TN 2 (06-09)

DI 26535.026 Denial Notices for Initial Disabled Widow(er) Medicare Coverage Only, Medicare Qualified Government Employee (MQGE), CDB and Medicare Only DWB Claims

The Field Office (FO) forwards initial and reconsideration Medicare Qualified Government Employee (MQGE) disability cases for a worker, Childhood Disability Beneficiary (CDB), or Disabled Widow(er) Benefits (DWB) to the Disability Determination Services (DDS), when a disability determination is necessary. DDS can identify MQGE cases when the FO creates a message in the Electronic Disability Collect System (EDCS).

When completing a notice for a MQGE claim, the DDS examiner:

  • designates DDS or (D/L) and the appropriate notice or paragraph in item 29 of the SSA-831 (Disability Determination and Transmittal); and

  • prepares and releases the denial notice unless the claim is selected for Quality Assurance (QA) or Pre-effectuation Review (PER).

If the claim is selected for QA or PER review, the DDS:

  • prepares the notice; and

  • places the undated notice in the appropriate section of the Certified Electronic Folder (CEF) for release by the reviewing component.

References:


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DI 26535.026 - Denial Notices for Initial Disabled Widow(er) Medicare Coverage Only, Medicare Qualified Government Employee (MQGE), CDB and Medicare Only DWB Claims - 07/01/2009
Batch run: 07/01/2009
Rev:07/01/2009