Effective Dates: 04/06/2018 - Present Previous | Next

TN 24 (02-19)

DI 23022.030 Identifying and Receipting Compassionate Allowances (CAL) and Quick Disability Determinations (QDD) Cases

CITATIONS:

20 CFR §§ 404.1619, 416.1019

A. Electronic identification

1. Electronic Disability Collect System (EDCS)

When the field office (FO) transfers a case in EDCS, the selection software determines whether the case qualifies for CAL fast-track processing; and, the predictive model (PM) identifies cases for QDD fast-track processing. When a case is identified as a CAL or QDD, an EDCS onscreen message prompts the FO to complete full non-medical development in MSSICS and MCS. The FO must select OK to close the message box to proceed with the transfer.

NOTE: 

The selection software for CAL and the PM for QDD does not consider cases that are fully paper (i.e. all claims in the case are EDCS exclusions). The FO must establish at least one of the claims in EDCS for the selection software to consider the case for CAL, or for the PM to consider the case for QDD. The official folder may be a Certified Electronic Folder (CEF) or a paper Modular Disability Folder (MDF).

 

If the Disability Determination Services (DDS) identifies CAL criteria for a fully paper claim, the DDS and FO follow normal expedited claim procedures, such as those used for terminal illness (TERI) cases.

2. DDS case processing systems

All CAL and QDD cases have an associated Electronic Folder Interface (EFI) download. The EFI download contains a data element that identifies the case as CAL, QDD, or both. The DDS case processing system recognizes the CAL and QDD indicators on the EFI, propagates them to the DDS case processing system screens, and uses them for special processing logic.

B. Visual identification of CAL or QDD indicators

CAL and QDD cases are identified on the EDCS routing form or as an indicator in eView.

1. EDCS routing form

CAL and QDD cases will have “QUICK DISABILITY DETERMINATIONS: YES” or

“COMPASSIONATE ALLOWANCES: YES”, or both in large letters at the top of the page.

2. CAL and QDD indicator in eView

The CAL and QDD indicators display as separate header(s) on all eView screens, regardless of whether the selection software or PM screened the case or a user manually added it. The CAL indicator allows the user to access the EDCS CAL page in order to view or manually add, remove, or reinstate a CAL action. The screen will show one of the following messages:

  • •

    QDD: Y and CAL: Y - The case is currently a QDD and CAL case.

  • •

    QDD: N and CAL: N - The case is not currently a QDD or CAL case.

  • •

    QDD: N and CAL: Y - The case is currently a CAL only case.

  • •

    QDD: Y and CAL: N - The case is currently a QDD only case.

NOTE: 

The DDS case processing system also displays a CAL or QDD indicator.

 

C. CAL condition identified after receipt of claim

The DDS, the Office of Quality Review (OQR), and the Office of Hearings Operations (OHO) can manually add cases to CAL processing. If the adjudicator identifies an alleged or existing condition or illness that would allow CAL processing, refer to the processing instructions in DI 23022.055.

D. Automatic EFI “Accept Jurisdiction” of CAL and QDD cases: receipt date

The DDS case processing system download and receipt queue indicates whether a case has been marked for fast-track processing. To ensure quick processing of CAL and QDD cases, the DDS case processing systems automate the “Accept Jurisdiction” EFI transaction (0123).

The system also indicates whether the Document Management Architecture (DMA) stored an image of the signed SSA-827 Authorization to Disclose Information to the Social Security Administration (SSA). The DDS should monitor the Download/Receipt queue to expeditiously receipt and assign CAL or QDD fast-track cases.

The DDS will take one of the following actions:

  • •

    Accept jurisdiction and receipt, and assign the case to a QDD and CAL adjudicator the same day that it posts to the Download/Receipt queue, if possible; or

  • •

    Resolve by close of business any circumstances that would cause them not to receipt the case. For example, if the FO transfers the case to the wrong DDS, The DDS rejects the case and sends it back to the FO.

NOTE: 

Do not automatically reject jurisdiction of cases that do not have an SSA-827 in DMA

For additional information about DDS case receipt, see DI 81020.015.

E. CAL indicator information and actions

This section identifies the information available from the CAL indicator in eView. To take actions related to CAL or QDD status, see DI 23022.055.

1. Accessing the CAL indicator

To access the CAL information for the applicant, and the available actions related to the CAL indicator, in the electronic folder (EF) in eView, select the:

  • •

    yellow "Edit (Lock Case)" link at the top of the page, and

  • •

    hyperlink labeled "CAL" in the top right-hand frame of the EF in eView.

2. CAL indicator is CAL: Y

When the CAL indicator is Y, the following information will display:

  • •

    CAL Home Page - This hyperlink connects the user to the Office of Disability Policy (ODP) CAL website that contains information on CAL, and lists the CAL conditions.

  • •

    CAL Condition(s) - Each applicable condition detected appears as a separate hyperlink leading to the applicable page with the CAL ODP website.

  • •

    CAL History - The summary table displays the most recent CAL action first and includes the following fields:

    • –

      Date: Date the CAL was added, reinstated, modified, or removed;

    • –

      Action: Possible CAL actions are added (manually or through the selection software), reinstated, modified, or removed;

    • –

      Office Code: Office responsible for the "Action";

    • –

      Level: Adjudicative level of the claim;

    • –

      Conditions: If added, modified, or reinstated, the selected conditions will appear. If removed, the field will be blank;

    • –

      Reason: Documented rationale for the "Action" will display one of the following:

      • •

        Auto Selected - Displays if the selection software detected CAL conditions;

      • •

        Auto-Removed due to EDCS reactivation - Displays when we reactivate a case through EDCS and the last action taken was "Auto-Selected";

      • •

        Any user-selected reason from a predefined drop down list;

      • •

        Other - Followed by user entered text.

3. CAL indicator is CAL: N

Any previous CAL designation will display in the CAL History field. Based on the last CAL history action performed, the system will display one or more of the buttons on the lower portion of the CAL window. If the CAL indicator is No, you will see the following options:

  • •

    Add;

  • •

    Reinstate;

  • •

    Modify; or

  • •

    Remove

To Link to this section - Use this URL:
http://policy.ssa.gov/poms.nsf/lnx/0423022030
DI 23022.030 - Identifying and Receipting Compassionate Allowances (CAL) and Quick Disability Determinations (QDD) Cases - 04/06/2018
Batch run: 09/03/2019
Rev:04/06/2018