Basic (12-10)

DI 40101.005 Processing Center (PC) Processing Title II Disability and MQGE Claims

The following instructions include the responsibilities of the Processing Centers (PCs) when they are processing initial and subsequent Title II Disability and Medicare Qualified Government Employment (MQGE) claims. The term PC includes the following SSA components:

  • the Office of Disability Operations (ODO),

  • the Office of International Operations (OIO), and

  • six other Program Service Centers (PSCs).

A. PC responsibilities

All of the PCs have responsibility for processing and maintaining some disability claims. However, ODO processes the majority of domestic disability and MQGE claims and all the End Stage Renal Disease (ESRD) claims. The OIO has responsibility for processing disability, retirement, and survivor claims for any record where a claimant resides outside of the United States.

B. PC maintenance background

In 1983, the maintenance of Title II and MQGE disability claims where the number holder (NH) is age 59 or over transferred from the Field Office (FO) to PCs 1-6 except when a beneficiary lives outside of the United States (US). As of December 6, 2014, PCs now maintain title II disability and MQGE claims age 54 and over.

C. DDS makes disability determination

If the Disability Determination Services (DDS) makes the disability determination, then the PCs are responsible for processing the payment if the FO does not process it via Modernized Claims System (MCS). Claims Authorizers (CAs), and Benefit Authorizers (BAs) effectuate claims in the PC. The FO forwards such claims directly to the PC module. Module addresses are available via PCOM ITEM 20 Detailed Office/Organization Resource System (DOORS), see reference MSOM DOORS 001.001.

In addition to the SSA jurisdiction claims listed in DI 40101.010A, the PCs have final authorization for the following types of claims, which are excluded from District Office Final Authorization (DOFA):

  1. a. 

    adverse claims;

  2. b. 

    current awards where there is a prior claim with an appeal pending;

  3. c. 

    Survivor claims for Railroad Board (RRB) jurisdiction determination pending; and

  4. d. 

    eClaims that the FO submits to the regional office (RO) or PC for a precedent decision.

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DI 40101.005 - Processing Center (PC) Processing Title II Disability and MQGE Claims - 12/11/2014
Batch run: 01/12/2015