TN 4 (12-09)

DI 20101.045 Jurisdiction User’s Guide

A. Initial cases

Type Claim

Situation

Jurisdiction

Reference

DIB, DWB, CDB

Claimant living

DDS in the State of actual residence

DI 20101.030

CDB, DWB

Filed after death

SSA

Title II Claim Filed After Death (Chart), DI 23510.025

DIB

Filed after death

DDS in the State of residence at death, or SSA, if filed more than three months after death

Title II Claim Filed After Death (Chart), DI 23510.025

DIB

Death within waiting period

SSA

Title II Claim Filed After Death (Chart), DI 23510.025

DIB, DWB, CDB
(See Title XVI instructions below for concurrent claims)

Claimant dies after filing

DDS in the place of residence at time of receipt

Title II Claim Dies After Filing (Chart), DI 23510.020

CDB

AOD after age 22 or more than 7 years after CDB termination

SSA. See P.L. 108-203 for an exception due to SGA cessation- Then DDS has jurisdiction.

DI 20101.001B.3.

DIB, DWB

AOD after DLI/PP

SSA or DDS in the State of residence - see reference

DI 20101.001B.1.

DIB, DWB

EOD after DLI or PP (returned to DDS)

DDS in the State of residence

DI 20101.001A.3.

DIB

Application prior to date first insured

DDS in the State of residence

DI 20101.001A.1.

Title XVI
(See Title XVI instructions below for concurrent claims)

Claimant dies after filing

SSA or DDS in the State of residence

Title XVI Claimant Dies After Filing (Chart), DI 23510.035

Title XVI

Non-disability alert

SSA

DI 20101.001D.1.

Title XVI

Receiving DIB, CDB or DWB

SSA

DI 20101.001C and Collateral Estoppel, DI 27515.000

Title II or XVI

Work issue cases - current onset and no possible closed period or TWP

SSA

Initial and Subsequent Work Issue Cases, DI 24001.005

Title II or XVI

Engaging in SGA - current onset and no possible closed period or TWP

SSA

Initial and Subsequent Work Issue Cases, DI 24001.005

Title II or XVI

Work activity is not SGA

DDS in the State of residence

Initial and Subsequent Work Issue Cases, DI 24001.005

Title II or XVI

FO reversal of technical/SGA Denial

DDS in the State of residence

DI 20101.010C.2.

Title II or XVI

SGA ceased

DDS in the State of residence

Initial and Subsequent Work Issue Cases, DI 24001.005

Title II

Engaging in SGA–possible closed period

DDS in the State of residence

Initial and Subsequent Work Issue Cases, DI 24001.005

Title II or XVI

Engaging in SGA–visual impairment alleged

DDS in the State of residence

Jurisdiction of Blindness Cases, DI 26001.010

DIB

Totalization

SSA

Disability Determination Services (DDS) Review and Development of Totalization Claims, DI 23550.001.

DIB, DWB, CDB

Foreign claim

SSA

DI 20101.030B

Title II or XVI

U.S. possession

SSA

DI 20101.030C

Title II or XVI

Northern Mariana Islands

Federal Disability Examiner

DI 20101.030D

Title II or XVI

Career railroad or railroad annuitants

GLPSC-DPB

DI 20101.040A

B. Subsequent claims

Type Claim

Situation

Jurisdiction

Reference

DIB, DWB or CDB

Receiving DIB, DWB, or CDB

SSA or DDS in the State of residence

DI 20101.001B.4.

SSI

Receiving DIB, DWB, CDB

SSA or DDS in the State of residence

DI 20101.001B

DI 20101.001C and Collateral Estoppel DI 27515.000

DIB, DWB, CDB

Receiving SSI

SSA or DDS in the State of residence

DI 20101.001B.4. and Collateral Estoppel DI 27515.000

DIB, DWB

Prior denial after DLI/PP

SSA

DI 20101.001B.2.

CDB

AOD more than 7 years after CDB termination

SSA. See P.L. 108-203 for an exception due to SGA cessation- Then DDS has jurisdiction.

DI 20101.001B.3.

Title II or XVI

Hearing pending

SSA

DI 20101.025B

Title II or XVI

AC review pending

DDS in the State of residence

DI 20101.025C

Title II or XVI

Court action pending-common issue

SSA

DI 20101.025F

Title II or XVI

Court action pending on same type of claim – no common issue

DDS in the State of residence

DI 20101.025E.1.

Title II or XVI

Hearing pending on other type claim–common issue

ALJ

DI 20101.025

Title II or XVI

Hearing pending on other type claim–claimant or ALJ objects to joining claims or no common issue

DDS in the State of residence

DI 20101.025

C. Reconsideration cases

Type Claim

Situation

Jurisdiction

Reference

Title II or XVI

Reconsideration requested

DDS in state of residence

DI 20101.010A

Title II or XVI

Claimant leaves state of initial decision

DDS in state of residence

DI 20101.010A

Title II or XVI

Claimant leaves state before determination completed

Transfer to state of current residence

DI 20101.010B.1.

Title II or XVI

Claimant refuses to provide reconsideration evidence

DDS in the state of current residence

DI 20101.010B.2.

Title II or XVI

Two different DDS prepared different decisions

DDS in state of current residence

DI 20101.010B.3.

Title II or XVI

FO reconsideration reversal of prior SGA denial

DDS in the state of residence

DI 20101.010B.4.

