In situations where the waiting period applies and the NH’s AOD is more than five
full months before FRA and the Disability Determination Services (DDS) establishes
an onset less than five full months before FRA, a substantive determination of onset
will have been made.
The other six Program Service Centers – Disability Processing Branch, Disability Processing
Specialist (DPS) must prepare an amended or revised SSA-831 using reg-basis code “X2”.
ODO will not be involved in processing these cases because the NH is over age 54.
This type of denial is limited to those cases in which the field office has established
the claimant’s date of birth (see DI
Preparing the SSA-831 – Waiting Period Applies – Onset is More Than 5 Months before FRA
Complete the special entries for the SSA-831 as follows:
Item 22: Enter “X1” if onset has not been established (allegation is used). Enter
“X2” if DDS has established an onset.
Item 27: Fully rationalize the basis for the determination. If additional space is
necessary, check the second block and continue the rationale on an SSA-4268.
Prepare an SSA-567 in paperless and route the claim to the CA through the paperless
process with an attached Form SSA-559 (Claims Folder/Material Transmittal), instructing
the CA to process the “X2” denial through the Modernized Claims System (MCS). In addition,
add necessary dictated language in the SSA-573 (Special Typing Instructions) for the
CA to add to the notice.
NOTE: If the DDS has established an onset later than the AOD, the DDS should have prepared
and released the personalized disability notice (PDN). If the DDS did not do so, the
(DE/DPS) must prepare and release the PDN.