TN 2 (05-15)

A. Agency responsibility

The agency's policy is to complete a CDR on every case. Such a CDR may be deferred, if it falls into one of the following categories:

1. Reasons unrelated to the disability, e.g., weather, travel, hospitalization (short duration); or

2. Life-threatening situations (with or without regional office approval), see DI 13005.070 and DI 28040.100C.

NOTE: The Disability Determination Services (DDS) annotates on the bottom of the form SSA-847-U3 (Social Security Administration Request for Case Action) in remarks “Deferral for Life Threatening Situation Regional Office Approval Received on (date).”

If the DDS believes any other case should receive deferral, the DDS will contact the regional office for guidance. DDS retains the folder if development can be complete within two months. The DDS returns all other cases to Office of Disability Operations (ODO)/Program Service Center (PSC)-Disability Review Section (DRS). In these deferred cases, the DDS includes a specific diary date, not to exceed 6 months.

B. Contact with the medical source prior to the field office (FO) CDR interview

Generally, the CDR begins with the FO contacting the disabled individual/payee via mail to complete all the necessary CDR forms.

An optional CDR procedure is applicable only in potential suicide/homicide cases. In those cases, the FO may decide that contact should be made with the medical source before the FO interview. This contact determines if the source can furnish information on how the individual may react to the CDR. The regional policy will establish whether this contact is made by the FO or a DDS physician. The FO forwards the folder to the DDS if:

• The name of the last known medical source is in the folder;

• After a review of the evidence, the FO decides to follow the optional procedure; and

• Regional policy requires the contact made by the DDS physician.

The DDS's inquiry to the medical source should be clear and concise, similar to the example below, and released with the form SSA-1994 (Cover Sheet Confident Medical Info).

EXAMPLE:

“Our records show that you were the medical source for (Beneficiary’s Name) in (date). (Beneficiary’s Name) case is scheduled for a continuing disability review. Because of the individual's past medical history, if you continue to treat the individual, we need your assessment as to what impact the initial interview and subsequent contacts by SSA or State agency employees might have on (Beneficiary’s Name) mental status or suicidal/homicidal potential. Please respond as soon as possible.”

The DDS checks the second block on Form SSA-1994 (Cover Sheet Confident Medical Info) and follow up with the medical source if there is no response within 10 days. During any telephone contact with the medical source, the DDS must emphasize that the inquiry is due to our concern for the individual's health and well- being.

If the source states he cannot make this judgment, the DDS returns the folder to the FO to proceed with the CDR in the usual manner. If the source says he is no longer the medical source for the identified individual, the DDS should make one attempt to contact a family member or community representative identified in the case folder as having close contact with the individual. The DDS should limit the second effort to an attempt to identify the individual's current medical source. If identified, the DDS writes to this physician. Otherwise, no further attempts are made and the folder is returned to the FO to schedule the face-to-face interview.

If the medical source indicates that the face-to-face interview would have negative effects on the individual's mental health and/or increase suicide/homicide potential, the DDS documents the case file, and contacts the regional office for guidance. In life threatening situations, consideration should be given to deferring the CDR.

The face-to-face interview will be scheduled by the FO and the case processed as usual under the following circumstances:

1. The medical source states that there is no current threat of suicide/homicide potential, or

2. The medical source refuses to provide an opinion on the individual's suicide/homicide potential, or

3. The medical source states that the individual is no longer a patient and is not aware of a current treating source.

NOTE: In all circumstances, the DDS will accurately document the case before returning the case to the FO.

See DI 55025.010 for medical CDR processing instructions for beneficiaries with Tickets to Work.