Identification Number:
DI 81010 TN 28
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. 28, 10/25/2019

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 81010.100 Electronic Disability Collect System (EDCS) Actions Page

Updating the link to EDCS Action Items.

DI 81010.100 Electronic Disability Collect System (EDCS) Actions Page

A. EDCS Actions Page - Overview

The EDCS Actions Page alerts the Field Office (FO) if FO action is needed on a Certified Electronic Folder (CEF) due to actions taken by the component with jurisdiction (e.g., Disability Determination Services (DDS), Office of Hearings Operations (OHO), Disability Processing Branch (DPB), Office of Quality Review [OQR]). The two types of alerts that appear on the EDCS Actions Page are:

  • Electronic Assistance Requests (ARs); and

  • Action Items (AIs).

1. Accessing the EDCS Actions Page

The EDCS Actions Page is the first page that appears after opening EDCS for the first time each day. To return to the actions page at any time, select the “EDCS Actions” link on the Disability Case Selection Screen.

2. Viewing ARs and AIs

ARs and AIs can be sorted and viewed by:

  • Office;

  • Unit code;

  • Date of the AR or AI; or

  • A combination of the three.

3. Assigning ARs and AIs

When a new AR or AI is received, it is automatically:

  • Assigned to the unit code propagated from the mainframe; and

  • Stored in the EDCS database.

The unit code updates only when information is re-propagated from the mainframe during:

  • Case transfer;

  • Update-After-Transfer (UAT);

  • Manual re-propagation done by the user.

ARs and AIs can be:

  • Reassigned to another unit; or

  • Transferred to another office.

NOTE: Items may appear without a unit code assigned or with a unit code that is not used in that particular office. A member of FO management, or other designated person, must review EDCS Actions Page daily to assign ARs and AIs that:

  • Do not have a unit code; or

  • Have a unit code that is not used by anyone in that office.

B. Assistance Requests (ARs)

  • Are performed when one component contacts another for assistance while still retaining full jurisdiction of the case; and

  • May be sent or received from any office processing CEFs.

EXCEPTION: FOs can receive, but cannot initiate ARs.

NOTE: Many DDS case processing systems do not have full electronic AR functionality. These DDSs cannot accept or reject jurisdiction, cancel, close, transfer, or follow-up using the AR Electronic Folder Interface (EFI) transactions. However, these DDSs can still request and respond to electronic ARs.

DDSs with the Modernized Integrated Disability Adjudication System (MIDAS) software (CA, DE, AK, and MO) are able to perform all AR functions. To determine which other DDSs have full AR functionality, contact your Regional Office (RO) or local support staff.

The EDCS Actions Page lists ARs from DDS, OQR, or OHO. The FO user can:

  • Request a list of all ARs for the office; or

  • Refine the search by unit code and date.

1. AR Status on the EDCS Actions Page

The status of an AR appears on the EDCS Actions Page as:

  • “Transaction in progress” – Indicates that the AR has been accepted by the FO and the action is sent to the Electronic Folder Interface (EFI);

    NOTE: As all DDS legacy systems do not have the latest software to support ARs, requests that have been accepted cannot be closed out or transferred to another office. The ARs show up as “Transaction in Progress”. Central Office is aware of this problem and is working on a resolution. Regional Offices will alert FOs as to when this problem will be resolved.

  • “Not yet accepted” Indicates that the AR has not been “accepted” or “transferred” by the FO user;

  • “Pending” – Indicates that the transaction has been processed through EFI and the FO can take any action necessary to complete the AR.

NOTE: If the FO transfers the AR to another office/component, the AR will no longer appear on the actions page.

2. Taking Action on ARs

NOTE: If the DDS requesting assistance does not have the full AR functionality, the FO must add a message to eView when:

  • Rejecting the AR back to the DDS;

  • Transferring the AR to another office; or

  • Closing the AR.

To process the AR, the FO must do one of the following:

  • Accept the AR – The FO then has the ability to work the request and then close it;

  • Reject the AR – The requesting office is notified that the FO has rejected the request and is given the reason why it was rejected;

  • Transfer the AR – If the AR was misrouted or if jurisdiction of a claim moved to another area, transfer the AR to the appropriate FO. Transferring the AR moves it to the new office’s actions page and removes it from the original actions page. The requesting office is alerted of the transfer; or

  • Close the AR – The FO closes the AR once all necessary actions have been taken and/or all documentation has been added to the CEF. The FO can select:

    • To close the request (with comments); or

    • “Could not complete request” which requires entry of the reason why the AR could not be completed.

      NOTE: When the AR is closed, the initiating office receives notification that the AR is closed.

3. Requesting Office Cancels the AR

The office requesting the AR may cancel the request either before or after the AR has been accepted. When the AR is cancelled:

  • All previous transactions displayed for that request are removed from the Assistance Request History section in eView; and

  • An AI appears on the EDCS Actions Page notifying the FO the AR was cancelled.

C. Action Items (AIs)

AIs are shown on the EDCS Actions Page to alert the FO of:

  • Actions involving movement of the case (e.g., allowances, denials, rejected claims, and other case transfers routed to the FO); and

  • Messages added to the CEF by the office of jurisdiction.

