POMS Reference

DI 810: Electronic Disability Guide (eDG) Procedures for the Electronic Process

BASIC (04-08)

A. Background

Disability Determination Services (DDS) prepares the decision notice using the DDS legacy system (Levy, Midas, Versa or Independent claims processing software) and uploads the notice to the certified electronic folder (CEF).

Electronic notice information/content is stored only in the DDS legacy system, and is available to the Office of Quality Review (OQR) only as an image and not as data. Since the notice is unavailable as data, the disability quality branch (DQB) can print a copy of the decision notice but does not have the capability to electronically modify an electronic notice. Consequently, the DQB must prepare a new notice, when necessary.

B. Overview of Process

The majority of DDS notices are correct, and the DQB dates and releases it to the claimant and any appointed representative (e.g., attorney or non-attorney representative) at the conclusion of the review. The CEF will include a dated image of the released notice, and the DQB does not have to annotate the CEF with the date the notice is released. The notice release date is entered in the OQR legacy system and can be viewed in eView on the Case Review screen under the Case Data tab.

There are instances, however, when the notice is incorrect, either because of the review findings or because the notice itself is technically deficient. When this occurs, the quality reviewer must prepare a corrected notice for the CEF.

C. Procedure - Corrective Action

When DQB must prepare a corrected notice(s) per GN 04440.236, Correcting Deficient Notices, or because the review findings result in a personalized notice being required, take the following action:

  • Manually prepare the new notice(s);

  • Send the notice into the CEF using the DocSend utility or by faxing. Refer to DI 81030.055, Adding Documents to the Certified Electronic Folder (CEF);

  • Annotate the incorrect notice “Do Not Process” in the Note Field in eView, per GN 04440.237, Determination Forms Technical Corrective Action. Do this prior to OQR legacy system clearance.

    NOTE: If the DDS prepared notice is unacceptable per guidelines in GN 04440.236A.3., the DQB returns the CEF to the DDS for corrective action (unless the DQB chooses to prepare a corrected notice). The DDS does not have to return the CEF to the DQB.

D. Procedure - Releasing Notices

Release the date-stamped notice (either the notice prepared by the DDS or the corrected notice prepared by the DQB) at the conclusion of your review.

Ensure that copies of notices are sent to the appropriate appointed representative (e.g., attorney or non-attorney representative), if there is a representative.