BASIC (06-10)

DI 44005.010 Completion of the SSA-831 (Disability Determination and Transmittal) for Joint Freeze Cases (Except 20/40 Allowance Cases)

A. Allowances: Freeze only – Not insured for Disability Insurance Benefits (DIB)

Complete the following items on the SSA-831:

Item 17 (Diary)

Regular procedures apply – DI 26510.020, DI 26525.000.

Item 22 (Reg. basis code)

See DI 26510.045 for codes.

Most common codes: (A1) meets listing, (B1) equals listing, (C1) med/voc

Item 23 (Med List No)

If claimant meets or equals a listing–show listing code. See DI 26510.050 for Item 23 format – enter up to 7 positions of the appropriate listing number, e.g. listing 4.02 A2 should be coded as “004.02A2”.

Items 32 – 33

Complete items 32 through 33 per DI 26510.090. See DI 24501.002C.2. for the Medical Consultant/Psychological Consultant (MC/PC) signature requirements. See DI 24501.004 for medical specialty codes for Item 32 B.

NOTE: The MC/PC signature requirements for Joint Freeze SSA-831s are the same as for dual eligibility cases.

Items 37 and 38

Sign and date—SSA code is “04”

Items 20, 25A and 28

Usually completed by the Railroad Retirement Board (RRB)—if not, complete these entries per DI 26510.035, DI 26510.065, and DI 26510.080 respectively.

  • Make two photocopies of the SSA-831; annotate one “Folder copy” and the other one “Data copy” at the bottom of the form. On these copies only, change the diagnosis basis codes in Items 16A and B to the SSA codes per DI 26510.015. Do not amend the coding on the original RRB SSA-831.

  • File the original SSA-831 on the left side of the folder.

B. All denials (regardless of insured status for cash DIB)

Complete the following items on the SSA-831:

Item 22 (Reg. basis code)

See DI 26510.045 for codes.

Most common codes: (F1) non-severe, (H1) past work, (J1) other work

Items 19, 20 and 25A

Usually completed by RRB–if not, complete these entries per DI 26510.030, DI 26510.035, and DI 26510.065 respectively

Items 32-33, 37 and 38

Same as for allowances

  • Make two photocopies of the SSA-831. Annotate one copy “Folder copy” and the other one “Data copy”. On these copies only, change the diagnosis basis coding in Item 16A and B to the SSA codes per DI 26510.015. Complete the field office code and address in Item 12. Do not amend the coding on the original RRB SSA-831.

  • File the original SSA-831 on the left side of the folder.


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