When processing the form SSA-789, the FO must:

1. a. 

   Check that the form is complete with the following information.

   1. 1. 

      The individual indicated whether they wish to appear at the disability hearing;

   2. 2. 

      The individual completed the block for 'interpreter' and 'language' needs, if applicable;

   3. 3. 

      The individual or representative payee does not need to sign the form; and

   4. 4. 

      The FO must date the SSA-789 at the top of the form upon receipt.

      NOTE: 

      A completed Modernized Supplemental Security Income Claims System (MSSICS) appeals output can act in place of the SSA-789 in Title XVI and concurrent cases if the individual also provides a clear written indication of dissatisfaction with the initial CDR determination.

2. b. 

   If the SSA-789 is incomplete, take the following actions.

   1. 1. 

      Call the individual for the necessary information.

   2. 2. 

      If the individual has no phone or the attempt is not successful, send a call-in/come-in letter and set a 15-day diary.

   3. 3. 

      The FO must document attempts to contact the individual on an SSA-5002 (Report of Contact). The FO must place a copy of the SSA-5002 in the folder.

   4. 4. 

      If the individual does not respond within the 15 days regarding whether they want a hearing or need an interpreter, forward the case to the disability determination services (DDS) for resolution.

   5. 5. 

      Provide the individual with a copy of the SSA-789 if applicable.

   6. 6. 

      Provide the individual with the English or Spanish version of the form SSA-888 (Reconsideration/Disability Hearing Procedures). Versions of these documents are located in DI 33095.025 or DI 33095.030.

   7. 7. 

      Provide the individual with the local and toll free telephone numbers for the FO and DDS in their service area. Explain to the individual that we prefer they call the DDS with substantive questions or if they need to report a change related to the disability hearing.

      NOTE: 

      The Social Security Administration (SSA) does not expect individuals to make long distance phone calls. Individuals may call either the FO or DDS using the local or toll free number.

The FO must provide the individual with a copy of their statutory benefit continuation (SBC) election statement. For information about the SBC election statement, see DI 12027.010B.4.

The FO must ensure that form SSA-827 has the appropriate signature and date, as in DI 11005.056.

The FO must verify that form SSA-3441-BK is complete. If the form is incomplete, the FO must take the following actions:

1. a. 

   Contact the individual if the SSA-3441-BK received was not fully completed or any information appears to be incorrect.

2. b. 

   Note if there are any auditory observations made during the telephone conversation with the individual.

3. c. 

   Document additional information that you received from the individual in the Electronic Disability Collect System (EDCS), the form-3367 (Disability Report - Field Office) or on an electronic or paper form SSA-5002 (Report of Contact).

   1. 1. 

      For Title II cases, see MS MCS 008.007 (Report of Contact [RPOC]); and

   2. 2. 

      For Title XVI cases, when documenting the report of contact in:

      1. a. 

         Report of Contact page.

      2. b. 

         Non-MSSICS, prepare a paper form SSA-5002 to document the additional information and add this form to the electronic or paper folder.

In Title XVI childhood disability cases, the FO must verify that form SSA-3881-BK is complete. If the form is incomplete, take the same actions described in DI 12026.025A.4 in this section.

For Title II cases, the FO must complete the following:

1. a. 

   Document the CDR appeal information, including SBC election, in EDCS.

   NOTE: 

   A post-entitlement online system (POS) input is no longer necessary

2. b. 

   In EDCS, complete and transfer the CDR appeal to DDS or the Disability Hearing Unit (DHU). The Disability Control File (DCF) and Master Beneficiary Record (MBR) automatically update as a result of the EDCS transfer.

3. c. 

   Upon receipt of the CDR appeal determination from the DDS or DHU, review the MBR to ensure the applicable information was received from EDCS and the DCF updated automatically. Verify the SBC termination, if applicable. The MBR should automatically update within five days.

4. d. 

   If the MBR does not automatically update in five days, the FO must proceed with manual actions to update the MBR and verify that the DIBCESS issue is pending on PCACS and follow-up with the PSC as necessary. For additional information on manually updating the MBR, see DI 12026.025C.2 in this section.

For Title XVI cases, the FO must complete the following:

1. a. 

