Identification Number:
DI 81010 TN 25
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. 25, 10/04/2019

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. These revisions do not change or introduce new policy or procedure.

Summary of Changes

DI 81010.210 Electronic Continuing Disability Review (eCDR) Exclusions

Clarified introductory text.

Added sections C and D to enhance clarity. The information in these sections was copied directly from DI 81010.030.

DI 81010.210 Electronic Continuing Disability Review (eCDR) Exclusions

Most Continuing Disability Review (CDR) cases can be processed electronically, however there are CDR cases still processed as Electronic Disability Collect System (EDCS) exclusions. See DI 81010.030 for more information on EDCS exclusions.

A. Beneficiaries without Social Security Numbers (SSN)

Some auxiliary and survivor beneficiaries may not have their own Social Security Numbers (SSNs). These individuals never filed for SSNs and are receiving Child Disability Benefits (CDB) or Disabled Widows Benefits (DWB) on other wage earners’ SSNs. Process cases for beneficiaries without their own SSNs using paper CDR procedures.

B. Processing Electronic Continuing Disability Reviews (eCDRs) With Pending Claims

Beneficiaries may become eligible for another benefit (e.g. SSI recipient attains insured status for Title II benefits) while currently receiving disability payments. If a beneficiary files for another benefit and is selected for a CDR, the Field Office (FO) must process both as Certified Electronic Folder (CEF) Exclusions with paper folders. If possible, the FO should establish the new claim in EDCS. Follow the procedures outlined in Certified Electronic Folder (CEF) Exclusions - DI 81010.030C.

FO Processes New Claim and Initiates CDR at the Same Time

  1. 1. 

    Enter the new claim on the Modernized Claims System (MCS)/Modernized Supplemental Security Income Claims System (MSSICS) mainframe systems;

    NOTE: Certain Childhood Disability Beneficiary (CDB) and Disabled Widow Beneficiary (DWB) cases do not require establishment of an MCS claim prior to creating an EDCS case. For more information on conversion cases see Childhood Disability Benefits (CDB) General - RS 00203.080 and DI 81010.020B.

  2. 2. 

    Initiate the CDR on the Disability Control File (DCF);

  3. 3. 

    Enter the SSA-3368 and SSA-3367 in EDCS;

  4. 4. 

    Obtain SSA-454 to capture any information not on the 3368 and SSA-827s. Place the SSA-454 and SSA-827s in the Comparison Point Decision (CPD) folder;

  5. 5. 

    Create a paper Modular Disability Folder (MDF) for the new claim. Staple the new MDF to the CPD folder. Form more information on creating a MDF see, General Overview of the MDF DI 70005.005;

  6. 6. 

    Transfer the claim and CDR on MCS/MSSICS/DCF;

  7. 7. 

    Add message to EDCS and the routing form: “CEF exclusion- initial claim filed with CDR/Age 18 redetermination. Initial claim entered in EDCS”;

  8. 8. 

    Transfer the claim in EDCS. On EDCS Transfer screen, select “Paper folder has been created for this filing” and “Prior paper folder attached”;

  9. 9. 

    Attach EDCS route slip to paper folders and send to DDS;

  10. 10. 

    Mail the paper folder to the Disability Determination Services (DDS).

CDR Pending and New Claim Filed

If the FO conducts an interview and discovers that an eCDR is pending at the DDS or Office of Quality Performance (OQP), process as follows:

  1. 1. 

    Enter the new claim on the MCS/MSSICS mainframe systems;

    NOTE: Certain Childhood Disability Beneficiary (CDB) and Disabled Widow Beneficiary (DWB) cases do not require establishment of an MCS claim prior to creating an EDCS case. For more information on conversion cases see Childhood Disability Benefits (CDB) General - RS 00203.080 and DI 81010.020B.

  2. 2. 

    Complete the SSA-3368, SSA-3367 on paper and obtain signed SSA-827s;

  3. 3. 

    Create a paper MDF. Form more information on creating a MDF see, General Overview of the MDF DI 70005.005;

  4. 4. 

    Transfer the claim on MCS/MSSICS mainframe systems;

  5. 5. 

    Attach SSA-408, route slip to the paper folder with a remark “Associate with eCDR transferred on mm/dd/yyyy. Convert eCDR to paper per Certified Electronic Folder (CEF) Exclusions - DI 81010.030 and Electronic Claims Receipt Process - DI 81020.015C. Please update the PFI for CDR claim to reflect change to paper folder processing.”

  6. 6. 

    Route the paper folder to the Disability Determination Services (DDS).

Claim Pending and CDR Initiated

If an initial/reconsideration/appeal is pending at the DDS or ODAR and a CDR comes due:

  1. 1. 

    Initiate the CDR in DCF.

  2. 2. 

    Obtain the SSA-454 or SSA-3368 for age 18 redeterminations, and SSA-827s.

  3. 3. 

    Transfer the CDR to the applicable office via the DCF.

  4. 4. 

    Prepare a paper MDF for the initial claim. Print sections A - D and file in the paper folder. Form more information on creating a MDF see, General Overview of the MDF DI 70005.005;

  5. 5. 

    Attach SSA-408, route slip to the paper folder with a remark “Associate with EDCS case transferred on mm/dd/yyyy. Convert to paper per Certified Electronic Folder (CEF) Exclusions - DI 81010.030 and Electronic Claims Receipt Process - DI 81020.015C. Please update the PFI for claim to reflect change to paper folder processing.”

  6. 6. 

    Mail the paper folder to the DDS/ODAR office.

C. Expedited Reinstatement (EXR) Cases

Although EDCS supports electronic continuing disability reviews (eCDRs), EXRs remain EDCS exclusions. Software changes and an updated business process are required before EXR cases can be correctly processed using EDCS in the eCDR process.

D. Statutorily Blind Determination Cases

During a work CDR, a beneficiary may allege having a visual impairment. These statutorily blind determination cases are EDCS exclusions. Though these cases are processed as CDRs, the DDS must make an initial statutorily blind determination. Software changes are needed to process these cases in EDCS. For paper processing procedures, see DI 13010.135.


DI 81010 TN 25 - FO Procedures - Electronic Process - 10/04/2019