PROGRAM OPERATIONS MANUAL SYSTEMPart DI – Disability InsuranceChapter 235 – Specific Case InstructionsSubchapter 05 – Title II Child CasesTransmittal No. 4, 10/05/2021
This is a Quick Action Transmittal. No change to the current policy. We are clarifying the existing instructions.
Summary of Changes
DI 23505.001 Disabled Minor Child (DMC) Cases
In subsection E. we added additional clarification that the DDS prepares the notices in all partially favorable and denial cases.
CITATIONS: Public Law (P.L.) 97-35
Spouse’s, mother’s, and father’s benefits end when the youngest child-in-care attains age 16, but child’s benefits continue to age 18, regardless of disability status.
A disability determination for the alleged DMC is necessary to entitle the mother or father to continue to receive benefits. If the DMC continues as disabled at age 18, convert the DMC to childhood disability beneficiary (CDB) status. For a child age 18 or over, the CDB provisions apply. See complete CDB instructions in “Childhood Disability Benefits (CDB)” per DI 10115.000.
When a disability determination is necessary for a child age 15 1/2 to age 18, the field office (FO) sends the case to the disability determination services (DDS) in the state where the child resides. The FO may identify these cases on the SSA-3367 (Disability Report – Field Office) with the remark: “For (Spouse's, Mother's, or Father's) Benefits Only. First possible month of entitlement for mother or father (mm/dd/yyyy).
To determine if a child is under a disability for child-in-care provisions, use the sequential evaluation process applicable to Title II Adult and CDB claims. See “Sequential Evaluation” per DI 22001.000.
At step 3 of the disability evaluation process (Does impairment(s) meet or equal a listing?), consider Part “B” of the listings first. If the child’s alleged impairment(s) does not meet or equal a Part “B” listing, consider the Part “A” listings.
NOTE: The “functional equivalence” policy applicable to Title XVI child cases does not apply to DMC cases, or any other Title II cases. For details, see DI 25225.001.
For Electronic Disability Collect System (EDCS) claims, DDS receives an alert about the electronic claim transfer via the Electronic Folder Interface download and on receipt of the EDCS Routing Form. The FO enters the controlling date into the SSA-3367 (Disability Report – FO). DDS uses this date in development and evaluation for an onset date.
If the established onset date (EOD) is on or before the recommended controlling date, enter the remark, “EOD on or before mm/dd/yyyy” in item 34 of the SSA-831 (Disability Determination and Transmittal).
If the recommended controlling date is a future date, and disability is currently established, enter the remark, “EOD at least (date of
adjudication)” in item 34 of the SSA-831.
A small number of EDCS exclusion cases may use an SSA-831 instead of the EDCS routing form. The controlling date for these cases is located in Item 11 (Remarks). Complete remaining items according to “Completion of Form SSA-831 – Title II, Title XVI and Concurrent Claims” per DI 26510.000.
The DDS prepares the notices in all partially favorable or completely unfavorable disability determinations, the DDS prepares a personalized disability explanation (PDE) in the third person.
For EDCS exclusion cases, forward the paper modular disability folder to the FO with the PDE attachment, and award or disallowance notice, for release.
For more information about preparation and specific content of the notice, see:
“How to Prepare the Notice” per NL 00603.000,
“Electronic Case Closure” per DI 81020.130, and
“Personalized Disability Explanation in Initial Closed Period and Unfavorable Onset Date Allowances” per DI 26530.015.