POMS Reference

This change was made on Jul 6, 2018. See latest version.
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DI 11010.045: Claimant Cannot Be Contacted or Whereabouts Unknown or Claimant Does Not Wish to Pursue Title II Claim

changes
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  • Effective Dates: 04/17/2013 - Present
  • Effective Dates: 07/06/2018 - Present
  • TN 49 (08-08)
  • DI 11010.045 Claimant Cannot Be Contacted or Whereabouts Unknown or Claimant Does Not Wish to Pursue Title II Claim
  • A. Policy
  • A disallowance is usually preferable to a withdrawal; this is particularly true in disability cases.
  • 1. Explanation - disallowance and withdrawal situations
  • The following subsections contain processing instructions for Title II disallowance and withdrawal situations when the claimant cannot be contacted or does not wish to pursue his/her claim or the claimant’s whereabouts are unknown.
  • 2. Reference
  • See W/D vs. Disallowance - GN 00206.015 for a discussion of policy and procedures applicable to withdrawals.
  • See W/D vs. Disallowance - GN 00206.011 for a discussion of policy and procedures applicable to withdrawals.
  • B. Claimant cannot be contacted or whereabouts unknown
  • 1. Unable to contact claimant
  • When, despite all reasonable efforts, the claimant cannot be contacted, record all efforts to contact him/her, and evaluate the claim on the basis of evidence in the official folder.
  • 2. Claimant's whereabouts unknown
  • Record all efforts to locate the claimant on a Report of Contact (RC) in the official folder or the RPOC screen in MCS.
  • 3. Processing the claim
  • Forward the claim to the DDS or other appropriate component for a medical determination if there is medical evidence in the file. If the claim is subsequently allowed, see Suspension Events (SUSP) - MCS 009.016 and Entitlement and Eligibility Processing - Overview - SM 03020.001 for instructions on field office (FO) direct input of suspension events. Establish a diary to control address development. Do not input “RPD” data in the Rep Payee field of Modernized Claims System (MCS) when benefits are suspended because the number holder’s (NH’s) address is unknown. See Handling Unknown Address Claims -GN 01010.300B.1. Using these procedures allows processing through Earnings Computation (EC), the preferred method. If those instructions cannot be followed, process the claim by preparing an Automated 101 (A-101) (Determination of Award) and transfer the claim to the Program Service Center (PSC) so the allowance can be recorded while placing the claimant in suspense status. Advise the PSC via RPOC; BCRN and/or SSA-3601 (Claims Routing Form) to place the NH in suspense status S-6 (address unknown). See Handling Unknown Address Claims - GN 01010.300.
  • If the claim is not sent to DDS or other appropriate component for a medical decision, disallow for “lack of medical evidence,” code 000M5 or 000M6.
  • C. Claimant does not wish to pursue Title II Claim - Discontinuance of Development
  • A claimant may indicate by a written or oral statement that he/she does not wish to pursue the claim. A disallowance may be proper in this situation. If it appears that the reason for the action is difficulty encountered in securing evidence, advise the claimant that the FO is able to help. However, if the claimant remains uncooperative and appears capable, do not offer additional assistance. See Investigating Allegations of Misuse - GN 00604.020C.3. if a representative payee is not cooperative. Before disallowing the claim, explain to the claimant that the claim may be disallowed unless he/she submits required evidence. Document the official folder that the claimant has received that explanation. Process as follows:
  • * Official folder in DDS
  • If the disability file is in the DDS, telephone the DDS to advise them that the claimant is not pursuing the claim.
  • The DDS:
  • * completes any required development,
  • * prepares the SSA-831 Disability Determination and Transmittal,
  • * enters decisional data, and
  • * returns the case to the FO.
  • * Official folder in FO
  • If the FO has not transmitted the disability file to the DDS and the claimant does not wish to pursue his/her claim, process the claim in the FO using disallowance code 000M3 or 000M4 Disability Denial Codes - SM 00380.100. For Certified Electronic Folder (CEF) cases, see Processing Field Office (FO) Determinations - DI 81010.140.
  • If the claim is a career railroad or foreign claim forward the claim to Great Lakes Program Service Center- Disability Processing Branch (GLPSC-DPB) for Railroad Retirement Board (RRB), or Office of International Operations (OIO), respectively. If the claimant submits medical evidence to the FO, transfer the official disability folder to the DDS unless the case is not DDS jurisdiction. (See Completing the SSA-831 - DI 11010.205 for the appropriate remark to enter in item 11 of the SSA-831).