Basic (03-86)

DI 43535.010 Claims Development Branch

The disability examiners in the Claims Development Branch of INTPSC will receive all foreign agency requests for medical evidence from the totalization modules. Each request will be jacketed in a blue folder with a covering transmittal slip (SSA-559). The remarks section of the SSA-559 will identify the country requesting the medical evidence. (See DI 43535.035, Exhibit 1.)

Most requests will be identified by a social security number (SSN). Occasionally a request will be identified by name only.

A totalization folder (blue jacket) will never leave INTPSC for any reason. All of the material in the blue jacket totalization folder may, however, be photocopied and released to the DDS. The folder will be returned to the totalization module while the medical evidence is being developed. After the medical evidence is associated with the totalization folder, the examiner will complete the SSA-1278-U3 (see DI 43535.035, Exhibit 7, 8, and 9), and return the folder to the totalization module.

Occasionally, a prior SSA folder (brown jacket), may be attached to the blue jacket totalization folder. If medical evidence received as a result of a foreign request points to a possible reopening of the SSA claim or raises a continuing disability issue, the examiner should return the folder (as above) to the totalization module to prepare the reply to the foreign agency. If DIB insured status is met based on U.S. coverage alone, indicate that the prior claim and a copy of the new evidence should be sent to the appropriate component in ODO/PSC-DRS for consideration of reopening, after all actions are completed. (See DI 42001.000.) If DIB insured status is not met on U.S. coverage, ask the totalization module to develop a totalization claim, if the folder does not show that this development has been undertaken. The claimant may meet DIB insured status based on a combination of U.S. and foreign coverage. (See GN 01702.400.)

If a continuing disability issue is raised on an INTPSC jurisdiction case, indicate that the folder should be returned to the FDE for initiation of a CDR. If a continuing disability issue is raised on a case outside INTPSC jurisdiction, indicate that the folder and a copy of the new evidence should be forwarded to the appropriate component for review and a possible CDR.