Identification Number:
DI 10005 TN 4
Intended Audience:See Transmittal Sheet
Originating Office:ORDP ODP
Title:FO Responsibilities
Type:POMS Transmittals
Program:Title II (RSI),Title XVI (SSI),Disability
Link To Reference:
 

PROGRAM OPERATIONS MANUAL SYSTEM
Part DI – Disability Insurance
Chapter 100 – Background and Overview
Subchapter 05 – FO Responsibilities
Transmittal No. 4, 08/11/2020

Audience

PSC: CA, CS, DE, DEC, DTE, ICDS, IES, ILPDS, ISRA, PETE, RECONR, SCPS, TSA, TST;
OCO-OEIO: BET, BIES, BTE, CR, CTE, ERE, FCR, FDE, PETL, RECONE, RECONR;
OCO-ODO: BET, BTE, CR, CST, CTE, CTE TET, DE, DEC, DS, PAS, PETE, PETL, RCOVTA, RECONE, RECOVR;
ODD-DDS: REF;
FO/TSC: CS, CS TII, CS TXVI, CSR, CTE, DRT, FR, OA, OS, RR, TA, TSC-CSR;

Originating Component

ODP

Effective Date

Upon Receipt

Background

This is a Quick Action Transmittal. These revisions do not change or introduce new policy or procedure.

Summary of Changes

DI 10005.015 Case File Movement

The language was revised for clarity and consistency with the revised collateral estoppel policy.

DI 10005.015 Case File Movement

A. Movement of cases between the field office (FO) and the Disability Determination Services (DDS)

The following applies when case folders are returned to the FO from the DDS.

1. Basic rules

When to return cases:

DDS should return initial claims to an FO only if:

  • A disability determination has been made, and the case is not part of the Disability Quality Branch’s (DQB) review component sample, or

  • DDS does not need to make a disability determination on the case,

  • The SSA-827 is not in the file, and

  • The FO requests the claim be returned.

When not to return cases:

DDS should not return cases to an FO if a disability determination is needed. DDS should request FO assistance, evidence, claimant contact, etc., by the most expeditious method available (e.g., EDCS Assistance Request (AR)), keeping jurisdiction in the DDS.

Exception : See “SGA issues” in Table 2, Examples, in this section.

2. Examples

The DDS should return the case when it: (no FO contact required)

The FO should request that the DDS return the case when it:

  • Discovers a technical or non-medical denial is applicable (DI 11010.040 and DI 13010.105E.). See also DI 81010.140.

  • Receives notice of the SSI claimant’s death; the FO determines disability decision is not needed (DI 11055.050).

  • Receives notice that the Title II claimant died within five months of AOD (DI 11010.075.)

  • Receives a request for withdrawal (DI 11010.075).

  • Discovers the case is under SSA jurisdiction (DI 11010.075).

The DDS should not return the case to the FO when:

  • Failure to pursue or whereabouts unknown is an issue (DDS makes a determination), DI 11010.045.

  • The claimant moves to another state (send folder directly to other DDS after notifying the FO). See DI 11010.255.

  • Additional information is needed from the claimant (DDS contacts claimant).

  • An SSI claimant attains age 65 (DDS tells the FO; DDS still makes determination).

  • The case is part of a DQB review component sample.

  • Collateral estoppel potentially applies (DI 11011.001).

DDS should contact the FO for assistance (DDS keeps jurisdiction) when it:

Title II insured status alerts

If DDS receives a systems-generated alert regarding Title II insured status, telephone the FO to verify status before returning the folder.

SGA issues

  • FOs should resolve SGA issues prior to sending folders to DDS.

  • If DDS receives a case with an unresolved SGA issue or discovers an SGA issue during case development, the DDS should send an electronic assistance request (AR) in eView to the FO requesting SGA development.

B. References

  • DI 81010.030, Certified Electronic Folder (CEF) Exclusions and Limitations

  • DI 81010.085, Transferring Cases in Electronic Disability Collect System (EDCS)

  • DI 81010.100, Electronic Disability Collect System (EDCS) Actions Page

  • DI 81010.140, Processing Field Office (FO) Determinations

  • DI 81020.100C Electronic Assistance Request (AR)


DI 10005 TN 4 - FO Responsibilities - 8/11/2020