   Use MSSICS to update the Supplemental Security Record (SSR) to document the filing of the medical cessation appeal as well as the SBC election, if applicable.

   NOTE: 

   If a direct SSR update is required, the FO can use the manual T-XVI case creation process in EDCS to manually enter the required fields in EDCS on the CDR Information page.

2. b. 

   Use EDCS to review and ensure that the appeal and the SBC election data propagated successfully from MSSICS. In EDCS, the appeal data should mirror the information that was entered in the MSSICS appeal data.

3. c. 

   In EDCS, complete and transfer the medical cessation appeal to DDS or DHU.

4. d. 

   Upon receipt of the medical cessation determination from the DDS or DHU, review the SSR to ensure applicable information was received from EDCS and updated the DCF. Review the SSR for pertinent fields (for example, PSY or DIAR) that trigger automated cessation, if applicable.

5. e. 

   Review the SSR to ensure the SBC benefits are properly terminated, if appropriate.

6. f. 

   If the SSR do not automatically update in five days, the FO must proceed with manual actions to update the SSR. To manually update the SSR, see DI 12026.025C.2 in this section.

For concurrent (Title II and Title XVI) cases, the FO must complete the following:

1. a. 

   First, use MSSICS to document the medical cessation appeal data on the SSR prior to entering EDCS.

   NOTE: 

   If the case is a concurrent appeal, the FO must first complete MSSICS prior to opening the appeal in EDCS.

2. b. 

   Review EDCS to verify the concurrent establishment of the appeal segments. Proceed with addressing additional appeal questions that will capture the Title II appeal data.

3. c. 

   In EDCS, complete and transfer the medical cessation appeal to the DDS or DHU. Ensure both the Title II and Title XVI segments are included in the case transfer.

4. d. 

   Upon receipt of the medical cessation determination from the DDS or DHU:

   1. 1. 

      Review both the SSR and MBR to ensure medical cessation appeal determination automatically posted; and

   2. 2. 

      That SBC benefits have ended for both titled programs.

      NOTE: 

      No POS action is required for the Title II claim.

5. e. 

   The MBR and SSR should both update within five days.

6. f. 

   If the MBR and SSR do not automatically update in five days, the FO must proceed with manual actions to update the MBR and SSR, see DI 12026.025C.2 in this section.

If there is a system input exclusion for a Title II case, the FO must complete the actions in DI 12026.025C.2 in this section to record the appeal information. For a Title XVI system exclusion, the FO must attempt to seed the cases that are outside of MSSICS, see MS 00302.001. If the seeding attempt is unsuccessful, the FO should attempt to load the appeal using a direct SSR update. For manual DCF inputs and screen displays, see CDR 001.000, CDR 001.014, CDR 001.025 and CDR 001.026.

The eCDR includes electronic folder (EF) case processing for initial continuing disability reviews (CDRs) and Age-18 redeterminations. If the disabled individual is appealing a CDR we processed in EDCS, process the reconsideration electronically. For processing appeals using eCDR in electronic folder cases refer to:

• •

  DI 81010.255 (Electronic Continuing Disability Review (eCDR) Cessation Reconsiderations); and

• •

  DI 81010.257 (Electronic Continuing Disability Review (eCDR) Cessation Appeals-ALJ Hearing).

When the FO is unable to load the CDR reconsideration appeal cases into MSSICS or EDCS, the MBR and SSR are unable to automatically update the DCF. Cases that are not in the EDCS will not be visible for tracking and are only available for tracking in MI Central.

The FO must record a CDR reconsideration appeal with an exclusion for a Title XVI case using the following actions:

1. a. 

   For MSSICS cases, input the CDR reconsideration information in MSSICS. For more information, see MS MSSICS 020.001 (Appeals - Overview); and

2. b. 

   For non-MSSICS cases, use MSSICS direct SSR update to establish the CDR reconsideration, see MS 00302.001. For more information, see MS 00302.001 (Direct SSR Update - Overview).

To record a CDR reconsideration appeal with an exclusion for a Title II only case, use the EDCS Exclusion Appeal (EEAI) screen to input the appeal request in the DCF. To see additional information on completing the EEAI screen inputs, see CDR 001.025. The DCF will pass the appeal request and SBC information to the T2R background program, which will automatically update the MBR. The Title II case will not require a POS input.

