Claimant cannot be located at last known address or claimant’s whereabouts unknown.
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Claimant’s whereabouts unknown.
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Disability Determination Services (DDS) has received a statement regarding capability
- allowance only; or The Field Office (FO) indicates that an Retirement and Survivor
Insurance (RSI) claim has been filed (see When to Develop Capability, DI 23001.005B).
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"Claimant capable (or incapable) per Dr. (name) report of (date)."
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Claimant’s impairment meets listing 12.05A.
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"Claimant incapable - Listing 12.05A.
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When capability development was needed (see When to Develop Capability, DI 23001.005B) and DDS has been unable to secure evidence of capability - recommendation based
on evidence in file - allowance only; or the FO indicates that an RSI claim has been
filed.
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"Capability unresolved - review of medical evidence (identify by source and date)
suggests claimant is capable (or incapable)."
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When capability development was needed (see When to Develop Capability, DI 23001.005B) and DDS has been unable to secure evidence of capability - allowance only; or
The FO indicates that an RSI claim has been filed.
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"Capability unresolved."
NOTE: It is not necessary to specify capability for a minor child since the child will
already have a representative payee. However, if Item 5 of the Disability Determination
and Transmittal, SSA-831 (or elsewhere) indicates that the claim was filed by the
child, consider the question of capability.
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DDS recommends payment of benefits before completion of its onset development (Onset,
DI 25501.000).
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"Return folder to DDS after award payment-possible earlier date of onset (date) to
be developed."
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Potential Onset Date (POD) is less than 5 full calendar months before the month of
death and no earlier onset is possible.
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"Death in waiting period-no possibility of earlier onset."
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Established onset date (EOD) is different than POD in Title II cases.
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"Change in onset" [This applies whether the EOD is favorable or unfavorable to the
claimant.]
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EOD after the month of filing in Title XVI cases.
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“Adverse onset.”
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More than one optional diary reason applies.
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"Diary reasons (show applicable reason codes)".
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Vocational Diary established.
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"Vocational Diary established."
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Trial Work Period (TWP) Diary Established.
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"TWP Diary (month/year)."
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Case reviewed by DDS Quality Assurance.
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"DDS QA."
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Earnings discrepancy indicated by the presence of an unprocessed Form SSA-7000-U3,
Notice of Determination of Self-Employment Income; SSA-7010-U3 Notice of Determination
of FICA Wages or SSA-4500-U6, Federal Determination of Error in State’s Wage Reports,
in file.
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“Earnings discrepancy.”
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At the time of determination, claimant is working and the work may meet criteria for
TWP month(s). (TWP can begin no earlier than the filing date or DOE, whichever is
later.)
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“TWP” case.
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An interim notice is prepared.
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“SSA-1157-U2 (DI) or (SI).”
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Representative payee files for claimant after receipt of SSA-831 in DDS, insufficient
space in Item 5 to show change.
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“John Doe for Mary Doe”
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Medicare only and concurrent Disability Insurance Benefits (DIB)/Medicare qualified
government employment (MQGE) claims
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"MQGE Case"
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Res judicata issue in a subsequent Title II claim. See DI 27516.005.
Denial for res judicata initial claim
Recon denial for res judicata
Prior claim not located
Exception to res judicata other than prior claim not located
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The issue of disability is res judicata
Recon affirmation res judicata applied
Res judicata not applied prior claim not located
Res judicata not applicable
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The claimant dies prior to adjudication and a determination is necessary for Medicaid
purposes only.
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"Died (date of death). Determination for Medicaid Only."
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Drug Addiction and Alcoholism (DAA) is not material, DAA Condition.
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"DAA Not Material-DAA Condition (X, Y, or Z, as applicable)." See Drug and Alcohol
Addiction (DAA), SM 05905.059.
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No current evidence of DAA condition.
DAA previously established on the record in a prior determination/decision.
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"No evidence of DAA condition-W." See Drug and Alcohol Addiction (DAA), SM 05905.059.
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DAA is material. Denial.
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"DAA is material-(A, D, or B, as applicable)." See Drug and Alcohol Addiction (DAA),
SM 05905.059.
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If the FO annotates "Child in Care," a claimant is seeking initial or continuing entitlement
based on having a disabled child in care who is alleged to have both a physical and
mental impairment. Enter this remark if a documented mental impairment exists which
is not shown as the primary or secondary diagnosis.
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Type of mental impairment, type of report; e.g., “Intellectual Disability, Dr. Moore's
Report, July 22, 2006."
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A disability determination is needed for an individual who received transferred resources
from an Supplemental Security Income (SSI) applicant or recipient. The determination
is needed to establish whether the person who transferred the resources is eligible
for SSI.
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"Disability determination needed for SSI transfer of resources case. Alleged onset
date is the date of the resource transfer. See Exceptions Transfers to a Trust, SI 01150.121."
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SSI claimant attains age 18 after claim filed but before we make a determination or
decision. See, If You Attain Age 18 After You File Your Disability Application But
Before We Make A Determination or Decision, DI 25201.010.
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Period starting with attainment of age 18 adjudicated under adult rules.
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Childhood case allowance – medical evidence indicates that maternal drug or alcohol
addiction is an underlying cause of the impairment (i.e., child born addicted).
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“Possible Representative Payee issue – impairment related to maternal drug or alcohol
abuse. See medical report from___________, dated_____.”
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Childhood case allowance – medical evidence indicates the child’s mother or father
is an alcoholic or drug addict.
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“Possible Representative Payee issue – mother/father has a drug/alcohol abuse problem.
See medical report from__________, dated_____.”
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Childhood case allowance – medical evidence indicates that the child may suffer from
abuse.
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“Possible Representative Payee issue – medical evidence indicates child abuse. See
medical report from_________, dated _____.”
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DIB, Childhood Disability Benefit (CDB) or Disabled Widow's Benefit (DWB) felony or
confinement impairment denials.
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“Disabling impairment is (felony) or (confinement) related.”
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DDS enters one of these remarks in Re-entitlement claims for Disability and Medicare
Benefits per DI 23050.001
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"Count prior months of benefit entitlement toward Medicare waiting period" (fully
favorable determination); or "Do not count prior months of benefit entitlement toward
Medicare waiting period" (partially favorable determination).
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Possible Fraud or Similar Fault (FSF) in a determination or decision, per DI 23025.000
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"FSF in the determination - see related documents in file."
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Closed and open period of disability established on a single application.
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Interim Closed Period (enter EOD for closed period and date of the end of closed period)
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Adverse Medical Reopening
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Adverse Medical Reopening. Revised Determination dated ___________.
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Reconsideration of an Adverse Medical Reopening (RAMR) with a closed period decision.
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Revised systems input required-FO must request Payment Center (PC) update diary to
closed period.
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