TN 4 (12-09)

DI 20101.015 Social Security Administration (SSA) and Disability Determination Services (DDS) Jurisdictions- Continuing Disability Cases

A. DDS jurisdiction for medical continuing disability review (CDR) cases

The following components generally send CDR cases to the DDS in the State where the claimant resides:

  • Office of International Operations (OIO)

  • Program Service Center (PSC)

  • Field Office (FO)

If the claimant moves to another State or to a foreign country, the DDS that received the case from SSA transfers the case to the DDS in the State where the claimant now resides, or to the OIO, if the claimant moves to a foreign country. If a beneficiary receives benefits under a primary number holder (NH) who has a foreign address, the OIO has jurisdiction.

To transfer a case:

  • Certified electronic folder (CEF) – see Electronic Case Routing Before Final Determination DI 81020.125.

  • Modular disability folder (MDF) – see Disability Determination Services (DDS) and Social Security Administration (SSA) Jurisdictions – Claimant Moves DI 20101.035B.3.

For instructions on transfers due to a claimant moving within or outside of the U.S., see Social Security Administration (SSA) Jurisdiction According to Geographic Location DI 20101.030.

For jurisdiction instructions on DQB returns case to DDS and the claimant moves, see DI 20101.035C.9.

NOTE: If a cessation is being considered for an individual who received aid for at least one month prior to 07/73 (non-rollback conversion case), the State whose plan applies takes jurisdiction of the case for the final cessation decision.

B. SSA jurisdiction for CDR

Jurisdiction guidelines for CDRs in the following areas are the same as the guidelines for initial claims:

C. Processing continuing disability work-issue cases

In cases where the beneficiary with a Title II claim is working, the FO:

  • Prepares a determination on the work activity, regardless of whether the beneficiary is engaging in SGA;

  • Screens and reviews the case to ensure that a medical CDR is appropriate;

  • May forward the CDR to the DDS, when appropriate.

The DDS has jurisdiction of cases where work is determined not to be SGA, and may also have jurisdiction of some cases after an Extended Period of Eligibility (EPE). For additional information on the jurisdiction after an EPE, see Extended Period of Eligibility (EPE) DI 28055.000.

1. FO determines work is not SGA (Title II)

If the FO concludes that the work activity is not SGA and the medical CDR is applicable, then DDS has jurisdiction. The FO then:

  • Records the work information on an SSA-821(Work Activity Report – Employee) or SSA-820 (Work Activity Report – Self-Employed Person) using eWork; and

  • Uploads or faxes the form to the CEF.

When you add an eForm to the CEF or fax a document to eView after the case has been transferred to the DDS, an alert in eView notifies the DDS that the CEF has been updated.

NOTE: For Electronic Disability Collect System (EDCS) exclusions/limitations, or non-CEF cases that have been entered into the Electronic Disability Collect System (EDCS), the FO forwards the completed form to the DDS.

2. FO determines work is SGA (Title II)

The DDS has jurisdiction for cases where the FO has determined that work is SGA if:

  • New and material evidence or a statement of ability to engage in SGA is received from the claimant; or

  • There is a medical improvement expected (MIE) diary.

For additional instructions see, Initial and Subsequent Work Issue Cases DI 24001.005 and Effect of SGA on Disability Status DI 24001.010.

D. Section 1619 cases where a CDR is required

The DDS processes Section 1619 CDR cases in accordance with the procedures in Overview of the 1619 CDR DI 28075.600. For additional jurisdictional guidance and case processing policies, see Failure to Cooperate-Insufficient Evidence Decision (FTC) DI 13015.001 and Whereabouts Unknown (WU) Policy for a CDR- FO DI 13015.011 – .

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DI 20101.015 - Social Security Administration (SSA) and Disability Determination Services (DDS) Jurisdictions- Continuing Disability Cases - 12/08/2009
Batch run: 10/29/2019