Following are two claim situations involving a claimant moving to or from Puerto Rico
or the Virgin Islands:
SITUATION #1 – Claimant files in U.S.
Claimant files a Title XVI-only or concurrent Title II and Title XVI claims in the
U.S., and then moves to Puerto Rico or the Virgin Islands before or after transmittal
to a U.S. DDS.
FO action – U.S. FO actions
If retroactive benefits would be payable:
-
1.
Annotate the disability file showing claimant's change of address. (If a transmittal
was already done, notify the DDS of record about the change of address.)
-
2.
Send the medical portion to the U.S. DDS (if not already done).
-
3.
Send an informational Report of Contact (RC) to the Puerto Rico or the Virgin Islands
FO to notify them of the current claim situation.
-
4.
When the DDS returns the disability determination:
If the determination is an allowance:
-
•
Retain the Title XVI file.
-
•
Route Title II (for concurrent claims) to ODO or to the appropriate PC (following
existing instructions).
-
•
Send copies of the SSA-831(s) (Disability Determination and Transmittal) to the Puerto
Rico or the Virgin Islands FO.
If the determination is a denial:
-
•
Retain Title XVI or concurrent Title II and Title XVI file.
-
•
Send copies of SSA-831(s) to the Puerto Rico or the Virgin Islands FO.
FO action – Puerto Rico FO Actions
Retain the SSA-831(s) sent by the U.S. FO.
DDS action – U.S. DDS Actions
-
•
Retain jurisdiction for both claim(s).
-
-
•
Route to the FO servicing the first U.S. address.
SITUATION #2 – Claimant files in Puerto Rico or the Virgin Islands
Claimant files for Title II in Puerto Rico or the Virgin Islands, then moves to the
U.S. and files for SSI.
FO action – U.S. FO Actions
-
1.
Call Puerto Rico or Virgin Islands FO to ascertain the status of the Title II claim.
-
2.
Allowance - If a Title II disability allowance determination has been made and it is a paper
claim:
-
•
Request a copy of the Title II SSA-831 and the SSA-250 (Development Worksheet) verifying
the allowance.
-
•
Adopt the Title II determination and make necessary Title XVI payment input.
-
3.
Denial
-
•
Request that the Puerto Rico or the Virgin Islands FO send the folder to the U.S.
FO.
-
•
Send the Title II denial file with the Title XVI disability/blindness material to
U.S. DDS for a Title XVI determination.
-
4.
If the Title claim is still pending:
-
•
Request the Puerto Rico or the Virgin Islands FO to notify the U.S. DDS of the situation
and request an expedited determination.
-
•
When the Puerto Rico or the Virgin Islands FO does make the disability determination,
follow the steps in FO action – U.S. FO actions, Step 2 (for an allowance) or Step
3 (for a denial).
U.S. DDS action
Adjudicate the Title XVI claim, adopting Title II denial (if indicated).
Puerto Rico - DDS action
May transfer jurisdiction of the Title II claim to the DDS where the claimant currently
resides.
NOTE: If the Puerto Rico DDS does transfer jurisdiction of the Title II claim to a U.S.
DDS, the Puerto Rico DDS notifies the U.S. FO.