TN 32 (03-08)

DI 23535.012 Disability Determination Services (DDS) Responsibilities in Presumptive Disability (PD) Cases Involving an Allegation of Human Immunodeficiency Virus (HIV) Infection or Acquired Immunodeficiency Syndrome (AIDS)

For details about field office (FO) responsibilities in presumptive disability (PD) cases involving an allegation of human immunodeficiency virus (HIV) or acquired immunodeficiency syndrome (AIDS), see DI 11055.241.

A. Procedure -- Medical File Received in DDS without the SSA-4814-F5 or SSA-4815-F6 Check-Block Form

If the medical file is received in the DDS without the check-block form, the DDS:

  • Verifies that a PD finding has been made by the field office (FO); or

  • Determines if a PD finding is appropriate if a PD finding was not made by the FO. (Assess using DDS procedures as detailed in DI 23535.010.)

    ALERT: It is not necessary to await receipt of the form from the FO before making a PD finding. The DDS is not restricted to the categories on Forms SSA 4814-F5 or SSA-4815-F6, but may make a PD finding at any time that the evidence is sufficient to establish a high degree of probability that the claimant alleging HIV infection or AIDS will be found disabled.

B. Procedure -- Individual Alleges HIV Infection or AIDS But Has No Medical Source

The DDS orders a Consultative Examination (CE) immediately if:

  • The medical file is received in the DDS and the folder has been flagged “No Medical Source/CE Needed,” and

  • The DDS is unable to identify a medical source or obtain MER.

    For CE ordering guidelines and instructions, see DI 22510.005.

C. Procedure -- Check-Block Form Received in the DDS

Upon receipt of the completed check-block form (SSA-4814-F5 or SSA-4815-F6 as appropriate), the DDS:

  • Associates the form with the claims folder, if necessary;

  • Reviews the form, and any other medical evidence forwarded by the FO;

  • Determines if a PD finding is appropriate if a PD finding was not made by the FO. (Assess using DDS procedures as detailed in DI 23535.010.)

  • Follows locally established procedures specific to the Legacy system to indicate PD findings if a PD finding is for Certified Electronic Folder (CEF) and non-CEF Electronic Disability Collect System (EDCS) cases.

    For PD findings in EDCS exclusion cases, check the “Disability Determination Services Disposition” block and annotate in that portion of the form, “PD made on (mm/dd/yyyy)” prior to filing in the paper Modular Disability Folder (MDF).


To Link to this section - Use this URL:
http://policy.ssa.gov/poms.nsf/lnx/0423535012
DI 23535.012 - Disability Determination Services (DDS) Responsibilities in Presumptive Disability (PD) Cases Involving an Allegation of Human Immunodeficiency Virus (HIV) Infection or Acquired Immunodeficiency Syndrome (AIDS) - 08/01/2013
Batch run: 01/15/2019
Rev:08/01/2013