BASIC (02-12)

DI 71005.005 Disability Determination Services (DDS) Initial Claim Procedures for Title II Initial Disability Claims Mexican Residents File in the United States

DDS in Texas, New Mexico, California, and Arizona participated in a pilot to test the feasibility of making disability determinations on claims for residents of Mexico filed in the United States (U.S.) instead of transferring the claims to the Office of International Operations (OIO) for signoff by an OIO Disability Examiner.

A. DDS initial claims procedures

Adjudicate initial title II claims following usual procedures. Upon completion of all disability determination actions, transfer the claim to the border field office (FO) to associate with the non-medical portion of the claim.

NOTE: Contact the border FO to discuss any questions related to ceasing medical development (e.g., substantial gainful activity earnings), before returning the claim to the border FO.

1. Limited English proficiency

If the claimant has limited English proficiency, requests language assistance, or it is evident that the claimant requires language assistance, follow the procedures in DI 23040.001

2. DDS medical development procedure

When completing initial medical development, follow the procedures in DI 22505.001 and DI 81020.110. You are encouraged to make doctor-to-doctor contact by telephone where possible.

NOTE: When initiating a follow-up letter or telephone call, use the existing procedures in DI 22510.019. You may allow additional time for correspondence to and from Mexico due to potential mail delays.

3. Spanish evidence

Utilize translation services to translate any medical evidence received in Spanish according to the procedures in DI 23040.001.

B. Consultative examinations (CE)

1. Scheduling a CE

If medical evidence is not readily available, or the medical evidence of record (MER) is inadequate, schedule a CE. The claimant’s treating source is the preferred CE provider. However, if you cannot use the claimant’s source, schedule the CE in the United States (U.S).

NOTE: Due to mail delivery issues in Mexico, you may schedule the CE at least 21 days from the date of the notice.

2. Claimant fails to keep CE appointment

If the claimant fails to keep the scheduled CE appointment, follow the guidelines in DI 23007.010. If you are unable to contact the claimant, document the file and prepare a determination based on the information in the file.

NOTE: It is the claimant’s responsibility to attend the CE. If the claimant states that he or she cannot return to the U.S. for a CE, transfer the claim to OIO to arrange the CE through the Foreign Service Post.

C. Preparing the disability determination

Upon receipt of the MER, the CE report, or both evaluate the findings and, if the evidence if sufficient, prepare a disability determination according to the usual procedures.

D. Claimant moves during the adjudication process

To determine jurisdiction if the claimant moves during the adjudication process, follow the procedures in DI 20101.035 - Disability Determination Services (DDS) and Social Security (SSA) Jurisdictions when the Claimant Moves.


To Link to this section - Use this URL:
http://policy.ssa.gov/poms.nsf/lnx/0471005005
DI 71005.005 - Disability Determination Services (DDS) Initial Claim Procedures for Title II Initial Disability Claims Mexican Residents File in the United States - 02/22/2012
Batch run: 02/22/2012
Rev:02/22/2012