Identification Number:
EM-20060
Intended Audience:RC/ARC/AD/FO/WSU/PSC/OCO/OCO-CST/DDS/OQR/OHO/OAO
Originating Office:ORDP ODP
Title:Disability Cases with an Allegation of Coronavirus Disease (COVID-19) as a Medical Condition
Type:EM - Emergency Messages
Program:Disability
Link To Reference:See Reference at the end of this EM.
 
Retention Date: 06/17/2021

A. Purpose
      This Emergency Message (EM) provides instructions for processing and flagging electronic disability cases when a person alleges Coronavirus Disease (COVID-19) as a medical condition, or when we discover a person has a medically determinable impairment (MDI) of COVID-19.

    B. Background
        Coronavirus Disease 2019 (COVID-19) is an infectious disease caused by a newly discovered coronavirus. COVID-19 symptoms can range from no symptoms to severe illness. While COVID-19 is primarily a respiratory disease, emerging data suggest that it may also lead to cardiovascular, renal, dermatologic, neurological, psychiatric, or other complications. For more information, see Long-Term Effects of COVID-19 | CDC. Older adults and people of any age with underlying medical conditions, including, but not limited to, diabetes, heart and lung disease, chronic kidney disease, cancer, and obesity, may be at increased risk for more severe illness. For more information, see People with Certain Medical Conditions and Risk for Severe COVID-19 Illness | CDC. COVID-19 is a new disease and the medical community is still learning about the severity of the illness and its long-term effects.

      C. Processing Instructions
          We created the COVID-19 flag exclusively for the purposes of identification, tracking, and data collection. All components should follow normal case processing procedures for cases when a person alleges COVID-19 as a medical condition, or we discover a person has an MDI of COVID-19. Special handling is not required for cases involving COVID-19 unless the case qualifies for priority processing per DI 23020.001.

        D. Flagging Instructions
            We will apply the COVID-19 flag to all electronic cases when a person alleges COVID-19 as a medical condition, or when we discover a person has an MDI of COVID-19. We will not flag paper cases for COVID-19 because we are using the COVID-19 flag for management information purposes only.

            If the COVID-19 flag is added to a case and the evidence does not establish an MDI of COVID-19 per DI 24501.020A, remove the flag. For example, a person alleges COVID-19 as a medical condition, however the medical evidence indicates a false positive test. Follow the steps in DI 81010.080B.3. or DI 81020.085D. Document the reason for the removal in a message in the Electronic Disability Collect System (EDCS) or eView.

            IMPORTANT: Do not add the COVID-19 flag for other reasons related to the COVID-19 pandemic, such as when a person alleges he or she is medically at high risk for COVID-19 or unable to work due to increased risk for COVID-19.

            1. Field Office (FO) and Workload Support Unit (WSU) Instructions
              If a person alleges COVID-19 as a medical condition, take the following steps:
                · For a new initial claim, request for reconsideration, request for a hearing, request for Appeals Council review, or a continuing disability review (CDR), add the COVID-19 flag in EDCS prior to transfer per DI 81010.080B.1.b.
                · For cases already transferred, add the COVID-19 flag in eView per DI 81010.080B.1.a.
            2. Disability Determination Services (DDS) Instructions
              If the FO did not flag a case with an allegation of COVID-19 or the DDS discovers a person has an MDI of COVID-19:
            3. Office of Quality Review (OQR) Instructions
              OQR will verify that the COVID-19 flag is in eView.

              If the FO or DDS did not flag a case with an allegation or MDI of COVID-19, or OQR discovers a person has an MDI of COVID-19:
            4. Office of Hearing Operations (OHO) Instructions
                OHO will verify that the COVID-19 flag is in eView. OHO will also add the CVMI - COVID-19 Medical Impairment case characteristic in the Case Processing and Management System (CPMS) or the Hearings and Appeals Case Processing System (HACPS).

                If the FO or DDS did not flag a case with an allegation or MDI of COVID-19, or OHO discovers a person has an MDI of COVID-19:
                  · Add the COVID-19 flag in eView per Standard Hearing Operations Procedure (SHOP) 1.4.2.10 and
                  · Add the CVMI - COVID-19 Medical Impairment case characteristic in CPMS or HACPS.
              5. Office of Appellate Operations (OAO) Instructions
                  OAO will verify that the COVID-19 flag is in eView and the CVMI - COVID-19 Medical Impairment case characteristic is in the Appeals Review Processing System (ARPS).

                  If the FO, DDS, or OHO did not flag a case or add the case characteristic with an allegation or MDI of COVID-19, or OAO discovers a person has an MDI of COVID-19:
                    · Add the COVID-19 flag in eView per DI 81010.080B.1.a., and
                    · Add the CVMI - COVID-19 Medical Impairment case characteristic in ARPS.
              Direct all program-related and technical questions to your Regional Office (RO) support staff or Processing Service Center (PSC) Operations Analysis (OA) staff. RO support staff or PSC OA staff may refer questions or problems to their Central Office contacts.

              OQR personnel should direct questions to their local management.

              OHO personnel should direct questions to local management. OHO managers may seek guidance from the RO. RO managers may refer questions or unresolved issues to the Division of Field Procedures in the Office of the Chief Administrative Law Judge.

              OAO personnel should direct any program-related or technical questions to the Executive Director’s Office.

              References:
              DI 23020.001 Priority Cases
              DI 24501.020 Establishing a Medically Determinable Impairment (MDI)
              DI 81010.080 Alerts, Flags, and Messages in the Electronic Disability Collect System (EDCS)
              DI 81020.085 Certified Electronic Folder (CEF) Flags
              EM-20060 - Disability Cases with an Allegation of Coronavirus Disease (COVID-19) as a Medical Condition - 12/16/2020