Establish the appeal request via the Dallas Appeals Program or manually enter the information into the MCS and MSSICS appeal screens as appropriate.
EXCEPTION: If the claimant submits an appeal of an FO determination (for example, failure to
cooperate or substantial gainful activity (SGA)) and the FO reverses the initial denial,
see DI 81010.145 Processing Reconsideration Requests of Field Office (FO) Determinations
and DI 12005.010 Processing a Reconsideration Request for an Initial Non-Medical or Technical Denial.
If the deciding issue in concurrent Title II/Title XVI cases is the same (e.g., medical/vocational denial), complete the appeal screens for each title. For
exception cases (e.g., MCS or MSSICS exclusions), obtain one form SSA-561 (Request
for Reconsideration) and specify in the “CLAIM FOR” text that it applies to both claims.
If the reconsideration request is limited to one
title only, document the claim folder(s) to reflect the reason(s) the claimant is not requesting
reconsideration for both claims.
NOTE: If an application involves claiming Title II and Title XVI benefits, or claiming
more than one Title II disability benefit, and the claimant appeals any medical issue
for any of the benefits, the entire claim is under review, including any favorable
determination regarding disability status. Therefore, transfer the case as a concurrent
claim to DDS.
The FO may still effectuate the favorable determination, but the claimant should be
aware that our determination regarding the medical issue is not final.
If the other claim was a technical denial that is not under appeal, do not forward
the technically denied claim to DDS as the issues under appeal are not the same.
If the claimant has limited the appeal in multiple claim situations (DIB/DWB or DIB/CDB), document this on the appeal request
in the space provided for the appeal reason. If in concurrent cases the claimant limits
his or her appeal to Title XVI-only, see SI 00510.001 Overview of the Filing for Other Program Benefits Requirement.
If the issues differ in concurrent claims (e.g., technical denial on the Title XVI claim and medical denial by the DDS on the
Title II claim), and the claimant disagrees with both decisions, complete the appropriate
MCS and MSSICS appeal screens. If you cannot complete the appeal screens in MCS or
MSSICS, obtain an SSA-561 and process the appeals in accordance with the procedures
applicable under the respective program.
If the case is an MCS/MSSICS exclusion, and the claimant has not already submitted a written request as described in GN 03102.100C.2. The Reconsideration Process, obtain an SSA-561.
If the claimant submits non-medical evidence, refer to DI 81010.135 Storing Non-Medical Evidence in the Electronic Folder (EF).
If the claimant submits medical evidence, follow DI 81010.125 Receiving Medical Evidence in the Field Office
NOTE: A manually loaded appeal request must be printed and stored on the Print and Store (PRST) screen to ensure that a copy
is stored in the Online Retrieval System (ORS). For appeals brought into MCS/MSSICS
via the Dallas Appeals Program, the program automatically completes the PRST screen
for the user, saving the appeal request to ORS.