DI 44005.020 Processing Joint Freeze Cases if Number Holder (NH) is Insured for Disability Insurance Benefits (DIB)
A. Processing joint freeze 20/40 allowance cases — NH has not filed for DIB
Take the following actions when:
A joint freeze allowance determination is made,
NH is insured for cash DIB purposes, and
NH has not filed an application for disability benefits with SSA.
1. Completing the SSA-831
Follow the instructions for freeze only allowances in DI 44005.010.
In item 29, cross out “NLN” if already written by the RRB and enter “SSA-L810 20/40 LTR”.
Add the remark “20/40 for DIB” in Item 34, if not previously entered.
Make two photocopies of the SSA-831. Annotate one “SCAN 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 format per DI 26510.015.
File the original SSA-831 on the left side of the folder.
2. Dispatching the folder
Follow instructions for dispatching joint freeze cases in DI 44005.015.
3. Releasing the notice
Prepare, date, and release the notice “SSA-L810 20/40 LTR.” (Make an original and two copies.) File one copy in the joint freeze folder. Paperclip the second copy of the notice to the “SCAN COPY” of the SSA-831. Paperclip the “SCAN COPY” and the “DATA COPY” of the form to the front of the joint freeze folder. Dispatch the case to the Railroad Retirement Board (RRB). No follow up control is needed.
The Great Lakes Program Service Center-Disability Processing Branch (GLPSC-DPB) control clerks will separate the “SCAN” and “DATA” copies of the SSA-831 upon folder dispatch. The “SCAN COPY” and SSA-L810 20/40 LTR will receive priority scanning into the paperless processing system, in anticipation of a possible claim for cash DIB benefits with SSA.
NOTE: In those allowance cases in which the annuitant meets the insured status requirements for DIB benefits with SSA but has excluded SSA benefits from the scope of the RRB application, the GLPSC-DPB sends a notice to the NH advising that SSA has established a period of disability freeze for him or her, and that the NH is also insured for DIB. The notice explains that the NH would need to file an application for benefits with SSA to be entitled to DIB.
A computer-fillable version of the “SSA-L810 - 20/40 LTR” is available in DPB LETTERS – Railroad Cases. The notice provides the RRB contact information at www.rrb.gov and the toll-free number, 1-877-772-5772.
Since there is a dollar for dollar offset of RRB benefits for any SSA benefits, the notice advises the NH to contact RRB to determine if filing a claim for SSA benefits would be advantageous. In most cases, there is no advantage for the railroad (RR) annuitant to file a disability claim with SSA. However, if the claimant has dependents who would be eligible for Social Security benefits, it may be to his or her advantage to file with SSA. Only the RRB has sufficient information to advise the claimant if it would be advantageous to file with SSA.
B. Processing joint freeze 20/40 allowance cases – NH files for DIB
Following a joint freeze 20/40 allowance determination, if the NH files for DIB benefits with SSA:
1. Send email to RRB
Immediately send an email to the RRB mailbox address asking RRB to expedite copies of the SSA-831 and RRB medical evidence to you, per our agreement on “20/40 Allowance Cases”.
Follow the guidelines in the “Joint Freeze Instructions for 20/40 Allowance Cases” file, on the GLPSC-DPB shared drive, in the “Railroad Cases” folder.
Send the request to RRB as soon as you learn that a claim has been filed. You do not need to wait until the case is receipted into the Modernized Integrated Disability Adjudicative System (MIDAS). RRB has agreed to return photocopies of their disability determination and evidence to GLPSC-DPB within three weeks of the initial request.
2. Modify the SSA 831
Upon receipt of the evidence from RRB, modify the SSA 831 as follows:
Item 3 – change the filing date to the date the SSA application was filed.
Item 7 – change “Type of Claim” from “FZ” to “DIB”.
Item 12 – add the SSA field office (FO) address and code
Item 16 A and B – change diagnosis codes to SSA format per DI 26510.015.
3. Scan documents
Scan (or fax) into the certified electronic folder (CEF) the modified SSA 831, medical evidence of record (MER), and other documents such as residual functional capacity (RFC) forms, SSA-416, etc., which were material to the disability determination.
4. Close the case
Close the case as an allowance, following the MIDAS NONMID Signature process, since the SSA-831 disability determination has already been approved and signed by the GLPSC-DPB specialist and medical consultant/psychological consultant (MC/PC).
Follow the usual Disability Determination Services procedure for closing a CEF per DI 81020.130E (See DI 81020.130F when closing a CEF converted to paper folder.) Transfer jurisdiction of the case to the FO.
No additional coordination is required with RRB unless a new and material issue arises in connection with the NH’s claim for DIB, which casts doubt on the accuracy of the original joint freeze allowance determination.
C. NH acquires DIB insured status after freeze allowance and files for DIB
NOTE: Field office instructions can be found in DI 11050.025, “Processing New Initial Claim if Joint RRB-SSA Freeze Previously Completed.”
Following entitlement to a period of disability freeze, if the NH subsequently acquires sufficient quarters of coverage to meet the cash DIB insured status requirements, and files a claim for DIB, the GLPSC-DPB specialist should prepare an SSA-833 continuance determination as follows:
Item 9 – Check the DISABILITY block, and block A – CONTINUES
Item 10 – Check block 10 D – OTHER
Item 12 CODE – Enter “N/A”
Item 13 – Check this block if an SSA 4268 personalized rationale is prepared
Item 24 – Remarks: Annotate “Career RR DIB attainment – NH insured for cash DIB purposes beginning MM/DD/YY.”
Item 29 – Indicate “S”.
NOTE: If the NH files for DIB following a freeze allowance, and additional medical evidence indicates medical improvement in the NH’s condition, initiate medical Continuing Disability Review (CDR) development via the FO to determine if the NH’s disability continues. The FO will screen the case and initiate a medical CDR per DI 13005.025, then return the case to GLPSC-DPB for a determination of medical continuance or cessation.
If disability continues, prepare an SSA-833 cash DIB continuance following DI 44005.020C in this section. If disability ceases, prepare an SSA-833 medical cessation to terminate the period of disability freeze and send a copy of the determination to RRB.