POMS Reference

GN 04440: Federal Quality Review of Disability Determinations

TN 8 (06-04)

A. Introduction

A group I medical documentation deficiency involving onset exists if the correct date (i.e., either the DLI, prescribed period for a disabled widow/er claimant or age 22 for a childhood disability claimant) is clearly documented, and the medical evidence in file does not support the onset date established by the adjudicating component; i.e., the correct onset date could be after the DLI, prescribed period or age 22.

B. Policy — Corrective Action

Send group I medical documentation deficiencies involving onset to the adjudicating component for corrective action.

C. Procedure — Review Component

For group I medical documentation deficiencies involving onset, take the following action:

  1. Prepare an SSA-1774-U5 and send the case to the adjudicating component.

  2. Ask the adjudicating component to:

    • Develop the medical documentation.

    • Return the case to the review component.

  3. Send a copy of the SSA-1774-U5 to the regional CD or follow established regional procedures if CD does not wish to receive copies of all deficiency returns.

  4. Notify the FO either by sending a copy of the SSA-1774-U5 or by other means such as a telephone call if an early alert was sent per GN 04440.201E.3. See also DI 11010.340.

  5. Code the group I deficiency and enter the review findings into DICARS.

  6. Ensure results data input when the case is returned.