TN 49 (08-08)

DI 11010.265 Jurisdiction and Routing of Concurrent Title II-Title XVI Claims for Claimants who Move to or from Puerto Rico, U.S. Virgin Islands (VI), Mexico, or Canada

A. Background

The Puerto Rico Disability Determination Services (DDS), VI DDS, and Office of Central Operations/Office of International Operations (OCO/OIO) prepare Title II disability determinations for foreign claimants. SSI is not available to those who reside outside the 50 States, the District of Columbia and the Northern Mariana Islands. Therefore, when a claimant moves to or from Puerto Rico, U.S. Virgin Islands, Mexico, or Canada apply the following procedures. See DDS Assistance for Certain Canadian Claims - DI 43510.055 for information on Canadian claims in the pilot project States of Maine, New York, Minnesota, Montana and Washington.

B. Procedure – claimant moves to Puerto Rico or U.S. Virgin Islands from the U.S.

Take the following action when a claimant resides in the U.S., files a Title XVI claim or a concurrent Title II/Title XVI claim, and moves to Puerto Rico, or U.S. Virgin Islands before the claim is sent to the Disability Determination Services (DDS).

If no retroactive Title XVI benefits are due:

  • Deny the Title XVI claim (SSI does not apply in Puerto Rico or U.S. Virgin Islands-see Ineligibility Due to Absence from the United States/Developing Presence - SI 00501.410), and forward the Title II claim to the DDS servicing Puerto Rico or the U.S. Virgin Islands. Refer to Detailed Office Organization Resource System (DOORS) for the correct servicing DDS.

  • Update the Modernized Claim System (MCS) screens with the correct address of the claimant and transfer the claim via the Case Movement (MOVE) screens on MCS. Refer to Case Movement (MOVE) - MSOM MCS 020.002. Advise the field office (FO) in Puerto Rico or the U.S. Virgin Islands of the transfer. Refer to DOORS for the correct servicing DDS.

  • Update all actions in EDCS.

If retroactive Title XVI benefits are due:

  • Update the MCS and Modernized Supplemental Security Income Claims System (MSSICS) screens with the change of address. If the claims were already sent to DDS, contact DDS with the new address information. For Certified Electronic Folder (CEF) cases follow the instructions in Using the Update-After-Transfer (UAT) Utility - DI 81010.095.

  • Forward the claim to the DDS that services the U.S. address at the time of filing. Refer to DOORS for servicing DDS.

  • Notify the servicing FO in Puerto Rico or U.S. Virgin Islands, of the status of the claim. Refer to DOORS for the servicing FO.

  • Explain the situation in the remarks Section of the SSA-3367 (Disability Report-Field Office).

  • If the DDS returns the claim as an allowance, adjudicate the claim.

  • Retain the Title XVI claim in the FO and send the Title II claim to the appropriate PC if the official folder is paper.

  • If the claim is a denial, retain both files in the FO. If the official folder is paper, send a copy of the SSA-831 (Disability Determination and Transmittal) to the Puerto Rico or U.S. Virgin Islands FO, or notify them of the existence of an electronic folder.

C. Procedure – claimant moves from Puerto Rico or U.S. Virgin Islands to the U.S.

When a claimant who resides in Puerto Rico, or U.S. Virgin Islands files a Title II claim, then moves to the U.S. and files a Title XVI claim, take the following action:

  • Check the status of the Title II claim. If there is a final decision, request the folder (if official paper folder), from Puerto Rico or U.S. Virgin Islands; and

  • If the decision is an allowance, apply the adoption criteria in FO Adoption Decision - DI 11011.005. If the decision is a denial, send the concurrent folder to the DDS for a decision on the Title XVI claim.

  • If there has not been a final decision on the Title II claim, notify the Puerto Rico or U.S. Virgin Islands FO of the change of address. The Puerto Rico or U.S. Virgin Islands FO notifies their servicing DDS and requests an expedited decision.

  • Annotate the MCS Remarks screen with the new address. If the official folder is electronic, use the UAT utility to notify the DDS, see Using the Update-After-Transfer (UAT) Utility - DI 81010.095.

  • If the Puerto Rico or U.S. Virgin Islands DDS decides to transfer the claim to the DDS servicing the U.S. address, send the Title XVI claim to the DDS to be associated with the Title II claim for a concurrent decision.

D. Procedure – claimant moves to Mexico or Canada from the U.S.

When a claimant who resides in the U.S. files a Title XVI or concurrent Title II/Title XVI claim and moves to Mexico or Canada, the FO takes the following action:

If no retroactive Title XVI benefits are due:

  • Deny the Title XVI claim (since SSI benefits are not payable in Mexico or Canada).

  • Forward the Title II claim to OCO/OIO; see DDS Assistance for Certain Canadian Claims - DI 43510.055 for information on the Canadian pilot project in Maine, New York, Minnesota, Montana and Washington.

  • Update the MCS screens with the correct address of the claimant and transfer the Title II claim via the Case Movement (MOVE) screens on MCS. See Case Movement (MOVE) - MSOM MCS 020.002.

If retroactive Title XVI benefits are possible:

  • Transfer the claims to OIO for the concurrent Title II/Title XVI medical determination. OIO receipts both claims and fully process the Title II claim.

  • After the medical decision, OIO transfers the Title XVI claim back via the MSSICS screens to the FO servicing the last U.S. residence to adjudicate the decision. See Ineligibility Due to Absence from the United States/Developing Presence - SI 00501.410B.3. and Loss of United States Citizenship, Alien Status or Residence (N13) and Absence from the United States (N03) - SI 02301.225.

  • Send a Title XVI only claim to the DDS of the last U.S. residence. Explain the situation to the DDS in the Remarks Section of the SSA-3367.

E. Procedure - claimant moves from Mexico or Canada to the U.S.

When a claimant who resides in Mexico or Canada files a Title II claim and then moves to the U.S. and files a Title XVI claim, take the following action:

  • Contact OIO and advise them that the claimant now resides in the U.S. and has filed for Title XVI.

  • Annotate MCS (DW03) with the new address.

  • OIO advises the FO if they will retain jurisdiction of the claim or transfer it to the DDS U.S. servicing address.

    NOTE: This depends on the stage of development of the decision.

  • If OIO maintains jurisdiction of the claim, they prepare a concurrent decision and advise the FO.

  • If OIO transfers the claim to the DDS servicing the U.S. address, the FO contacts the DDS and request a concurrent decision.

  • If the official folder is paper, send a copy of the SSA—831 and any new medical information to the servicing DDS.

  • If the claim has been entered into EDCS, use the UAT function in EDCS to transfer the case. See Using the Update-After-Transfer (UAT) Utility DI 81010.095 regarding foreign claims. The Foreign Service Post (FSP) in Mexico and the designated border FOs near Mexico and Canada take claims electronically; however, the OIO DDS converts the file to paper. The claim would be initiated via EDCS and transferred to OIO. OIO converts the claim to a paper folder or the FO creates a paper folder if medical evidence is received at the time of application.


To Link to this section - Use this URL:
http://policy.ssa.gov/poms.nsf/lnx/0411010265
DI 11010.265 - Jurisdiction and Routing of Concurrent Title II-Title XVI Claims for Claimants who Move to or from Puerto Rico, U.S. Virgin Islands (VI), Mexico, or Canada - 05/07/2012
Batch run: 05/07/2012
Rev:05/07/2012