Identification Number:
DI 81010 TN 81
Intended Audience:See Transmittal Sheet
Originating Office:ORDP ODP
Title:FO Procedures - Electronic Process
Type:POMS Full Transmittals
Program:All Programs
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. 81, 10/22/2024

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 transmittal resolves a PolicyNet Feedback Atlanta Region submitted highlighting the necessity for running a pre-adjudicative earning commutation (EC) prior to transfer to ensure the Date First Insured (DFI) will propagate into EDCS.

 

Summary of Changes

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

Subsection A, second bullet - Added a requirement to complete a pre-adjudicative earning computation (EC) run prior to transfer

 

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

A. Preparing the CEF for transfer

The Certified Electronic Folder (CEF) is the official folder for the disability case. Do not prepare a paper folder unless one of the exclusions in Certified Electronic Folder (CEF) Exclusions and Limitations - DI 81010.030 applies.

When transferring a CEF in EDCS to the Disability Determination Services (DDS) or to the Office of Disability Adjudication and Review (ODAR), the Claims Representative (CR) must take the following actions:

  • Receipt the application for benefits on the DWO1 screen in MCS and MSSICS;

  • Complete a pre-adjudicative earnings computation (EC) run in MCS so that the Date First Insured (DFI) will propagate to EDCS. If needed, repropagate or complete an Update After Transfer (UAT) for any updates/changes to EDCS;

  • Ensure all EDCS forms are complete and resolve any edits;

  • If a case has been marked as a Compassionate Allowance (CAL) case, determine if full non-medical development is needed;

  • Create eForms that do not require a claimant signature or completion, sign them electronically, and save them to the CEF;

  • Create eForms that do require a claimant signature and completion per eForms DI 81010.115 or Using Form Attestation for Work Activity Reports DI 81010.120, for forms using signature proxy;

  • Handle non-medical evidence per instructions in Storing Non-Medical Evidence in the Electronic Folder (EF) DI 81010.135;

  • Process medical evidence submitted by the claimant per Receiving Medical Evidence in the Field Office (FO) DI 81010.125;

  • Create bar codes for faxing material to the CEF per Faxing Documents into the Certified Electronic Folder (CEF) Using Barcodes DI 81010.090;

  • Annotate EDCS if sending or requesting a paper folder for a prior filing per Paper Folder Indicators (PFIs) DI 81001.020;

  • Ensure a valid, signed and dated SSA-827 (Authorization to Disclose Information to the Social Security Administration) is in the EF (see Field Office Instructions for Obtaining Form SSA-827 DI 11005.057); and

    IMPORTANT: It is imperative to use the correct document type bar code sheet if faxing a wet signed SSA-827 into the EF, before transferring any of the claims on the EDCS case. The Medical Evidence Gathering and Analysis through Health Information Technology (MEGAHIT) system sends the request only when the SSA-827 is in the EF at case transfer or is found within a predetermined time frame. For more information regarding health IT automated requests, see Receiving Evidence in Disability Determination Services (DDS) DI 81020.060

    NOTE: Adult claimants (age 18 or older) signing on their own behalf, child claimants (under age 18) signing on their own behalf, and individuals with the authority to sign on behalf of a child claimant have the option to electronically sign and submit Form SSA-827. For more information about the electronic signature process for Form SSA-827, see DI 11005.056.

  • Control auxiliary claim development on an auto-initiated case via the mainframe development worksheet or Workload Management Information (WMI) listing, or both.

REMINDER: If a case is a CEF exclusion, the official folder is the paper Modular Disability Folder (MDF). Store all documents in the MDF and transfer it to the appropriate component per Statements and Other Documentation GN 00301.285. For further information, see Certified Electronic (CEF) Exclusions and Limitations DI 81010.030.

B. Reviewing the Title II/Title XVI Summary

The Title II/Title XVI Summary page displays the pending EDCS claims, arranged by claim title. To enter or modify claim information, select the Edit Claims button to display the Title II/Title XVI Information page.

The Title II/Title XVI Information page allows you to enter and edit information previously found on the MCS and MSSICS transfer screens. From the Title II/Title XVI Information page, you may enter new data or edit existing data:

  • Claim Type

  • Number Holder’s SSN

  • BIC (Beneficiary Identification Code);NOTE: The BIC can be read-only, or editable, depending on the claim type

  • Study List Code

  • MQGE Subtype

  • Transfer Remarks

  • Litigation Code

C. Transferring the CEF

You must transfer the electronic case in EDCS to ensure:

  • Accurate information is sent to the Disability Determination Services (DDS), the Office of Disability Adjudication and Review (ODAR), or to another FO; and

  • The EDCS record is locked.

Once the EDCS case is locked, FO changes are limited. If the case requires changes after transfer of jurisdiction, use the Update-After-Transfer Utility (see Using the Update-After-Transfer (UAT) Utility DI 81010.095).

To transfer a case in EDCS to DDS, ODAR, or another FO, the transferring FO must take the following steps:

  1. 1. 

