TN 10 (04-09)

DI 26510.095 Completing Item 34 (Remarks) on the SSA-831

Use Item 34 to alert SSA personnel to any special circumstance or situations in previous Items on the SSA-831.

NOTE: This chart includes only a few examples of special situations that might be annotated in Item 34. It is not an exhaustive list.

This is an optional alert that may not be displayed by all DDS processing systems, functionality varies among the State DDS offices.

Situation

Enter In Remarks

Claimant cannot be located at last known address or claimant’s whereabouts unknown.

Claimant’s whereabouts unknown.

DDS has received a statement regarding capability -- allowance only; or The Field Office (FO) indicates that an RSI claim has been filed (see When to Develop Capability, DI 23001.005B).

"Claimant capable (or incapable) per Dr. (name) report of (date)."

Claimant’s impairment meets listing 12.05A.

"Claimant incapable -- Listing 12.05A.

When capability development was needed (see When to Develop Capability, DI 23001.005B) and DDS has been unable to secure evidence of capability -- recommendation based on evidence in file -- allowance only; or The FO indicates that an RSI claim has been filed.

"Capability unresolved -- review of medical evidence (identify by source and date) suggests claimant is capable (or incapable)."

When capability development was needed (see When to Develop Capability, DI 23001.005B) and DDS has been unable to secure evidence of capability -- allowance only; or

The FO indicates that an RSI claim has been filed.

"Capability unresolved."

NOTE: It is not necessary to specify capability for a minor child since the child will already have a representative payee. However, if Item 5 of the Disability Determination and Transmittal, SSA-831 (or elsewhere) indicates that the claim was filed by the child, then the question of capability must be considered.

DDS recommends payment of benefits before completion of its onset development (Onset, DI 25501.000).

"Return folder to DDS after award payment--possible earlier date of onset (date) to be developed."

AOD is less than 5 full calendar months before the month of death and no earlier onset is possible.

"Death in waiting period--no possibility of earlier onset."

EOD different from AOD in Title II cases.

"Change in onset" [This applies whether the EOD is favorable or unfavorable to the claimant.]

EOD after the month of filing in Title XVI cases.

“Adverse onset.”

More than one optional diary reason applies.

"Diary reasons (show applicable reason codes)".

Vocational Diary established.

"Vocational Diary established."

TWP Diary Established.

"TW Diary (month/year)."

Collateral estoppel is the basis of the determination.

"Collateral estoppel."

Case reviewed by DDS Quality Assurance.

"DDS QA."

Earnings discrepancy indicated by the presence of an unprocessed Form SSA-7000-U3, Notice of Determination of Self-Employment Income; SSA-7010-U3 Notice of Determination of FICA Wages or SSA-4500-U6, Federal Determination of Error in State’s Wage Reports, in file.

“Earnings discrepancy.”

At the time of determination, claimant is working and the work may meet criteria for TWP month(s). (TWP can begin no earlier than the filing date or DOE, whichever is later.)

“TWP” case.

An interim notice is prepared.

“SSA-1157-U2 (DI) or (SI).”

Representative payee files for claimant after receipt of SSA-831 in DDS, insufficient space in Item 5 to show change.

“John Doe for Mary Doe”

EOD for DWB is based on consideration of vocational factors and would result in a month of entitlement (MOE) prior to 1/91 (generally onsets prior to 7/2/90), but the MOE is restricted to
1/91 under P.L. 101-508.

"MOE restricted to 1/91 - P.L. 101-508."

A Title II or Title XVI adult medical/vocational decision is adopted to a DWB claim and the onset (generally prior to 7/2/90) would result in a MOE prior to 1/91, but MOE is restricted to 1/91 under P.L. 101-508.

"DIB/SSI adopted for DWB purposes under P.L. 101-508, MOE cannot be earlier than 1/91."

The claimant dies prior to adjudication and a determination is necessary for Medicaid purposes only.

"Died (date of death). Determination for Medicaid Only."

DAA is not material, DAA Condition.

"DAA Not Material-DAA Condition (X, Y, or Z, as applicable)." See Drug and Alcohol Addiction (DAA), SM 05905.059.

No current evidence of DAA condition.

DAA previously established on the record in a prior determination/decision.

"No evidence of DAA condition--W." See Drug and Alcohol Addiction (DAA), SM 05905.059.

DAA is material. Denial.

"DAA is material-(A, D, or B, as applicable)." See Drug and Alcohol Addiction (DAA), SM 05905.059.

If the FO annotates "Child In Care," a claimant is seeking initial or continuing entitlement based on having a disabled child in care who is alleged to have both a physical and mental impairment.  Enter this remark if a documented mental impairment exists which is not shown as the primary or secondary diagnosis.

Type of mental impairment, type of report; e.g., “Intellectual Disability, Dr. Moore's Report, July 22, 2006."

A disability determination is needed for an individual who received transferred resources from an SSI applicant or recipient. The determination is needed to establish whether the person who transferred the resources is eligible for SSI.

"Disability determination needed for SSI transfer of resources case. Alleged onset date is the date of the resource transfer. See Exceptions—Transfers to a Trust, SI 01150.121."

SSI claimant attains age 18 after claim filed but before we make a determination or decision. See If You Attain Age 18 After You File Your Disability Application But Before We Make A Determination or Decision, DI 25201.010.

Period starting with attainment of age 18 adjudicated under adult rules.

Childhood case allowance – medical evidence indicates that maternal drug or alcohol addiction is an underlying cause of the impairment (i.e., child born addicted).

“Possible Representative Payee issue – impairment related to maternal drug or alcohol abuse. See medical report from___________, dated_____.”

Childhood case allowance – medical evidence indicates the child’s mother or father is an alcoholic or drug addict.

“Possible Representative Payee issue – mother/father has a drug/alcohol abuse problem. See medical report from__________, dated_____.”

Childhood case allowance – medical evidence indicates that the child may suffer from abuse.

“Possible Representative Payee issue – medical evidence indicates child abuse. See medical report from_________, dated _____.”

DIB, CDB or DWB felony or confinement impairment denials.

“Disabling impairment is (felony) or (confinement) related.”


To Link to this section - Use this URL:
http://policy.ssa.gov/poms.nsf/lnx/0426510095
DI 26510.095 - Completing Item 34 (Remarks) on the SSA-831 - 04/19/2017
Batch run: 04/19/2017
Rev:04/19/2017