DI 81020.205 Receipting an Electronic Continuing Disability Review (eCDR)
A. Identifying eCDR Cases
All eCDR cases are sent to the Disability Determination Services (DDS) with an Electronic Disability Collect System (EDCS) Routing Form. The CDR process requires that the folder containing the most recent favorable medical decision, known as the Comparison Point Decision (CPD) folder, must be sent to the DDS/Office of Disability and Review (ODAR) along with a Disability Report Form (SSA-454, SSA-3368, SSA-3441 as appropriate) and SSA-827s. The CPD folders may be paper or Certified Electronic Folders (CEFs). The EDCS software monitors which DDS offices are able to process eCDR cases. DDS case processing software tracks whether the CPD folder is paper or electronic. If the CPD folder is electronic, it is linked to the eCDR electronically. For a list of EDCS Exclusions/Limitations, see Certified Electronic Folder (CEF) Exclusions and Limitations - DI 81010.030.
1. Certified Electronic CPD Folder
The Field Office (FO) will attach the SSA-454 or the SSA-3368 for Age 18 Redeterminations, and the SSA-827s to the route slip and mail them to the DDS. All CPD claim records and forms reside in the CEF; and the eCDR is created in a new CEF electronically and can be linked to the CPD CEF(s).
2. Paper CPD Folder
The Modular Disability Folder (MDF) or brown folder, containing the medical records for the most recent favorable medical decision will be retrieved by the FO using existing procedures and mailed to the DDS/ODAR office when the CDR is transferred electronically. The FO will flag all paper CPD folders that are associated with an eCDR claim. The paper CPD folder will follow the eCDR through all levels of CDR adjudication, initial and appeal. Although the eCDR claim will be transferred electronically, DDS/Office of Quality Performance (OQP)/ODAR should wait until the paper folder is received before receipting, developing or reviewing the eCDR. If the eCDR is routed to the medical consultant, Disability Quality Branch (DQB), FO or Processing Center (PC), the paper folder must always be routed to the same destination.
If the case is selected for review by OQP, the DDS will check the block, “CDR selected for Quality Review”. Upon completion of the review, DDS/OQP/Federal Disability Determination Services (FDDS) will line through the block “CDR selected for Quality Review” and check the block indicating the final decision.
Upon completion of the medical decision, follow DI 81020.250 for folder routing. Check the applicable block on the eCDR Paper CPD Folder Flag and mail the folder to the appropriate office. To view image of the “eCDR Paper CPD Folder Flag” see Associating the Comparison Point Decision (CDP) Folder with an eCDR – DI 81010.235B.
NOTE: The FO should follow procedures in DI 28035.001 - Disability Determination Services (DDS) Initial Receipt and Development of Lost Folders/Medical Evidence for Continuing Disability Review (CDR) if they are unable to locate the paper CPD folder
Do not scan all the material from the paper CPD folder into the eCDR. Scanning the critical medical evidence into the eCDR folder is at the discretion of DDS and in accordance with Electronic Case Documentation - DI 81020.065 and Documenting Comparison Point Decision (CPD) Evidence and Preparing the eCDR Rationale – DI 81020.230.
B. Receipting and assigning an eCDR case in the DDS
Upon receipt of an official paper CPD folder, or an EDCS Routing Form with an attached SSA-454-BK and SSA-827s for a CEF CPD:
Enter the receipt of the eCDR into the legacy system and NDDSS;
Accept jurisdiction of the eCDR (if appropriate);
Receive the Electronic Folder Interface (EFI) download that includes the basic beneficiary identification (e.g., name, phone number, address, SSN);
Determine if priority handling is required by reviewing any flags or messages; and
Update the Paper Folder Indicator (PFI) for both the CPD folder and the eCDR, if applicable. See Receipting an Electronic Continuing Disability Review (eCDR) - DI 81020.205E.
NOTE: Although the eCDR claim will be transferred electronically, DDS should wait until the paper folder is received before receipting, developing or reviewing the eCDR.
For receipting reconsideration (PH/DH) eCDR claims, see Processing a Reconsideration Appeal of an Electronic Continuing Disability (eCDR) Cessation - DI 81020.255.
For receipting Age 18 Redeterminations claims, see Disability Redeterminations – Age 18 Cases – DI 11070.030D and Case Received From FO and Cases Pending in DDS – General Process – DI 23570.015C.
NOTE: If the FO currently has arrangements to fax SSA-827s on initial and reconsideration cases, they may continue to do so for eCDRs.
C. Rejecting jurisdiction
If the folder has been routed to an incorrect DDS, reject jurisdiction.
If the CPD folder is paper, return the paper folder with the EDCS Routing Form to the originating FO.
If the CPD folder is a CEF, return the EDCS Routing Form and attachments to the originating FO.
NOTE: If the eCDR was misrouted, or if an EDCS routing form is received and there is no EFI download on the EFI download screen, query eView to verify that the eCDR case was created and transferred in EDCS. See Electronic Claim Receipt Process - DI 81020.015., for further instructions on whether to enter receipt of the case.
D. Receipting and Assigning Age 18 Redeterminations in the DDS
The DDS receipts and assigns Age18 Redeterminations as they would an eCDR. Follow the eCDR procedures as outlined in Receipting and Assigning an eCDR Case in the DDS. The SSA-3368-BK Disability Report Form-Adult is used instead of the SSA-454 for Age 18 Redeterminations. Receipt the case as an adult Title XVI case. For detailed instructions, see Electronic Claim Receipt Process - DI 81020.015.
E. Paper Folder Indicator on eCDRs
There are two new Paper Folder Indicators (PFIs) for eCDRs. Use the Case Status History page in eView or the DDS case processing software to update the PFI.
1. eCDR folder
The CDR folder is always downloaded electronically. If you identify an exclusion, (e.g., an appeal), update the PFI.
2. CPD folder
If the CPD folder is paper, ensure that the paper CPD folder indicator is “yes”. Update the PFI if you change the CPD folder from a CEF to paper.