P1709 How to Process a DDSA Reconsideration

MA1709

Did the customer report a decline in health or have additional medical documentation that was not yet available for DDSA’s consideration?

• If NO, STOP. There is nothing new for DDSA to reconsider. Continue with the appeal process.

• If YES, continue to step 2.

Request the customer or representative to provide the following completed forms as soon as possible, but no later than 10 calendar days:

• Reconsideration Disability Report (DE-122) form; and

• Authorization to Disclose Information to the Social Security Administration (SSA-827) form.

NOTE     Obtain an SSA-827 form for each medical services provider, unless the SSA-827 forms in the file are current.

When the customer asks for help to complete and submit the DE-122 form, help the customer complete the forms. This can be done over the phone with the customer.

Once you have the completed DE-122 and SSA-827 forms, complete the appropriate transmittal form:

• A Disability Determination and Transmittal (DE-123) form if the appeal concerns a disability determination for an initial application; or

• A Disability Redetermination and Transmittal (DE-123) form if the appeal concerns a disability redetermination. Write the word RECONSIDERATION in the remarks section.

Send the reconsideration disability packet along with the entire original DDSA packet within 2 workdays. Send the packet to DDSA via interoffice mail with the following information on the interoffice envelope:

DDSA MD 3671
Attn: Richard Poepsel or Kim Murphy
4000 N Central Ave #1800
Phoenix, AZ 85012-3512

NOTE     Be sure to include the return address: Inter Office Mail Site Code 90 with your submission.

Continue processing the eligibility appeal request.