Title II and Title XVI abbreviated applications (ABAPs) are two EDCS limitations. EDCS does not recognize them as valid claims and will not allow the FO to create a case.

The FO technician may initially establish an ABAP to process a technical denial. If the FO technician determines a technical denial is not appropriate, and the case will require a medical determination, the FO should follow the instructions below.

When multiple claims are filed at the same time and at least one of the claims is an EDCS exclusion, the official folder is paper. For partially electronic cases, the official folder is paper because there is no data in eView for the EDCS exclusion claim. Use EDCS to enter information on the non-exclusion claim(s), and file documentation that pertains solely to the excluded claim in the paper MDF. In eView, upload any documents that apply to both the electronic and the paper claim.

The FO will take the following actions to document both the electronic and paper folders properly:

• •

  Establish non-exclusion claim(s) in EDCS;

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  Create a paper MDF for EDCS exclusion claim(s);

• •

  File the documents that pertain solely to the excluded claim in the MDF (for example, SSA-831 form). In eView, upload any documents that apply to both the electronic and the paper claim (for example, SSA-3368, SSA-3441, and SSA-827);

• •

  Add a message to the EDCS case indicating that a related paper claim exists. Provide the current claim level, type, and Social Security Number (SSN) for the paper claim, conversion, or appeal along with the reason for the exclusion;

• •

  Update the paper folder indicator (PFI) in EDCS stating that a paper folder has been created for this filing, see DI 81010.085;

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  Transfer case in EDCS;

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  Print an EDCS routing form for the MDF and annotate the form with the following remark to shown an EDCS exclusion is associated with the case: “EDCS exclusion-associate with EDCS case transferred on MM/DD/YYYY."; and

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  Mail the paper MDF to the adjudicating office.

NOTE: If there is an EDCS case for a claim that has already been transferred out of the FO, and there is a subsequent claim filed that is an EDCS exclusion, follow the steps for creating the paper MDF in DI 81010.030C in this section. Utilize the Update After Transfer functionality when creating the message for the EDCS case stating that a paper claim exists, and inform the DDS that it is necessary to update the PFI in eView.

The DDS will:

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  Electronically process the electronic portion of the claim;

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  Only print documentation that pertains solely to the excluded claim (for example, SSA-831 and determination notice), and associate these items in the MDF for FO adjudication after making a determination;

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  In eView, upload any documents that apply to both the electronic and the paper claim. At case closure, the DDS will upload in eView a copy of the decisional documents (SSA-831/DDE) for the paper claim; and

• •

  Return the electronic and paper portions of the case to the FO after adjudication.

The hearing office (HO) will:

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  Fax or scan documentation for the excluded paper claim into the electronic folder. This ensures all folder documentation is stored in the electronic folder at the hearing level. Documentation includes the application, development, notices, and decision;

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  Add a message in eView that all documents from the paper claim have been added to the electronic portion of the case. ; and

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  Print and mail or fax a copy of the hearing decision for the excluded claim to alert the FO or Program Service Center to process the decision.

IMPORTANT: When all claims in a case convert to paper, all documents must be printed. For example, when the DDS closes a case without a determination and the "No Determination" reason is to "Stop Electronic Processing," all documents must be printed and added to the paper folder.

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  Essential Claims Folder Material – DI 20503.000;

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  Paper Folder Preparation – DI 32001.020; and

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  Paper Modular Disability Folder – DI 70005.000.

Multiple Pending Cases (MPC) are both an initial claim and a CDR for the same individual that are pending at the same time. For example, a Title XVI Age 18 Redetermination and a Title II Disability Insurance Benefits (DIB) or Childhood Disability Benefits (CDB) claim. EDCS cannot process MPC, unless one of the MPC scenarios below applies. The FO technician can process MPC by establishing one case in EDCS, and the second case as paper. Though one of the cases can be worked electronically, these cases are still official paper folders. Adjudicating components (for example, DDS) must print all documents at case closure and file in the paper folder.

NOTE: For MPC, the DDS must print all documents at case closure because MPC consists of two different classification folders (initial and CDR), and each folder should have its own documentation that supports the determination.

If an individual files an initial claim and has a pending CDR at the same time:

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  Enter the initial claim in EDCS and complete the disability forms;

  • –

    NOTE: Certain CDB and Disabled Widow Beneficiary (DWB) cases do not require establishment of an MCS claim prior to creating an EDCS case. Supplemental Security Income (SSI) cases that cannot be established in MSSICS can be established in EDCS utilizing the Manual Title XVI creation functionality. For more information on conversion cases, see Childhood Disability Benefits (CDB) General - RS 00203.080 and DI 81010.020B.

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  Transfer the initial claim in EDCS. On the EDCS Transfer screen, check the paper folder indicator “A paper CDR is being processed together with this case”;

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  Complete CDR forms and associate them with the Comparison Point Decision (CPD) folder or create a paper MDF for the CDR;

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  Print the EDCS routing form to attach to the paper MDF. Annotate the EDCS routing form with the following remark to show that an EDCS Exclusion is associated with the case: “EDCS exclusion-associate paper CDR with EDCS initial case transferred on MM/DD/YYYY"; and

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  Mail the paper MDF to the adjudicating office.

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  The DDS will return the electronic and paper portions of the case to the FO after adjudication.

The FO technician can establish MPC for the following scenarios in EDCS:

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  CDR Appeals Council (AC) or Federal Court (FC) level case, if a non-CDR case exists at the Initial (IN), Reconsideration (RC), or Hearing (HR) level;

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  A non-CDR case at the IN, RC, or HR level, if a pending CDR case exists at AC or FC level;

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  A non-CDR case for the AC or FC level case, if a pending CDR case exists at the IN, RC, or HR level;

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  CDR case for the IN, RC, or HR levels if a non-CDR case exists at the AC or FC level.

When a previously entitled beneficiary or recipient files an EXR, the FO processes the case per DI 13050.045. If the CPD folder was processed in EDCS, the FO will:

1. 1. 

   Fax all documents in the EXR package (see DI 13050.045B.2) to eView - use the MDF E barcode, and annotate the "Note" field with "EXR Documentation." If there is no eView record, use the Evidence Portal (EP), see DI 13050.045B.8.d .

2. 2. 

   Create an MDF (paper folder) for the EXR filing.

3. 3. 

   In eView, add a message to the closed case with the most recent favorable medical decision stating, “This case serves as the CPD folder for the EXR filing on MM/DD/YYYY.”

4. 4. 

   For the EXR paper folder, add a Report of Contact (SSA-5002) stating, “Please reference electronic CPD folder in eView for EXR filing. The case with the most recent favorable medical decision was dated on MM/DD/YYYY.”

5. 5. 

   Add EXR package documents to the paper folder.

6. 6. 

   Attach the EXR flag to the paper folder.

7. 7. 

   Mail paper folder to DDS.

The DDS and OHO will process EXR filing following normal processing procedures.

There are certain scenarios that will require the CEF to be converted to paper case processing. When converting a CEF to a paper case, the FO will:

1. 1. 

   Open the corresponding case in eView.

2. 2. 

   Lock the case for editing in eView.

3. 3. 

   Select the Status/History Tab and check the box a paper folder has been created for this filing.

4. 4. 

   Add a message (with no expiration date) explaining the reason for converting the case to paper and the date the case was converted to paper.

5. 5. 

   Unlock the case in eView.

6. 6. 

   Print sections A, B, and D of the case using single sided printing.

7. 7. 

   Discard the barcode cover sheets.

8. 8. 

   File the printed documents in the corresponding sections (A, B, and D) of the paper Modular Disability Folder (MDF).