TN 2 (03-10)

DI 44001.130 Notices – Dual Eligibility Railroad Cases

When the Great Lakes Program Service Center – Disability Processing Branch (GLPSC-DPB) makes a disability determination, the disability processing specialist (DPS) completes the disability determination forms SSA-831/832/833, personalized disability notices (PDNs), and any supplemental rationales using the MIDAS Legacy processing system. When the case is closed, the decisional notice and rationale are uploaded to the certified electronic folder (CEF) and stored in the appropriate section.

The DPS follows State disability determination services (DDS) guidelines for preparing notices when a totally or partially unfavorable disability determination is made, including preparation of the PDN and any supplemental rationales. Most fully favorable allowance determination notices are systems-generated; however, in certain situations, the GLPSC-DPB provides the field office (FO) with special instructions for notices released by the FO. See, Types of Notices DI 26535.005.

A. MIDAS notices

GLPSC-DPB uses the MIDAS legacy system to process all claims, both CEFs and modular disability folders, except for electronic disability collection system (EDCS) exclusion cases. For dual eligibility railroad (RR) claims adjudicated using the MIDAS legacy system, the following notices are available:

Document

Type

Description

Initial Claims

“I” paragraphs

 

L442

I71

RRB CC DENIAL

L443

I72

RRB T2 DENIAL

L443

I73

RRB T2 20/40 DENIAL*

L444

I74

RRB T16 DENIAL

PDN

I75

RRB FREEZE ALLOWANCE**

Reconsideration

“R” paragraphs

 

PDN

R71

RRB CC RECON DENIAL

L976

R72

RRB T2 RECON DENIAL

L1130

R73

RRB T16 RECON DENIAL

Continuing Disability

“C” paragraphs

 

L1013

C05

T2 CONTINUANCE

PDN

C01

T2 CESSATION

PDN

C06

T16 CESSATION

PDN

C12

T16 CONTINUANCE

PDN

C20

T2 CESSATION DWB

PDN

C21

T2 CESSATION AUX

* Use the RRB T2 20/40 DENIAL notice for dual eligibility medical denials when the NH does not meet the insured status requirements for cash disability insurance benefits (DIB). Do not use the RRB T2 20/40 DENIAL notice for joint freeze 20/40 cases, since joint freeze cases are paper cases and are not processed using MIDAS. See DI 44005.000 for joint freeze cases.

**Use the RRB FREEZE ALLOWANCE notice for dual eligibility disability allowances where the NH does not meet the insured status requirements for cash DIB benefits, but has been awarded a period of disability freeze.

B. Manual notices

For EDCS exclusion cases, the GLPSC-DPB prepares a manual notice. Manual notices for career railroad claims are located on the GLPSC-DPB shared drive, under “DPB Letters – Railroad Letters” and “RECON LETTERS.”

C. Railroad Retirement Board (RRB) eligibility paragraph

If the file does not reflect whether the claimant filed a claim with RRB, add the following paragraph to the allowance notice when the individual has at least 60 months of creditable RR service earned after 12/31/95 (or 120 months earned at any time):

We note that your railroad earnings record indicates that you have at least 60 months of creditable RR service earned after 12/31/95 (or at least 120 months earned at any time) which makes you eligible to apply for disability benefits under the disability provisions of the Railroad Retirement Act. If you have not already done so, you may wish to contact the Railroad Retirement Board regarding the filing of an application for disability benefits.

D. Pamphlets

Determine the appropriate pamphlets to be included with the various types of notices refer to NL 00603.115.


To Link to this section - Use this URL:
http://policy.ssa.gov/poms.nsf/lnx/0444001130
DI 44001.130 - Notices – Dual Eligibility Railroad Cases - 03/23/2010
Batch run: 04/14/2014
Rev:03/23/2010