Identification Number:
DI 81010 TN 33
Intended Audience:See Transmittal Sheet
Originating Office:ORDP ODP
Title:FO Procedures - Electronic Process
Type:POMS Transmittals
Program:Disability
Link To Reference:
 

PROGRAM OPERATIONS MANUAL SYSTEM
Part DI – Disability Insurance
Chapter 810 – Electronic Disability Guide (eDG) Procedures for the Electronic Process
Subchapter 10 – FO Procedures - Electronic Process
Transmittal No. 33, 01/10/2020

Audience

PSC: CA, CS, DE, DEC, DTE, ICDS, IES, ISRA, RECONR, SCPS, TSA, TST;
OCO-OEIO: BET, CR, CTE, ERE, FCR, FDE, FDEC, RECONE, RECONR, RECOVR;
DQB: DE, PA, PE, TL;
OCO-ODO: BET, BTE, CR, CTE, CTE TEDE, DEC, DS, PAS, PETE, PETL, RCOVTA, RECONE, RECONR, RECOVR;
ODD-DDS: ADJ, DHU;
FO/TSC: CS, CS TII, CS TXVI, CSR, CTE, DRT, FR, OA, OS, RR, TA, TSC-CSR;
OHO/OAO: HQ;

Originating Component

ODP

Effective Date

Upon Receipt

Background

This is a Quick Action Transmittal. The revisions to this section do not change or introduce new policy or procedure.

Summary of Changes

DI 81010.225 CDR Forms for Electronic Continuing Disability Review (eCDR) Reviews

The following title changes were made to B.2.:

DI 13015.001 new section title will be- Failure to Cooperate-Insufficient Evidence Decision (FTC) Policy for Continuing Disability Reviews (CDR)-Field Office; and DI 13015.005- Failure to Cooperate-Insufficient Evidence Decision (FTC) Suspension Procedures for Continuing Disability Reviews (CDR)- Field Office (FO).

DI 13015.010 will be archived. Whereabouts unknown policy will be moved into its own sections under:

DI 13015.011 Whereabouts Unknown (WU) Policy for a Continuing Disability Review (CDR)- Field Office (FO) and DI 13015.013 Whereabouts Unknown (WU) Determinations and Reinstatement Procedures for a Continuing Disability Review (CDR)- Field Office (FO).

DI 81010.225 CDR Forms for Electronic Continuing Disability Review (eCDR) Reviews

A. Creating CDR Forms

If the CDR is appropriate, contact the beneficiary to initiate the CDR as outlined in FO Personal Contacts - DI 13005.030. Send the required CDR forms to the claimant:

  • Print the SSA-454 (Continuing Disability Review Report) and SSA-827 (Authorization for Release of Medical Information).

  • Obtain other forms if necessary (e.g., SSA-820/821).

  • Control the CDR on the DCF by using tickle dates. Adding Actions to the DCF - DI 13010.500 contains instructions for manually adding actions to the DCF.

NOTE: See Creating a Record for an Age 18 Disability Redetermination in the Electronic Disability Collect System (EDCS) - DI 81010.232 for instructions on processing Age 18 Redeterminations. See CDR Forms for eCDR Review - DI 81010.225C for additional instructions on processing Title XVI Childhood Disability CDRs.

B. Conducting the Electronic Continuing Disability Review (eCDR) Interview

The beneficiary is expected to complete the CDR forms. See DI 13005.030 – FO Personal Contacts and DI 13005.035 – Exceptions to the Personal Contact.

Send the forms to the beneficiary if there is no face-to-face interview. Review the Master Beneficiary Record (MBR) and the Supplemental Security Record (SSR) to ensure that the packet is sent to the correct mailing address.

1. Receipt and Review of Forms

Upon receipt of the CDR packet, enter the receipt date on the DCF and review the forms for completeness. Contact the beneficiary to complete any section of the form that is not completed.

2. Non-receipt of Forms

If forms are not returned, send a follow-up notice. If still not returned or if returned as undeliverable, follow existing procedures for Failure to Cooperate - Insufficient Evidence Decision (FTC) Policy for Continuing Disability Reviews (CDR) - Field Office - DI 13015.001, Failure to Cooperate - Insufficient Evidence Decision (FTC) Suspension Procedures for Continuing Disability Reviews (CDR) - Field Office (FO) - DI 13015.005, Whereabouts Unknown (WU) Policy for a Continuing Disability Review (CDR) - Field Office (FO) - DI 13015.011, and Whereabouts Unknown (WU) Determinations and Reinstatement Procedures for a Continuing Disability Review (CDR) - Field Office (FO) - DI 13015.013.

3. Claimant-supplied Medical Evidence of Record (MER)

If the claimant or representative provides medical records to the FO, use the procedures in Receiving Medical Evidence of Record (MER) DI 81010.125B.2. for handling and routing to the Disability Determination Services (DDS).

C. Processing Title XVI Childhood Disability Electronic Continuing Disability Reviews (eCDR)

Title XVI Child beneficiaries are subject to Continuing Disability Reviews (CDR). The eCDR procedures for case selection, Comparison Point Decision (CPD) folder acquisition, and case development are the same as in adult CDRs. Processing and Screening Continuing Disability Review (CDR) Folders and Alerts - DI 13005.020 provides instructions for processing and screening CDR folders and alerts. FO Personal Contacts - DI 13005.030C.2. contains Field Office (FO) instructions for developing Title XVI Childhood Disability CDRs. Contact the Representative Payee to initiate the CDR.

1. Required Forms

Since the medical determination for child cases uses different criteria, additional forms are required to complete the CDR. Completion of the following forms is mandatory for a Title XVI Childhood Disability eCDR:

  • SSA-454 Continuing Disability Review Report (Completion of Form SSA-454-BK in Title XVI Child Cases - DI 13005.040);

  • SSA-827 Authorization to Release Medical Information to the Social Security Administration;

  • SSA-3881 Questionnaire for Children Claiming SSI Benefits;

  • SSA-3375-3379 Function Report-Child. Select the appropriate Function Report based on the age of the child.

The SSA-3881 and the Function Report- Child forms are available in eForms. They can be completed and saved electronically in eForms. The forms also can be printed, completed, and faxed to the Electronic Folder (EF) following procedures outlined in Storing Non-Medical Evidence in the Certified Electronic Folder (CEF) - DI 81010.135.

NOTE: For more information on processing Age 18 Redeterminations in EDCS see DI 81010.232, Creating a Record for an Age 18 Disability Redetermination in the Electronic Disability Collect System (EDCS).


DI 81010 TN 33 - FO Procedures - Electronic Process - 1/10/2020