    Resolve or override “Always Mandatory for Transfer” edits. For more information about mandatory fields and edits, see Fields and Edits in the Electronic Disability Collect System (EDCS) DI 81010.050.

    NOTE: Mandatory for Transfer edits do not apply if you are transferring the EF to another FO.

  2. 2. 

    Select all the claims to transfer on the EDCS Transfer screen.

    IMPORTANT: If the FO is unable to transfer all of the claims in the case to DDS at the same time on the same day, create a message on the EDCS Routing Form explaining the situation.

  3. 3. 

    Review the transfer destination:

    • For initial claims, you can over key the EDCS transfer destination or select the DDS office code from the drop-down list provided.

    • For appeals, you can over key the EDCS destination.

    • For transfer to another FO, you must enter a destination on the case transfer screen, since EDCS does not provide a default destination.

      NOTE: EDCS does not allow transfer of a claim(s) to a non-fully electronic claim processing DDSs.

  4. 4. 

    Select the appropriate paper folder indicators (PFIs) on the EDCS Transfer screen. For more information about PFIs, see DI 81010.085D in this section and Paper Folder Indicators (PFIs)DI 81001.020;

  5. 5. 

    Enter remarks in the Routing Form Remarks section, if applicable;

  6. 6. 

    Field Office contact information is propagated based on the logged-in user. FO contact information can be over keyed, if applicable;

  7. 7. 

    Select “OK” on the EDCS Transfer screen to transfer the case.

    • EDCS performs an automatic repropagation of mainframe data upon transfer to ensure that EDCS data corresponds to the current mainframe data.

    • An alert generates if EDCS cannot access RPS, MCS, or MSSICS. If this happens, the CR elects to proceed with the transfer or cancels and transfers the case later.

  8. 8. 

    Print and attach the EDCS Routing Form to any material you must mail to the receiving office.

    NOTE: If the case is a CEF Exclusion or if a prior paper folder is involved, attach the EDCS Routing Form to the front of the paper MDF and mail the paper MDF to the receiving office. For more information about the EDCS Routing Form, see DI 81010.087.

  9. 9. 

    Route paper evidence per these instructions:

    • DI 81010.125 Receiving Medical Evidence in the Field Office (FO); and

    • DI 81010.135 Storing Non-Medical Evidence in the Electronic Folder (EF).

D. Establishing paper folder indicators (PFIs) on the EDCS transfer screen

There are two sets of check boxes that appear on the EDCS Transfer Screen under the section labeled “Transfer disability folder to DDS/ODAR.” They are “Current Paper Folder Indicator” and “Prior Paper Folder Indicator.” To complete the PFIs, select the box next to “Transfer disability folder to DDS/ODAR” and select the box next to the appropriate indicator.

1. Current filing

The current filing check box asks, “What type of disability folder has been created?” This indicates whether a paper MDF has been created for the current filing. The available responses are:

a. “A certified electronic folder (CEF)”

Choose this option if all the claims for the case have been established in EDCS, and no other EDCS exclusion exists (e.g., initial disability claim and a Continuing Disability Review (CDR)), and the official folder for the case is a CEF.

b. “An official paper folder”

Choose this option if there is a CEF exclusion or a system limitation requiring creation of a paper folder. See Certified Electronic Folder (CEF) Exclusions and Limitations DI 81010.030.

c. “Not yet answered”

This option pre-fills if the case has not yet been transferred. You cannot transfer the case without choosing one of the options above.

2. Prior filing

The prior filing check box asks, “Are you sending an official paper folder (MDF) from a prior filing? This indicates whether a paper folder for a prior filing is currently available and is being sent to DDS/ODAR. The available responses are:

a. “Yes, sending a paper folder (MDF)”

Choose this option if the FO has the prior paper folder and is sending it to the DDS/ODAR.

b. “No, not sending a paper folder”

Choose this option if a prior paper folder does not exist or if a prior paper folder exists and is not available. If a prior paper folder becomes available at a later time, the receiving component updates the PFI to YES.

c. “Not yet answered”

This option pre-fills if the case has not yet been transferred. You cannot transfer the case without choosing one of the previous options.

E. FO sends SSA-827s to DDS but fails to transfer the EDCS case

Once DDS receives the EDCS Routing Form and SSA-827s from the FO:

  • the case is receipted into the DDS system; and

  • EDCS data is displayed within the DDS case processing screens.

FO failure to transfer jurisdiction of the EDCS case to DDS prevents:

  • EDCS data from propagating into the DDS case processing screens during DDS’s receipt process; and

  • DDS from processing the case electronically until the FO transfers the case to DDS.

NOTE: The FO maintains jurisdiction of the case until case transfer to DDS. The FO can change information in EDCS until the case is transferred. After transfer, the FO can still view the EDCS disability report information via eView.

If DDS determines the FO failed to transfer the case, DDS must contact the FO and ask them to transfer the case.

For more information on DDS procedures, see Electronic Folder Interface (EFI) Download DI 81020.005.



DI 81010 TN 81 - FO Procedures - Electronic Process - 10/22/2024