• •

  Enter all claims using MCS, MSSICS, and/or CCE as applicable.

• •

  Take full (not deferred) Title XVI applications.

Follow the normal interviewing guidelines in DI 11005.000 Disability Interviews, which includes recording the information into EDCS.

For instructions on establishing a claim in EDCS and EDCS exclusions, see DI 81010.020 Creating Electronic Disability Collect System (EDCS) Cases.

If you have any doubt as to whether the claim will result in an allowance, it is in the claimant’s best interest to complete an entire SSA-3368-BK (Disability Report – Adult). This action may help to avoid unnecessary re-contact.

If the claimant’s impairment(s) does not meet a presumptive disability category but seems particularly severe, and curtailing completion of the disability report might be appropriate, refer to:

• •

  DI 11005.020 Curtailing Completion of the SSA-3368 (Disability Report-Adult) or the SSA-3820 (Disability Report-Child) Forms

• •

  DI 81010.020F. Curtailing completion of the EDCS 3368 or EDCS 3820

• •

  The appropriate Regional Center for Disability Programs for guidance on curtailment, if necessary.

Department of Defense issues a DD Form 214 for each period of active duty service. It contains important information for claims development.

If the claimant submits a DD Form 214(s), place a copy into the Shared Evidence Screen (EVID) or the Non-Disability Repository for Evidence (NDRed) using the Evidence Portal (EP), or both.

IMPORTANT: To expedite handling of MC/WW claims, do not delay forwarding these claims to the DDS, even when the DD Form 214 is not readily available. Accept the claimant’s allegation that the disability occurred during military service without the DD Form 214 or other documentation.

For additional information, see MS 09701.001 Evidence Portal (EP) - Overview and MSOM EVID 001.002 Shared Processes Menu (SPMN).

Military disability benefits do not offset DIB if all military service is after December 31, 1956. For more information on military disability benefits see DI 52130.015.

Be alert to the possibility of a closed period of disability. Based on the evidence, a disability adjudicator may find that the claimant was disabled for a continuous period of at least 12 months, but at the time of adjudication the claimant is no longer disabled. In order to establish a closed period, the evidence must show a period of disability that has a definite beginning and ending date. In this situation, if they meet all other requirements, the claimant may be entitled to a closed period of disability.

For additional information on closed period of disability, see DI 25510.010 Closed Period Under Title II and DI 25510.015 Closed Period Under Title XVI.

Evaluating a closed period of disability always requires careful consideration of the medical improvement review standard. Additionally, adjudicators cannot establish a closed period of disability based on a finding of SGA alone, as the claimant may be entitled to work incentives. For return to work issues, see DI 13010.110 Return to Work.

When appropriate, develop for an earlier POD. The POD may be the same, earlier or later than the alleged onset date (AOD). When evaluating a claimant’s work, make sure to consider work incentives (e.g., IRWEs, subsidies, special conditions) when determining the reasonable worth of the work. When the POD is earlier than the AOD, develop and document any work issues after the AOD, or after the POD, using form SSA-821-BK (Work Activity Report – Employee), or the SSA-820-BK (Work Activity Report – Self-Employment).

Complete the SSA-823 (Report of SGA Determination-For SSA Use Only) in all initial claim determinations that require an SSA-820-BK or SSA-821-BK.

For more information on completing work activity reports and claims development, see:

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  DI 10505.035 Documenting Employment Cases Using the SSA-821-BK (Work Activity Report-Employee) and the SSA-823 (Report of SGA Determination-For SSA Use Only),

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  DI 10510.025 Documenting Self-Employment Cases Using the SSA-820-BK (Work Activity Report-Self-Employment) and the SSA-823 (Report of SGA Determination- For SSA Use Only),

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  DI 10005.005 Field Office (FO) Disability Development, and

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  DI 11005.045 Completing the Paper Form SSA–3367–F5 (Disability Report-Field Office)

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  Establish a UNIT code of “___XRQ” on the MCS DW01 screen or CCE Development Worksheet page for claimants who meet the MC/WW definition in DI 11005.003A.1.

  Use the first three characters of the unit code per local instructions (e.g., unit number, initials).

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  Establish an ISSUE of “MC/WW” to track the case.

Establish a listing code of 108 (for a list of the codes see GN 01040.100).

When sending an MC/WW claim to the DDS, take the following steps:

1. a. 

   EDCS claims: Annotate the EDCS remarks section with the words “Military Casualty/Wounded Warrior Case.” For instructions on transferring a EDCS case, see DI 81010.085 Transferring Cases in the Electronic Disability Collect System (EDCS).

2. b. 

   EDCS exclusions: Send the paper case in a priority mail envelope with a “Military Casualty/Wounded Warrior Case” designation on the outside of the envelope. For a listing of EDCS exclusions and limitations, see DI 81010.030 Certified Electronic Folder (CEF) Exclusions and Limitations.

Obtain a DDS Query (DDSQ) two days after the claim is transmitted to verify DDS received the claim. For paper cases, obtain a DDSQ seven days after the claim is transmitted. If the claim is not on the DDSQ, contact the DDS by email or fax to verify receipt.

Complete and add the MC/WW flag to the front cover of the claims paper folder. (See an exhibit of the flag in DI 11005.006I in this section.)

1. a. 

   Reconsideration request process: Refer to DI 12005.005 Processing a Reconsideration Request for a Medically Denied Initial Disability Claim, and DI 12005.010 Processing a Reconsideration Request for an Initial Non-Medical or Technical Denial.

2. b. 

   Hearing request process: Follow assembly and routing instructions in DI 12010.010 Assembly and Routing of Folders for Administrative Law Judge (ALJ) Hearing.

3. c. 

   Request for Appeals Council (AC) review: Follow instructions in DI 12020.001 Appeals Council (AC) Review.