DI 71001.030 Disability Determination Services (DDS) Process for Title II Initial Disability Claims Canadian Residents File in the United States
Disability Determination Services (DDS) in Alaska, Idaho, Maine, Michigan, Minnesota, Montana, New York, North Dakota, and Washington make the disability determination on initial disability claims and reconsideration requests Canadian residents file in United States (U.S.) border field offices (FO). Non-border field offices (FO) send claims filed by Canadian residents to the Office of International Operations (OIO) for a medical determination.
A. DDS initial claims process
Adjudicate initial title II claims following the usual procedures. Upon completion of all disability determination actions, transfer the claim to the border FO to associate with the non-medical portion of the claim.
NOTE: Contact the border FO to discuss any questions related to ceasing medical development (e.g., SGA earnings), before returning the case to the border FO.
1. DDS medical development and evaluation process
Follow normal medical development and evaluation procedures found in:
When initiating a follow-up letter or a telephone call, use existing DDS timeframes. You may allow additional time for mail to and from Canada.
2. Consultative examinations (CE) process
a. Claimant’s medical source
If Medical Evidence of Record (MER) is not readily available or is inadequate, arrange a CE. The claimant’s medical source(s) is the preferred CE provider. However, if we cannot use the claimant’s medical source, schedule the CE in the U.S. The DDS may also maintain a list of Canadian CE providers.
b. Travel distance to a CE
If the claimant indicates that he or she does not live within a reasonable traveling distance of the U.S. border, arrange the CE near the claimant’s residence.
c. Claimant fails to keep CE appointment
If the claimant fails to keep the scheduled CE appointment, follow the procedures in DI 23007.010. When initiating a follow-up letter or telephone call, use existing DDS timeframes. You may allow additional mail time for correspondence to and from Canada. If you are unable to contact the claimant, document the file and prepare a determination based on the information in the file.
B. Preparing the disability determination
Upon receipt of MER, CE report(s), or both, evaluate the findings and if the evidence is sufficient, prepare the disability determination according to normal medical and vocational evaluation procedures.
C. Claimant moves during the adjudication process
To determine jurisdiction if the claimant moves during the adjudication process, follow the instructions in DI 20101.035 Disability Determination Services (DDS) and Social Security (SSA) Jurisdictions when the Claimant Moves.