Identification Number:
NL 00725 TN 34
Intended Audience:See Transmittal Sheet
Originating Office:Systems OIS
Title:Modernized Claims System (MCS) Notices
Type:POMS Transmittals
Program:All Programs
Link To Reference:
 

PROGRAM OPERATIONS MANUAL SYSTEM
Part NL – Notices, Letters and Paragraphs
Chapter 007 – Letters and Paragraphs for Title II, Title XVI, and Title XVIII
Subchapter 25 – Modernized Claims System (MCS) Notices
Transmittal No. 34, 10/18/2021

Audience

PSC: BA, CA, CCRE, CS, DS, ICDS, IES, ILPDS, IPDS, ISRA, NPR, PETE, RECONR, SCPS, TSA, TST;
OCO-OEIO: BET, BIES, BTE, CC, CCRE, CDT, CR, CTE, ERE, FDE, PETL, RECONE, RECONR, RECOVR;
OCO-ODO: BTE, CCE, CR, CST, CT, CTE, CTE TE, DE, DEC, DS, DSE, PAS, PETE, PETL, RCOVTA, RECOVR;
FO/TSC: CS, CS TII, CSR, DRT, DT, FR, OA, OS, RR, TA, TSC-CSR;

Originating Component

OEIS

Effective Date

Upon Receipt

Background

We are updating Program Operations Manual System (POMS) sections in NL.00725.200 effective with Modernized Claims System (MCS) May 21, 2021 release.

The language changes and updates for notices in the attached sections are a direct result of updates requested by the Office of Disability Policy (ODP). These changes are in support of the ALS (Amyotrophic Lateral Sclerosis) Disability Insurance ACT of 2019 clearance package.

Summary of Changes

NL 00725.200 “DIB” UTIs – Disability

We introduce a new UTI, DIB075, in MCS Notices. The UTI explains that, for DIB claims allowed based on a qualified impairment and filing date of July 23, 2020 or later, we do not require the DIB beneficiary to wait five-months before benefits begin.

NL 00725.200 “DIB” UTIs – Disability

DIBC01 Caption

The Date You Became Disabled

DIBC02 Caption

The Basis For Our Decision

DIBC03 Caption

Our Decision

DIB001 5 Month Waiting Period – Month of Entitlement

To qualify for disability benefits,  (1)  must be disabled for five full calendar months in a row. The first month  (2)  entitled to benefits is  (3)  .


Fill-ins:
(1) “you”/“FN”
(2) “you are”/“he is”/“she is”
(3) date of entitlement to disability

DIB002 Lead-in Language for Closed Period and Later Onset Date Allowance

We recently told you that  (1) met the medical requirements to receive Social Security benefits. Now we are writing to tell you that  (2)   (3)  the other requirements. Therefore,  (4)   (5)  for  (6)  beginning  (7) .


Fill-ins:
(1) “you”/FN
(2) “you”/“she”/“he”
(3) “meet”/“meets”
(4) “you”/“she”/“he”
(5) “qualify”/“qualifies”
(6) “period of disability”/“monthly disability benefits from Social Security”
(7) date of entitlement to disability

DIB003 DIB/DWB/CDB Closed Period

We determined that  (1)  disability ended  (2)  . The first month that we could pay  (3)  benefits was  (4)  . We could pay  (5)  through the month  (6)  disability ended and the next two months. This means that the last month for which  (7)  entitled to benefits was  (8)  .


Fill-ins:
(1) FN possessive/”her”/”his”/”your”
(2) effective date (Date beneficiary went into T8/T6 LAF status in the format “Month YYYY”)
(3) ”her”/“him”/“you”
(4) date of entitlement in the format “Month YYYY)
(5) ”her”/“him”/“you”
(6) “her”/“his”/“your”
(7) “she was”/“he was”/“you were”
(8) effective date (Date beneficiary went into T8/T6 LAF status - 3 months in the format “Month YYYY”)

DIB004 State Agency and Medical Doctor Participation in Decision

Doctors and other trained personnel made the disability decision for us. They work for  (1)  State but used our rules to make their decision.


Fill-in:
(1) “your”/FN possessive

DIB005 Medical Doctor Participation in Non-State Decision

Our doctors and other trained personnel made the disability decision in  (1)  case.


Fill-in:
(1) “your”/FN possessive

DIB006 Benefits Payable up to 12 Months before DIB Filing Date

By law, we can pay benefits no earlier than 12 months before the month of filing. Since  (1)  filed for benefits on  (2)  , monthly payments will begin  (3)  .


Fill-ins:
(1) “you”/FN in format “Mr. Jack Jones”
(2) DOF in format “January 10, 1993”
(3) DOEC in format “April 1994”

DIB014 Benefits Terminated – DIB Cessation

The last month for which  (1)   (2)  entitled to benefits was  (3)  .


Fill-ins:
(1) Number holder's name, possessive/your
(2) family was/wife was/husband was/child was/children were
(3) effective date minus one month in format April 1997

DIB015 DDS Staff

The trained staff who decided this case work for the state but used our rules.

DIB075 DIB (NH only) - ALS Legislation - No 5 Month Waiting Period Applies

Benefits based on  (1)  begin the first full month after that date we found  (2)  became disabled. The first month  (3)  entitled to benefits is  (4) .


Fill-ins:
(1) amyotrophic lateral sclerosis (ALS)
(2) Beneficiary Full Name is/you
(3) Beneficiary First name is/you are
(4) Date of Entitlement in format "Month YYYY"

NL 00725 TN 34 - Modernized Claims System (MCS) Notices - 10/18/2021