • The duplicate folder received from all PCs should already be updated to your FO on PCACS and contains a SSNX ending with the last two digits of “11”. If PCACS has not been updated to your FO, contact the jurisdictional DRS/Module Manager in OCO/PSC. Provide the OCO/PSC contact with both the SSNX on the folder and DOC in which the folder is to be updated to in PCACS.

  • If transferring the folder to another FO, DDS, or ODAR, update PCACS to the new location. Note FO inputs update the location, but not the actual location or site date on PCACS.

  • Remember to update the DCF CDR FO Input (IFOA) screen when the folder reaches your office.

  • Even if the OCO/PSC cannot locate a folder or the folder does not contain medical evidence of any kind, conduct the CDR interview per DI 13005.030 in the usual manner and forward development to the DDS. The DDS may be able to find a “currently disabled” continuance based on current evidence in which case folder reconstruction is not necessary. See DI 13015.070.