Effective Dates: 09/08/2015 - Present Previous | Next

TN 38 (09-15)

DI 28030.005 Identification of Concurrent Title II/Title XVI Cases

A. Concurrent case handling

The Office of Earnings and International Operations-Office of Disability Operations (OEIO-ODO) and the program service centers (PSC) house the Title II paper folders for concurrent (Title II/ Title XVI) claims. The National Records Center (NRC) houses Title XVI paper folders. All electronic folders (EFs) are maintained in the electronic disability collect system (EDCS).

If a continuing disability (CD) event arises that warrants development, the field office (FO) will conduct a personal interview and transmit, or forward, the case to the disability determination services (DDS). For electronic continuing disability reviews (eCDR), the FO must forward any paper folder(s) associated with the case to the DDS as well.

NOTE: The FO will not conduct a personal interview on MINE (medical improvement not expected), or MINE-equivalent cases. For more information, see DI 28040.005.

In most concurrent (Title II/Title XVI) cases, an event that raises an issue of ability to engage in substantial gainful activity (SGA) under one title will also raise the same issue under the other title. When such an event occurs, the DDS receives the case for a continuing disability determination under each title.

If DDS receives a Title II case containing an SSI2 query, but the Title XVI material is not included, it is usually not necessary to obtain the Title XVI file. However, the DDS may request the paper Title XVI folder if it finds that additional documents or evidence are needed and this information may be contained in the Title XVI folder.

NOTE: Before proposing a cessation on a conversion case, the DDS should obtain the State Welfare Agency (SWA) records, if possible. Local conditions may require regional office guidelines on securing SWA records. For more information on conversion cases, see DI 23525.001.

In concurrent (Title II/Title XVI) cases involving a common issue (e.g., a medical issue), the DDS makes determinations simultaneously under both titles. Therefore, when there is a Title II cessation, but the Title XVI CD issue is unresolved, make all efforts to resolve the Title XVI issue so the determinations can be processed simultaneously.

B. DDS receipt of the concurrent case

1. The Certified Electronic Folder (CEF)

When the DDS receives an eCDR, the disability examiner (DE) must review the eView:

  • •

    “Case Data” tab for “CDR Dates/Types” to determine the type of case(s) involved and the reason for referral.

  • •

    “Case Documents” tab for Form SSA-5002 (Report of Contact) with relevant case information.

  • •

    “Alerts & Messages” tab for other information that may impact case development.

2. The Modular Disability Folder (MDF)

Every “paper” case folder should contain:

An SSI query when the FO conducted a personal interview.

A Form SSA-5002 stating whether the case involves Title II only (including a rationale for that decision, if necessary) or if Title XVI is involved (either Title XVI only or concurrent), and whether the case is a conversion case.

3. Review of the folder(s)

In identifying concurrent cases, the DDS reviews the content of the SSI query and any SSA-5002 in file. Any conflict should be resolved with the FO prior to the preparation of a determination. If an SSI query is not in file, the DDS must obtain a query prior to developing the CD issue. The DE should make a determination on all referred claims.

To Link to this section - Use this URL:
http://policy.ssa.gov/poms.nsf/lnx/0428030005
DI 28030.005 - Identification of Concurrent Title II/Title XVI Cases - 09/08/2015
Batch run: 07/10/2019
Rev:09/08/2015