NOTE: For a list of actions that appear in the action item section, refer to the EDCS Action Items list.

D. FO Action on DDS Special Notice Instructions

All special instructions previously listed on a paper routing form by DDS, such as an SSA – 408 (Route Slip), are now sent to the FO via ARs and AIs on the EDCS Actions Page. When special notice language is required, the DDS:

  • Inputs any special notice language into the CEF; and

  • Notifies the FO via a CEF message, which appears on the EDCS Actions Page, that there is special language the FO must include in the notice to the claimant.

NOTE: The special notice language will be included in the message or in a document added to the CEF.

If the FO is not releasing a cover letter in addition to the DDS prepared notice, the FO must:

  • Print the DDS notice;

  • Date stamp the notice;

  • Prepare a barcode cover sheet; and

  • Fax the notice into the CEF per Faxing Documents into the Certified Electronic Folder (CEF) Using Barcodes - DI 81010.090.

E. FO Action on Claims Rejected by OHO

OHO can take an action to reject jurisdiction of a case and send it back to an FO through the Case Processing Management System (CPMS). This action triggers a reject message of “Claim Rejected to FO” on the EDCS Actions Page and “Reject” on the eView Claims Action History Page. In concurrent claims, when OHO finds that the claim should include only one program, they reject the incorrect Title II or Title XVI claim per OHO’s Electronic Business Process.

NOTE: FO staff do not make a determination on hearing level cases nor manually clear the rejected claim in concurrent claims. In concurrent claims, when OHO rejects one claim but keeps the other, the FO cannot manually clear the rejected claim because a manual clearance closes both claims rather than just the rejected claim.

When the FO receives an AI from OHO rejecting jurisdiction of a case in a concurrent claim, the FO must:

  • Review the action item on the EDCS action page and determine why OHO rejected the claim;

  • Submit a vHelp request to allow RO staff to open a CAPRS ticket to close the rejected claim. When Systems closes the rejected claim, its status displays as “Transferred” and a message of “CO System Adjustment” is on the Claims Action History Page;

  • If the rejected claim’s next level of review is reconsideration, but the claimant submitted a request for hearing in error, process the claim per the instructions in GN 03103.120 and SI 04030.020.

F. Trailer Mail Requiring FO Action

If the DDS receives any trailer mail that requires FO action, DDS:

  • Scans the material into the CEF (the contract scanner may also scan the material); and

  • Contacts the FO if action is needed.

EXAMPLES: An appeal request misrouted to DDS, or an address change received after DDS closure.

G. DDS Processes a “No Determination” (ND)

DDS processes an ND when:

  • The current DDS does not need a medical decision; or

  • DDS is processing a reopening.

The ND:

  • Appears on the EDCS Actions Page as a “Transfer” or “TR”;

  • Does not close the EDCS case.

To determine why the DDS input the “TR” so that appropriate action can be taken on the case, the FO must:

  • Open eView; and

  • Review the messages and/or documents in file (e.g., SSA-831, SSA-5002, DDS worksheet).

NOTE: A “TR” received on the Actions Page does not always mean that a medical decision is not needed on the case or that MCS/MSSICS should be closed out.

There are three common scenarios where an ND is input by DDS:

1. No Medical Decision Needed

DDS makes a decision that:

  • DDS processing should stop; and

  • A medical decision is no longer required.

DDS may determine that no medical decision is needed if they are notified that the claimant:

  • Has died;

  • Has returned to work; or

  • Withdraws the claim.

The FO must:

  • Evaluate the DDS reason and determine if additional action is needed (i.e., evaluate work activity (SGA), claimant requested withdrawal of claim, etc.);

  • Input a FO Determination in EDCS (see Processing Field Office (FO) Determinations - DI 81010.140); and

  • Close out MCS and/or MSSICS as appropriate by following current instructions for each title.

    Refer to the following references for close out procedures:

    • For MCS: FO Action on Return of Title II Disability Determination from DDS - DI 11010.075, Title II Technical Denials, and Claims Not Requiring a Disability Determination

    • For MSSICS: Adjudicating Supplemental Security Income (SSI) Claims—General - SI 00601.080

NOTE: If DDS prepares the ND because the claimant has returned to work, the FO must determine whether the work is SGA before closing the EDCS claim. If the work is SGA, see Processing Field Office (FO) Determinations DI 81010.140. If the work is not SGA, transfer the EDCS claim by UAT back to the DDS for a medical decision.

2. DDS Transfers the Claim to another DDS

In this scenario, a medical decision is still needed when a DDS transfers the case to another DDS. The DDS adds a message to the CEF to document the case transfer to another DDS.

Upon receipt of the alert for the message, the FO must:

  • Check eView for a message regarding case transfer, change of address, etc.;

  • Input new address information into MCS and/or MSSICS as appropriate; and

  • Transfer the claims in MCS and/or MSSICS to the appropriate office using current procedures.


DI 81010 TN 28 - FO Procedures - Electronic Process - 10/25/2019