SSA - POMS: DI 70010.001 - Paper Modular Disability Folder (MDF) - Field Office (FO) Procedures

A. Introduction to the Certified Electronic Folder (CEF)

The Agency primarily processes disability claims using the Certified Electronic Folder (CEF). The Electronic Disability Collect System (EDCS) is used to enter disability claims information into the CEF. In rare situations, disability claims are excluded from electronic processing and cannot be established in EDCS. Such claims are EDCS exclusions (also known as CEF exclusions). For a discussion of what constitutes a CEF Exclusion, see DI 81010.030.

If all claims associated with the case are established in EDCS, create a CEF. If a CEF limitation occurs, the official folder becomes paper. Although there is an electronic folder (EF), the official folder must be paper. For a more complete discussion of the CEF versus the EF and the effects of each on processing disability claims, see DI 81001.005A.

If you cannot establish a claim in EDCS, you must use a Modular Disability Folder (MDF) to house the case documentation.

NOTE: Public contact personnel should not disclose disability claim determinations or decisions to a claimant or claimant representative until case processing is complete.

B. When the FO should use the MDF and when to use a two-part brown folder

For general instructions on using the MDF, see DI 70005.005.

The MDF houses the disability claim documents including appeals forms, queries, and any other evidence submitted.

File appropriate technical denials that are EDCS exclusions, Retirement Survivors Insurance claims, and other claims that do not require a disability determination in two-part brown folders. This folder becomes the official paper folder. For exceptions involving technical denials, see DI 70005.005A.3.

In addition to the general instructions, the following guidelines apply to FOs:

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When you receive a request for an appeal on a claim (previously filed in the official two-part brown folder), file the appeal and keep the paper request in the two-part brown folder. For additional information about filing appeal forms in the MDF, see DI 70005.005B.2. and DI 70005.005F.
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When you receive a request for an appeal on a claim previously filed in an MDF, file the appeal in the MDF according to assembly instructions in DI 70010.001C. in this section.
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When you receive a new disability claim and the prior claim(s) is housed in a two-part brown folder, file the new claim in an MDF and staple the prior claim to the back of the MDF, if needed for adjudication. Also, file any future appeal requests on the new disability claim in the MDF.
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When you receive a new disability claim and a prior disability claim(s) is housed in an MDF, file the new claim with the prior claim in the same MDF, if the FO has the prior claim. If the FO does not have the prior claim and you do not need the claim for adjudication, create a new MDF to house the new claim. Also, file any appeals or continuing disability review (CDR) actions in that MDF.

C. Filing instructions

Follow the filing instructions in DI 70005.001 through DI 70005.005, as well as the instructions listed here.

1. Queries

Keep only those queries that are necessary for documentation purposes.

EXAMPLE: Do not retain a primary insurance amount (PIA) estimate if an earnings record is in file or the earnings computation screens are available.

2. Medical records

When you receive any medical records while you still have the folder, file them in the Yellow (Back) section (Medical Records). Prong-file them in that section as received, or file them in treatment-date order. For additional filing instructions, see DI 70005.005C.

NOTE: File medical records in treatment-date order to facilitate further adjudication in the Office of Disability Adjudication and Review (ODAR).

3. Concurrent Title II/XVI cases

In concurrent cases, the MDF consists of two folders: the MDF and a two-part brown folder for the Title XVI claim. The MDF should contain all medical material and Title II non-medical material. Keep a copy of the Title XVI SSA-831 (Disability Determination and Transmittal) in the Yellow (Front) section (Payment Documents/Decisions) of the MDF, along with the original of the Title II SSA-831. In addition, place a copy of the Title II SSA-831 in the Title XVI two-part brown folder on the left side.

D. Routing instructions

1. Concurrent Title II/XVI cases

An attached two-part brown folder should contain all Title XVI non-medical material. In this way, all of the Title XVI material will go to the Disability Determination Services (DDS) or other adjudicating component along with the medical evidence.

NOTE: Normally, sending the Title II non-medical material to the DDS in the MDF with the medical evidence should not create any problems for the FO since virtually all claims information is available online via the Modernized Claims System.

When there is a reason to keep non-medical material in the FO, create a temporary two-part brown folder to house it. When the case returns from the DDS or other adjudicating component, file the material from the temporary folder into the appropriate sections of the MDF.

2. Processing Center (PC) jurisdiction cases

When the PC has jurisdiction, send the MDF (containing the Title II medical and non-medical material) to the PC, and retain the Title XVI non-medical material in the FO.

3. Appeals

When the FO receives a request for reconsideration on a disability claim that is filed in an MDF, place the SSA-561, Request for Reconsideration, in the Red section (Jurisdictional Documents/Notices), the disability related forms in the Blue section (Disability Related Development and Documentation), and any other material according to the general instructions in DI 70005.005B. and DI 70005.005F. Send the MDF to the DDS (or other appropriate component).

When the reconsideration involves concurrent claims, staple the two-part brown folder(s) to the back of the MDF and send it all to the DDS (or other appropriate component).

When you receive a hearing request on a concurrent case, file the HA-501, Request for Hearing by Administrative Law Judge, in the Red section (Jurisdictional Documents/Notices), the disability related forms in the Blue section (Disability Related Development and Documentation), and any other material in the appropriate section. For information about where to file specific kinds of material in the MDF, see DI 70005.005B. and DI 70005.005F. Staple any concurrent folders to the back of the MDF; attach any prior files located in the FO, and route to ODAR.

4. Postentitlement

When the FO receives an MDF case for postentitlement action (e.g., a CDR), prong file all postentitlement material in the appropriate sections of the MDF prior to routing the case for processing or storage.

NOTE: Discard any extraneous or duplicate material, prior to prong-filing. Prong-file all other material. Do not route the MDF with loose material in the folder.

When the FO receives a case in a two-part brown folder, FO staff should continue to use that folder to process the postentitlement action. Prong- file all loose material before routing.

NOTE: Do not reassemble the case into an MDF.

Social Security

Program Operations Manual System (POMS)

DI 70010.001 Paper Modular Disability Folder (MDF) - Field Office (FO) Procedures