For the Title II case reconsideration, once the appeal information is loaded to the DCF, the case will become visible in MI Central. EDCS will not be able to automatically update the location of the appeal case. At the time of the cessation or continuance determination, the DCF will automatically receive the determination and will automatically update the MBR.

For a Title II case hearing appeal, after inputting the appeal request using the EEAI screen, the DCF will automatically create an ALJT2EX tickle. These cases will not appear in the DCF pending file or in MI Central. When there is a medical decision on the hearing appeal, the FO must receipt it in the tickle on the DCF. A hearing affirmation, abandonment, dismissal, or withdrawal will continue to automatically post to the MBR. Hearing reversals will require a POS input to update the MBR.

Process the paper folder as follows:

Route the folder to the servicing FO’s DDS.

Route the folder(s) to the Great Lakes Program Service Center (GLPSC):

• •

  Follow the procedures for processing railroad cases in DI 29005.020 (GLPSC - Career Railroad and Railroad Annuitant Cases).

• •

  Include the DHU copy of the SSA-789 in the disability folder(s) and route the folder to:

  GLPSC, Disability Processing
  
  P.O. Box 87755
  
  Chicago, IL 60680-0955

Do not forward documents or information to the DDS associated with the servicing FO.

• •

  Include all documents and information in the disability folder and route the folder to the Office of Earnings and International Operations (OEIO). Do not forward a copy of the SSA-789 to the DDS.

• •

  Forward all materials to:

  Social Security Administration
  
  Office of Earnings and International Operations
  
  P.O. Box 17775
  
  Baltimore, Maryland 21235-7775

If the disabled individual contacts the FO, rather than the DHU or the disability hearing officer (DHO), take the actions according to how the individual makes contact.

In processing Title II cases with SGA issues, develop and resolve work issues discovered during DDS or DHU review using procedures in DI 10501.025, DI 13010.012, and DI 13010.025.

1. a. 

   If the work is SGA:

   • •

     Prepare an initial SGA determination if conditions meet the requirements for FO processing, and trial work period (TWP), extended period of eligibility (EPE), or extended Medicare does not apply.

   • •

     Advise the individual in the SGA cessation determination notice that we will not conduct a disability hearing on the medical cessation issue because we found them “not disabled,” due to work. For information on processing SBC, see DI 12027.040 and DI 12027.050.

   • •

     Send a copy of the SSA-833 (Cessation or Continuance of Disability or Blindness Determination and Transmittal) to the DHU to cancel the hearing process.

2. b. 

   If the work is not SGA, or is SGA but EPE or extended Medicare applies:

   • •

     Complete FO actions using existing SGA and EPE procedures.

   • •

     Return case to DDS or DHU for action on medical issue(s).

     The FO must upload all work CDR documentation to EDCS for electronic cases, and forward documentation to the DDS or DHU for paper cases because the DDS and DHU does not have access to other FO programs where this information could be stored.

Most material and information received is in writing. However, the FO must document any information obtained verbally on an SSA-5002 (Report of Contact) or other appropriate SSA form. Upload all new material or information received after the case left the FO into the electronic folder if possible. Check the case control system to establish if the folder is located at the DDS or DHU, and complete the following instructions:

The FO must transmit or forward the folder to the DDS if the individual fails or refuses to complete the necessary forms or provide additional evidence needed to support the request. Indicate what information is lacking using a Form SSA-5002 and associate this form with the appeal folder. If the DDS does not have enough information to make a medical determination, follow guidelines as outlined in DI 23005.001 or DI 23007.005.

The FO should never suggest to an individual to request a withdrawal of their CDR reconsideration.

The FO must put the death information on the individual’s record(s), and forward or upload the proof of death to the folder. Review the folder(s) to determine leads to anyone who may be entitled or adversely affected by the cessation determination.

• •

  Title II cases could include a surviving spouse, auxiliary beneficiaries, or a representative of the estate.

• •

  For Title XVI cases, refer to SI 02101.003 (SSI Underpayment Due - individual Deceased - General).

  NOTE: 

  A death certificate has the cause(s) of the death, which can aid the DHO in making a determination if the cause of death was related to the individual’s disability.