Insufficient Conversation Case Summary

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Group I, Category 66 Insufficient Documentation to show conformance to procedural requirements when a disability determination is based on failure to cooperate. ISSUE The DDS proposes a denial of this claim based on failure to cooperate. However, proper closeout procedures were not followed, as the claimant’s whereabouts possibly are unknown. CASE DISCUSSION & POLICY ANALYSIS (INCLUDING SPECIFIC REFERENCES) The claimant is an 18- year old filing a continuing disability review alleging depression and anxiety. The claimant has a history of anxiety and depression. She completed the SSA 3368 on 7/18/16 and indicated on the form she had not seen anyone for mental health but had a visit scheduled on 7/19/16. The DDS was unable to obtain additional information regarding the claimant’s conditions. The DDS proposed a medical cessation as of 11/10/16 due to failure to cooperate. The evidence in file is insufficient to assess the claimant’s condition. However, proper closeout procedures were not followed.…show more content…
The letter informed the claimant she might be contacted for additional information to process the claim. DDS contacted the claimant by phone for additional information regarding the claim on 10/17/16. Both the claimant and the third party were contacted, and left a voicemail. Call-in letters were also sent. The DDS attempted to contact the claimant and third party again by phone and mail on 10/27/16. Both the claimant and the third party were unresponsive. The DDS never made successful contact with the claimant. DI 28030.015.B indicates when the DDS has difficulty obtaining needed information from an individual or representative, DDS should request assistance from the field office (FO). The FO was never contacted for assistance in locating the

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