TN 64 (09-09)

DI 11055.150 Preparing the Official Disability Folder for Title XVI and Concurrent Title II/XVI Claims

If all the claims in a case are in the Electronic Disability Collect System (EDCS) and there are no EDCS exclusions or limitations, the case is a Certified Electronic Folder (CEF) and the official folder is electronic. If one claim in a case is an EDCS exclusion or limitation, the official folder is a paper Modular Disability Folder (MDF).

A. Preparing the Title XVI CEF

For procedures on preparing the CEF, see DI 81010.020.

References:

  • DI 81001.005, Certified Electronic Folder (CEF) Overview

  • DI 81001.015, Determining if a Folder is a Certified Electronic Folder (CEF)

  • DI 81010.030, Certified Electronic Folder (CEF) Exclusions and Limitations

  • DI 81010.085, Transferring Cases in the Electronic Disability Collect System (EDCS)

  • DI 81010.090, Faxing Documents into the Certified Electronic folder (CEF) Using Barcodes

B. Using the MDF for CEF exclusions

Assemble initial disability claims that are CEF exclusions in an MDF. Once a claim is filed in an MDF, it generally remains in that folder throughout its life (i.e., through appeals, post-entitlement actions, and storage).

For MDF policy and procedures, see DI 70005.005.

C. Preparing the MDF for CEF exclusions

Prepare only one MDF for each disability claimant. Make the entries with a black felt-tip pen or marker, paying particular attention to legibility and accuracy.

NOTE: Prepare separate MDF folders for each individual claimant, e.g., individual and spouse both claiming disability.

Reference:

DI 81010.030, Certified Electronic Folder (CEF) Exclusions and Limitations

1. Claimant’s SSN

  • Print the NH's Social Security Number (SSN) on the face of the folder tab;

  • Show the same SSN on the folder tab as is shown in Item 4 of the SSA-831 (Disability Determination and Transmittal) (see Completing the Paper SSA-831 DI 11010.205);

  • Leave a margin of approximately one-inch between the end digits and edges of the tab;

  • Use the Title XVI claim indicator after the SSN as follows: DC, DI, and DS for disabled child, individual, and spouse, respectively.

NOTE: In concurrent claim situations, the field office (FO) may, at its discretion, enter an “S” on the outside of the folder tab on the Title II folder to show Title XVI involvement or that the Title XVI claim is forthcoming. Otherwise, the FO shows the SSN followed by the appropriate beneficiary identification code on the folder tab of the Title II claim. For a list of Title II beneficiary identification codes, see SM 00550.010.

2. Claimant’s name

Print the surname first, followed by the first initial of the given name, on the reverse of the folder tab. In situations where the surname is common to a particular FO, if space is available, spell out the full given name.

3. Enclose claim material – Title XVI only

Enclose the Title XVI claim and medical material inside the appropriate disability jackets within the MDF.

4. Enclose claim material - concurrent Title II and Title XVI

  • Enclose the Title II claim and medical material inside the appropriate disability jackets within the MDF.

  • Enclose the Title XVI claim and related Title XVI materials inside the brown claims folder attached (stapled) to it.

5. Examples of MDF preparation

The following are examples of folder preparation based on the type of claims filed by a claimant:

EXAMPLE 1:

The applicant files a concurrent Title II and Title XVI disability claim. Prepare an MDF for the Title II claim along with disability materials, enclose the Title XVI claim in a two-part brown claim folder, and then attach (staple) to the back of the MDF.

EXAMPLE 2:

The individual and his/her spouse file concurrent Title II and Title XVI disability claims. Enclose the Title II portion of the claims in separate MDFs for each individual and attach (staple) the individual's SSI claim and related Title XVI materials in the corresponding two-part brown claim folders.

EXAMPLE 3:

The individual files a Title XVI aged claim and the spouse files a Title XVI disability claim. Prepare an MDF only for the disabled spouse. For the Title XVI aged claim for MSSICS cases, retain all evidence electronically in the Modernized SSI Claims System (MSSICS), the shared Evidence (EVID) screen, and The Non Disability Repository for Evidentiary Documents (NDRED).

EXAMPLE 4:

The individual and his/her spouse file Title XVI disability claims. Prepare a separate MDF for the individual and his or her spouse. Combine by attaching (staple) the back cover of the individual's MDF to the front cover of his/her spouse's MDF before forwarding to the DDS.

When concurrently filed Title II and Title XVI claims are not forwarded to the DDS at the same time, refer to DI 11010.090 for Title II modification of claim routing procedures and DI 11055.150 for more information regarding assembling and handling concurrent claims.

NOTE: Do not prepare an MDF for any Title XVI claim processed and held in the FO.

D. Associating prior paper folders with the current claim

If a medically denied individual files a subsequent application and the prior paper folder is associated with the current claim, cross out any previous date(s) of filing indicated on the front cover of the MDF or brown claims folder containing the medical evidence and SSA-831. No current date entry is necessary.

E. Identifying delayed cases

The field office (FO) considers a case delayed when any initial disability claim is still pending in the FO 70 days after the filing of the application.

To alert the Disability Determination Services (DDS) of a delayed case:

  • Add the Aged Flag in the Electronic Disability Collect System (EDCS) prior to transferring the case; and

  • Include an explanation in the space provided.

When a delayed claim is excluded from electronic processing, attach Form SSA-408 (Route Slip) to the upper edge of the front face of the paper Modular Disability Folder (MDF). Annotate on Form SSA-408 “Expedite – Delayed Case” (see OS 15020.035).


To Link to this section - Use this URL:
http://policy.ssa.gov/poms.nsf/lnx/0411055150
DI 11055.150 - Preparing the Official Disability Folder for Title XVI and Concurrent Title II/XVI Claims - 05/11/2015
Batch run: 05/11/2015
Rev:05/11/2015