Disability Case Document Index

Payment Documents/Decisions

Document Name(ID)	Decision Date	Receipt Date
Order of Dismissal (515)		02/25/2010
Disability Determination Transmittal (831)	01/23/2010	01/26/2010
Disability Determination Transmittal (831)	08/29/2009	09/03/2009
Disability Determination Transmittal (831)		05/26/2009

Jurisdictional Documents/Notices

Document Name(ID)	Receipt Date
Request for Hearing by ALJ (501)	07/03/2010
Request for Reconsideration (561)	06/03/2010
Misc Jurisdictional Documents/Notices (MDF B)	06/03/2010
Appointment of Representative (1696)	06/03/2010
Informal Remand Notices (INFRMD)	01/23/2010
Request for Hearing by ALJ (501)	10/28/2009
Request for Hearing Acknowledgement Letter (HRGACK)	10/28/2009
T16 Notice of Disapproved Claim (L444)	08/29/2009
Personal Decision Notice (PDN)	08/29/2009

Current Development/Temporary

Document Name(ID)

Receipt Date

Non-Disability Development

Document Name(ID)	Receipt Date
Misc Non-Disability Development (MDF D)	07/03/2010
SSI Income & Resources documents (SSIIR)	07/03/2010
Authorization For SSA To Obtain Account Records From A Financial Institution And Request For Records (4641)	05/21/2010
Authorization For SSA To Obtain Account Records From A Financial Institution And Request For Records (4641)	05/21/2010
SSI Income & Resources documents (SSIIR)	02/20/2010
SEI/Wage Verification (SEIVER)	02/20/2010
Application for Supplemental Security Income Benefits (8000)	10/28/2009
SSA Consent for Release of Information (3288)	10/27/2009

Disability Related Development

Document Name(ID)	Source	Date From	Date To	Receipt Date
Report of Contact (5002)				07/03/2010
DDS Internal Quality Assurance Form (INTRNLQA)				01/23/2010
Disability Report - Appeals (3441)				10/27/2009
Disability Report - Field Office (3367)				10/27/2009
Work Activity Report EE (821)				10/27/2009
Authorization for Source to Release Information to SSA (827)		10/26/2009		10/27/2009
CE Report Release Authorization (CERLSE)	INDUSTRIAL MEDICINE ASSOC PC	07/23/2009		07/23/2009
CE Appointment Notice (CEAPPT)	CAYUGA COMP PSYCH SERVICES, PC	07/17/2009		07/17/2009
Activities of Daily Living (ADL)		07/14/2009		07/14/2009
Copy of Case Development Claimant Correspondence (CASDVLTR)				07/08/2009
Copy of Case Development Claimant Correspondence (CASDVLTR)				07/08/2009
Copy of Case Development Claimant Correspondence (CASDVLTR)				07/01/2009
Report of Contact (5002)				06/18/2009
Copy of Case Development Claimant Correspondence (CASDVLTR)				06/18/2009
Activities of Daily Living (ADL)		06/18/2009		06/18/2009
Copy of Case Development Claimant Correspondence (CASDVLTR)				06/09/2009
Disability Report - Adult (3368)				05/26/2009
Work History Report (3369)				05/26/2009
Disability Report - Field Office (3367)				05/26/2009
Authorization for Source to Release Information to SSA (827)				05/22/2009

Medical Records

Document Name(ID)	Source	Date From	Date To	Receipt Date
DDS Disability Worksheet (WRKSHT)				01/26/2010
Psychiatric Review Technique (2506)				01/23/2010
Mental RFC Assessment (4734SUP)				01/23/2010
DDS Disability Worksheet (WRKSHT)				09/03/2009
Physical RFC Assessment (4734)				08/31/2009
Psychiatric Review Technique (2506)		08/26/2009		08/26/2009
Mental RFC Assessment (4734SUP)		08/26/2009		08/26/2009
DDS Medical Evaluation Document (MEDEVAL)		08/26/2009		08/26/2009
Medical Evidence of Record (MER)	VESID BINGHAMTON	09/03/2008		08/03/2009
Consultative Examination Report (CE)	CAYUGA COMP PSYCH SERVICES, PC	07/14/2009		07/28/2009
Consultative Examination Report (CE)	INDUSTRIAL MEDICINE ASSOC PC	07/21/2009		07/28/2009
Draft CE Report (CEDRAFT)				07/24/2009
Medical Evidence of Record (MER)	TOMPKINS COUNTY MENTAL HEALTH	07/02/2009		07/23/2009
Medical Evidence of Record (MER)	CAYUGA MEDICAL CENTER AT ITHAC	04/27/2002	05/02/2002	07/08/2009
Medical Evidence of Record (MER)	ROCHESTER PSYCHIATRIC CENTER	05/23/2003		07/02/2009
Medical Evidence of Record (MER)	TOMPKINS COUNTY MENTAL HEALTH	07/02/2009		07/02/2009
Medical Evidence of Record (MER)	FAMILY MEDICINE ASSOCIATES	07/01/2009		07/01/2009
Medical Evidence of Record (MER)	ELMIRA PSYCHIATRIC CENTER	05/08/2002	11/30/2007	06/19/2009

Queries

Document Name(ID)	Receipt Date
Summary Earnings Query (SEQY)	10/21/2010
Detailed Earnings Query (DEQY)	10/21/2010

Multimedia Files

Document Name(ID)

Judge/Owner

Hearing Date

Receipt Date

Claimant's Name