PROGRAM OPERATIONS MANUAL SYSTEMPart DI – Disability InsuranceChapter 710 – Processing Disability Claims Filed in the United States by Canadian and Mexican ResidentsSubchapter 05 – Processing Title II Disability Claims Filed in the United States by Mexican ResidentsTransmittal No. 1, 04/16/2020
This is a Quick Action Transmittal. The revisions do not change or introduce new policy or procedure.
Summary of Changes
DI 71005.005 Disability Determination Services (DDS) Initial Claim Procedures for Title II Initial Disability Claims Mexican Residents File in the United States
We updated the terminology and references in DI 71005.005A and B for consistency with the revised FTC policy effective 1/6/2020 and consistency with the medical evidence changes effective 3/27/2017.
DDS in Texas, New Mexico, California, and Arizona participated in a pilot to test the feasibility of making disability determinations on claims for residents of Mexico filed in the United States (U.S.) instead of transferring the claims to the Office of International Operations (OIO) for signoff by an OIO Disability Examiner.
Adjudicate initial title II claims following usual procedures. Upon completion of all disability determination actions, transfer the claim to the border field office (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., substantial gainful activity earnings), before returning the claim to the border FO.
If the claimant has limited English proficiency, requests language assistance, or it is evident that the claimant requires language assistance, follow the procedures in DI
When completing initial medical development, follow the procedures in DI 22505.001 and DI
24501.002. You are encouraged to make doctor-to-doctor contact by telephone where possible.
NOTE: When following up by letter or telephone, use the existing procedures in DI
22505.035. You may allow additional time for correspondence to and from Mexico due to potential mail delays.
Utilize translation services to translate any medical evidence received in Spanish according to the procedures in DI 23040.001.
If medical evidence is not available or insufficient, schedule a CE. The claimant’s own medical source is the preferred CE source. However, if you cannot use the claimant’s own medical source, schedule the CE in the United States (U.S).
NOTE: Due to mail delivery issues in Mexico, you may schedule the CE at least 21 days from the date of the notice.
If the claimant fails to attend the scheduled CE appointment, follow the guidelines in DI
22510.016D. For when to make a determination based on the evidence in the file, see DI 23007.015.
NOTE: It is the claimant’s responsibility to attend the CE. If the claimant states that he or she cannot return to the U.S. for a CE, transfer the claim to OIO to arrange the CE through the Foreign Service Post.
Upon receipt of the medical evidence, the CE report, or both evaluate the findings and, if the evidence if sufficient, prepare a disability determination according to the usual procedures.
To determine jurisdiction if the claimant moves during the adjudication process, follow the procedures in DI 20101.035 - Disability Determination Services (DDS) and Social Security (SSA) Jurisdictions when the Claimant Moves.