DI 11035.005 Developing Medicare for Qualified Government Employment (MQGE) Claims Using the Electronic Disability Collect System (EDCS)

A. Procedure for using EDCS in the disability claim-taking process

EDCS is a web-based application used to record the medical information for a disability claim. The information collected in EDCS mirrors the information collected on the paper disability reports (e.g., SSA-3368, Disability Report – Adult) and Internet Disability Reports (IDRs).

Process MQGE disability claims the same as Title II disability claims. Therefore, for purposes of electronic filing, follow existing Title II procedures as described below:

1. Collect the disability report information on the EDCS 3368 (adult)

(See “Completing the Disability Report Form SSA-3368” DI 11005.023.)

Use EDCS to record the claimant’s disability information that was:

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gathered during the interview with the claimant, or
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submitted on an IDR.

2. Complete the EDCS 3367 Disability Report – Field Office.

The questions on the EDCS 3367 screens correspond to those on the paper SSA-3367. (See DI 11005.045 Completing the Paper Form SSA-3367–F5 (Disability Report-Field Office).)

For specific and detailed instructions, refer to “Electronic Disability Guide (eDG) Procedures for the Electronic Process” DI 81000.000.

NOTE: If there are differences in the date last insured (DLI) or the prescribed period for MQGE and cash benefits, annotate the remarks section of the SSA-3367 to notify the Disability Determination Services (DDS) to avoid unnecessary development.

B. Procedure when EDCS exclusions or limitations are present:

When a case is an EDCS exclusion, the official folder is the paper Modular Disability Folder (MDF). See “Assembling and Transmitting the Official Folder to Disability Determination Services (DDS)” DI 11010.210B.

As previously stated, handle MQGE disability claims the same as Title II disability claims. Therefore, for purposes of folder preparation, follow existing Title II procedures as follows:

1. Federal worker

Use the number holder’s (NH’s) Social Security number on the face of the folder tab.

See Details:

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DI 11010.210 – Assembling and Transmitting the Official Folder to Disability Determination Services (DDS)
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DI 11055.150 – General – Disability Folder

2. Disabled widow(er)

Use the NH’s Social Security number on the face of the folder tab.

If a DWB claim, send the material to the DDS if the prescribed period meets all non-medical requirements, (see “Forms Used in a Disabled Widow(er) Benefits (DWB) Claim” DI 11015.025)

See Details:

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DI 11010.210 – Assembling and Transmitting the Official Folder to Disability Determination Services (DDS)
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DI 11015.015 – Field Office (FO) Processing of a Disabled Widow(er)’s Claim for an Electronic Disability Collect System (EDCS) Exclusion or Limitation Case
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DI 11055.150 – General – Disability Folder

3. Childhood disability claims

For situations that preclude immediate transmittal of CDB claims, consult “Deferred Development-Childhood Disability Benefit (CDB) Claims” DI 11020.040.

When a CDB is filing on the earnings record of a NH who is applying for DIB, do not transmit the CDB’s folder before the NH's folder. If the case is not precluded from immediate transmittal, send the CDB material to the DDS.

See Details: For guidelines on preparing a folder for a concurrent Title XVI/Title XVIII MQGE claim, follow DI 11010.210 and DI 11055.150ff.

NOTE: Never transfer the initial materials to the DDS for a disability determination if there is any doubt as to whether the claimant meets a non-medical requirement, e.g., disability insured status or prescribed period requirements.

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