TN 1 (09-10)
DI 32005.020 Disability Determination Services “No Determination” Routing – Paper Case Only
For electronic cases, follow the instructions in DI 81020.127.
A. Definition of “no determination” cases
“No determination” (ND) cases are cases that the DDS does not do a formal determination. The following list is not all-inclusive. Reasons for ND cases include:
Cases that are not in the DDS jurisdiction (for details of jurisdiction, see DI 20101.000); or
A Disability Insurance Benefit (DIB) or Disabled Widow(er) Benefit (DWB) case in which the claimant dies within five months of the alleged onset date, and no earlier onset is possible. (For details of death issues, see DI 23510.000); or
A Continuing Disability Review (CDR) case sent to the DDS for review when there is no continuing disability issue involved (see DI 28001.015); or
A CDR case where the beneficiary has died since the last disability determination.
B. Routing other disability determination services (DDS) jurisdiction cases
If the DDS receives a case not in its jurisdiction, redirect the case to the appropriate office, as follows:
If the case is addressed to another DDS, forward the case immediately;
If the case is addressed to the receiving DDS, but another DDS has jurisdiction:
Change all copies of the transmittal to the appropriate DDS,
Notify the FO of the transfer, and
Forward the case to the appropriate DDS, via an SSA-408.
If the receiving DDS cannot determine the appropriate DDS of jurisdiction, telephone the Regional Office for resolution of the jurisdictional question.
If the FO discovers a case is not in the DDS jurisdiction, the FO will telephone the DDS and request you to return the file, or provide forwarding instructions.
C. Re-routing Office of Disability Operations (ODO) or Program Service Center (PSC) jurisdiction cases
If the FO sends the DDS a file addressed to ODO or PSC, re-route the file to ODO or PSC by an SSA-408 without taking adjudicative action. In the SSA-408 “Remarks” section, state the reason for forwarding the case.
D. Death issues (title II, title XVI, Medicare Qualified Government Employee (MQGE))
For details on which cases require a determination and which cases do not, and for routing and SSA-408 instructions, see DI 23510.000.
E. Title II claimant dies or files an application for Retirement Insurance Benefits (RIB) before disability determination is completed
If the claimant files an application for RIB before completion of the disability determination, the DDS must process the disability claim to a formal determination because the benefit amount may depend on the disability determination.
If the claimant dies while the disability claim is pending, DDS action depends upon the earliest possible date of disability onset. If there is a possibility that you can establish onset at least five full months before the month of death, then the DDS must continue to develop the case and make a formal determination. If onset clearly cannot be established at least five full months before the month of death (e.g., alleged onset date (AOD) is within five months of death and the claimant performed substantial gainful activity (SGA) until AOD), then the DDS clears the case to the FO as a no determination. (See DI 23510.020.)
F. Title XVI claimant attains age 65 while case is pending in DDS
If the claimant attains age 65 while the case is pending in the DDS, call to alert the FO to initiate payment to the claimant as an aged person. Document the phone call on a SSA-5002 (Report of Contact).
G. Routing of continuing disability review (CDR) death or no issue case
When the DDS receives a CDR case and the DDS discovers that the beneficiary is deceased or there is, in fact, no continuing disability issue, send the file to ODO or National Records Center (NRC), depending on which component is the final repository for the claim.