Title II

Foreign claim

SSA (OIO)

DI 20101.030A

Title II or XVI

U.S. possessions

SSA

DI 20101.030B

Title II or XVI

Career railroad or railroad survivor annuitants

GLPSC-DPB

DI 20101.040A

Title II

End Stage Renal Disease (ESRD)

SSA

Processing Reconsideration, Hearings, and Appeals Medicare ESRD Cases MQGE Cases, DI 45005.001

Title II or XVI

Changed Identity

SSA

DI 20101.040B

Title II

Emergency Clause

SSA

DI 20101.040C

Title II or XVI

Informal remand of hearing

DDS which made the unfavorable decision, or SSA (OIO) if it was a foreign claim. (Transfer should be considered on a case-by-case basis with service to the claimant as the top priority).

Appeals Council (AC) Requests for Development, DI 29501.050A

D. Reopening cases

Type Claim

Situation

Jurisdiction

Reference

Title II or XVI

Reopening issue raised during development of a current claim

DDS handling current claim

DI 20101.005

Title II or XVI

Reopening issue raised by new and material evidence without new application

DDS in State of residence

DI 20101.005

Title II or XVI

Two different DDS prepared conflicting decisions

DDS in State of residence

DI 20101.010B.3.

DIB or DWB

EOD after DLI/PP (returned to DDS)

DDS in the State of residence

DI 20101.001A.3.

E. Continuing Disability Review cases

Type Claim

Situation

Jurisdiction

Reference

Title II or XVI

CDR

DDS in the State of actual residence

DI 20101.015

Title II or XVI

Claimant moves

Transfer to State of residence

DI 20101.015

Title II

Foreign claims

SSA

DI 20101.030B

Title II

Residence in U.S. possessions

SSA (OIO)

DI 20101.030C

Title II

Career railroad or railroad annuitant case

SSA

DI 20101.040A

Title II

End Stage Renal Disease (ESRD)

SSA

Processing Medicare End-Stage Renal Disease Reconsideration Cases, DI 45005.001 and End Stage Renal Disease (ESRD) Medicare Cases, Including MQGE Cases

DI 45001.000 through DI 45010.000

Title II or XVI

Changed Identity

SSA

DI 20101.040B

Title II

Emergency Clause

SSA

DI 20101.040C

Title II or Title II part of a concurrent case

SGA case

SSA

Initial and Subsequent Work Issue Cases, SSA-821-BK (Work Activity Report – Employee), & SSA-820-F4 (Work Activity Report – Self Employed Person).

DI 24001.005, DI 10510.025, DI 10505.035, and OS 15025.001

Title XVI or Title XVI part of a concurrent case

1619 status

DDS in the State of residence

Section 1619 Medical CDRs DI 40540.000

NOTE: Claims for Medicare based on ESRD are SSA jurisdiction. The processing center segment of the POMS, DI 45001.000 through DI 45010.000 provides additional information. Section 1619 CDRs are SSA jurisdiction. (See Section 1619 Medical CDRs, DI 40540.001).

F. Claimant moves

Type Claim

Situation

Jurisdiction

Reference

Title II , XVI and Concurrent

Moves to foreign country (temporary-less than 6 months)

DDS

DI 20101.035C.5

Title II

Moves to foreign country (permanent-6 months or more)

OCO/OIO

DI 20101.035C.2

Title II

Moves from foreign country

DDS in the State of actual residence

DI 20101.035C.7

Title II or XVI

Moves to another State

Transfer to the DDS in the State of residence

DI 20101.035A and DI 20101.035B.1

Title II or XVI

Moves to or from Puerto Rico, Guam, American Samoa, Virgin Islands

DDS in the state of residence, or FO - see reference

DI 20101.035B

Title II or XVI

DQB return and claimant moves

(any level claim)

DDS which received return

DI 20101.035C.9

DI 20101.010B.5 and

DI 20101.015A

Title II or XVI

Reconsideration - claimant moves to another State

DDS in the State of current residence

DI 20101.010A and DI 20101.010B.1

Title II or XVI

Reconsideration - claimant moves to or from Puerto Rico, Guam, or American Samoa

DDS - see reference

DI 20101.035C.10

Title II or XVI

CDR – claimant moves

Transfer to the DDS in the state of residence

DI 20101.015A

G. Work issues

Type Claim

Situation

Jurisdiction

Reference

Title II or XVI

Work issue cases

SSA

Initial and Subsequent Work Issue Cases

DI 24001.005

Title II or XVI

Engaging in SGA

SSA

Initial and Subsequent Work Issue Cases

DI 24001.005

Title II or XVI

Work activity is not SGA

DDS in the State of residence

Initial and Subsequent Work Issue Cases

DI 24001.005

Title II or XVI

Engaging in SGA - current onset and no possible closed period

SSA

Initial and Subsequent Work Issue Cases

DI 24001.005

Title II or XVI

SGA ceased after AOD

DDS in the State of residence

Initial and Subsequent Work Issue Cases

DI 24001.005

Title II

Engaging in SGA, possible closed period or TWP

DDS in the State of residence

Initial and Subsequent Work Issue Cases

DI 24001.005

Title II or XVI

Engaging in SGA, visual impairment alleged

DDS in the State of residence

Jurisdiction of Blindness

DI 26001.010.

Title II or XVI

FO reconsideration reversal of prior SGA denial

DDS in the State of residence

DI 20101.010B.4

Title XVI or Title XVI part of concurrent

Section 1619 case (previously work issue)

DDS in the State of residence

Section 1619 Medical CDRs, DI 40540.000

H. Special Cases