An SSI claim may occur in combination with one or more of the existing Title II disability (Disability Insurance Benefits (DIB), Disabled Widow(er) s Benefits (DWB), Childhood Disability Benefits (CDB)) and/or non-medical categories. A Title II non-medical claim is processed in the usual manner. Check Modernized Claims Systems (MCS), Master Beneficiary Record (MBR), Modernized Supplemental Security Income Claims System (MSSICS) and Supplemental Security Record (SSR) for a previously filed Title II disability claim, verify the status of any prior claims and provide information which may be necessary in completing the current action.

When sending the file to Disability Determination Services (DDS) for a medical decision for official paper folders, prepare separate SSA-831s, Disability Determination and Transmittal for each type of disability claim. Do not prepare SSA-831s if no medical determination is needed, e.g., for a technical denial, substantial gainful activity (SGA) denial or a collateral estoppel decision. The Disability Report forms SSA-3368 (Disability Report – Adult), SSA-3367 (Disability Report – Field Office), and SSA-3369 (Work History Report) can be entered into the Electronic Disability Collect System (EDCS), see DI 81010.025. When a claim cannot be entered into EDCS, see DI 81010.030.

If the claimant is working, the work is determined to be SGA, and the claimant does not allege a visual impairment, record the determination in accordance with DI 10501.025 and follow DI 11055.045. For CEF cases, see DI 81010.140.

Process the SGA denial, using the proper denial code as listed in DI 11010.205. Prepare the notice from the Document Processing System (DPS) program. The notice is located in DPS in the Initial Claims folder. For notice guidelines, see DI 11010.345C. Mail the notice to the claimant or appropriate applicant. Retain the paper Title II and Title XVI files in the FO until the appropriate shipment or destruction date.

If non-medical denials are involved on both claims, e.g., SSI Income and Resources denial and DIB denial for lack of insured status, retain both the Title II claim and the SSI claim in the FO (if the official file is paper) unless one of the exceptions in DI 11010.300 applies.

Send the disability material on both claims to the DDS. When critical non-medical requirements are in question on the Title II claim (see DI 11010.030) and a disability determination is required on the Title XVI claim, forward the official folder to the DDS. Document the folder with the FO action being taken on the disability claim. Be sure to enter the following in EDCS remarks section or in Item 11, Remarks of each SSA-831 before sending the claim to the DDS:

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  “Concurrent Title II/XVI claim”

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  “Title II claim pending in FO”

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  “SSI material on SSN forwarded” (date first claims material was forwarded to the DDS) on the Title II SSA-831.

For claims entered into EDCS, see DI 81010.085. When the critical non-medical requirements are resolved on the Title II claim being held, and a DDS Title II determination is necessary, transfer the Title II claim to the DDS. Then proceed as follows:

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  SSI Claim in the FO

  If the SSI claim is being forwarded to the DDS after the Title II claim:

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    Prepare and forward a SSA-5002, report of contact (RPOC) per DI 81010.085 and any disability evidence to the DDS.

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    Transmit the material using the prescribed electronic processing method.

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    For paper claims, place the SSI documents in a brown two part folder to be attached to the Modular Disability Folder (MDF) previously transferred to the DDS.

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    For claims entered into EDCS, use the UAT utility.

    If the SSI claim is a technical denial and has not been sent to DDS, it is not necessary to notify the DDS. For non CEF claims that were entered into EDCS for CEF cases, see DI 81010.020.

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  Title II Claim in FO

  If the critical non-medical requirements are met:

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    Prepare a Title II MDF, since this is the initial Title II transmittal. Forward the RPOC with the paper MDF, SSA-831, and any disability evidence to the DDS. Place the Title II non-medical material in the paper MDF. If SSI data was previously transmitted to the DDS, the DDS associates the official folders. For claims that were entered into EDCS, see use the UAT utility.

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    If the non-medical requirements are not met and the claim has not been sent to the DDS:

  It is not necessary to notify the DDS. For CEF claims, see DI 81010.020. Process the Title II claim in accordance with DI 11010.075.

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  Concurrent Title II/XVI Claims with Railroad (RR) Involvement

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    If the non-medical requirements are met for both claims:.

    Send the folder and the disability material for both claims to Great Lakes Program Service Center/ Disability Processing Branch (GLPSC/DPB). If it is subsequently determined the claimant is not eligible, contact GLPSC/DPB and request return of the folder. If the claimant alleges he/she has filed a disability application with the Railroad Retirement Board (RRB), see DI 11050.030.

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    If the claimant does not meet SSI non-medical requirements:

    Prepare a report of contact for the SSI file showing "Title II/Career RR claim forwarded to GLPSC/DPB on (date)" and send only the Title II claim to GLPSC/DPB. Be sure to include all evidence pertinent to the Title II claim. Enter "concurrent Title II/XVI claim" in Item 11, Remarks of the Title II SSA-831. In addition, enter "SSI denied by FO on non-medical issue" to alert GLPSC/DPB about the disposition of the SSI claim. Retain the SSI claim in the FO.

When Title II disability entitlement can be verified and is continuing, follow the instructions in DI 11011.001.

Send the SSI disability material in the official folder to the DDS. Verify the prior action. Enter "prior Title II denial (or cessation)" on the EDCS remarks page or in Item 11, Remarks of the SSA-831 and document the file to give the DDS as much information about the prior claim as is available from FO records. Do not request the prior folder. If the prior denial was on a disability basis, or was on a non-medical basis and there is indication that the Title II non-medical requirements may now be met, obtain a Title II claim and process as a concurrently filed Title II/XVI case. If a current Title II claim is not filed, document the SSI official folder with the reason. If the claimant is engaging in SGA, see DI 11055.095.

If the DDS or Disability Quality Branch (DQB) returns a Title II determination of allowance to the FO, take the following action:

If the Title II claim is a CEF and the Title XVI claim can be entered into EDCS, the DDS can view the medical evidence from the Title II claim in eView. See DI 81010.020. If the Title II claim is a CEF and the official folder is a paper MDF, prepare a SSA-831 for the SSI claim, place it and any new disability material in the Title II official folder, and transmit it to the DDS for a disability determination on the SSI claim.

Process and route the SSI claim in accordance with the instructions in DI 11055.025.