The procedures are the same as those for initial claims:

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  CEF – Process certified electronic folders according to the instructions in Electronic Disability Collect System (EDCS) Routing Form DI 81010.087; or

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  MDF – Process modular disability folders according to the instructions in Disability Determination Services (DDS) and Social Security Administration (SSA) Jurisdictions – Claimant Moves DI 20101.035B.

When a claimant files for a reconsideration of an initial medical determination, but fails or refuses to complete the necessary forms or to provide additional evidence to support the request, the DDS has jurisdiction and makes a determination based on the evidence in file, as outlined in DI 23007.000 Failure to Cooperate.

NOTE: The FO should make a reasonable effort to complete the appropriate forms (e.g., SSA-3441-F6, SSA-827) and secure supporting evidence before forwarding the reconsideration to the DDS as outlined in DI 81010.150 Processing Claims Appeals of Medical Decisions in Electronic Disability Collect System (EDCS). The DDS is required to follow up on FO requests for required forms by making a new written initial request; DI 22505.014A.

The following sequence of events may occur when the initial determinations were prepared by different DDSs:

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  The claimant files a Title II claim that is denied by the DDS in State A.

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  The claimant moves to State B and files a Title XVI claim that is denied by the DDS in State B.

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  The claimant then requests reconsideration of both denials.

The DDS in the State where the claimant currently resides has jurisdiction for preparing both reconsideration determinations.

If two different DDSs prepare conflicting decisions on two separate claims filed in separate States, the DDS in the State where the claimant currently resides has jurisdiction for reopening and revising any previous determination.

The FO sends the claim to DDS when:

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  An FO reconsideration case needs a medical-vocational determination after resolution of the work issue.

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  An initial denial or CDR cessation was made on the basis of SGA and the FO determines that the claimant or beneficiary was not engaging in SGA. The FO explains on the SSA-821 (Work Activity Report – Employee) why the initial determination is being reversed.

These claims are processed at the initial level by the DDS.

NOTE: SGA evaluation does not apply to Title XVI recipients eligible because of blindness.

Jurisdictional guidelines for the following issues are the same as the guidelines for initial cases:

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  Reconsideration cases for work issues – see Initial and Subsequent Work Issue Cases DI 24001.005.

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  Reconsideration cases where work activity is not SGA – see Initial and Subsequent Work Issue Cases DI 24001.005.

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  Reconsideration cases where SGA has ceased – see Initial and Subsequent Work Issue Cases DI 24001.005.

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  Reconsideration cases where the claimant is currently engaging in SGA and there is a possible closed period – see Initial and Subsequent Work Issue Cases DI 24001.005.

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  Reconsideration cases where there is an alleged visual impairment – see Jurisdiction of Blindness Cases DI 26001.010.

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  Foreign claims – see Social Security Administration (SSA) Jurisdiction According to Geographic Location DI 20101.030B.

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  Claimants in U.S. possessions – see Social Security Administration (SSA) Jurisdiction According to Geographic Location DI 20101.030C.

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  Claimants in Northern Mariana Islands – see Social Security Administration (SSA) Jurisdiction According to Geographic Location DI 20101.030D.

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  Career railroad or RR annuitant cases – see DI 20101.040A.

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  Changed identity cases – see Processing Disability Cases Involving Railroad (RR) Service, Changed Identity, Emergency Clause Agreements, or Unresolved Jurisdiction Cases DI 20101.040B.

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  Emergency clause – see Processing Disability Cases Involving Railroad (RR) Service, Changed Identity, Emergency Clause Agreements, or Unresolved Jurisdiction Cases DI 20101.040C.

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  SGA cases – see Initial and Subsequent Work Issue Cases DI 24001.005.

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