DI 11010.355: Jurisdiction and Routing of Cases after Return from the Disability Determination Services (DDS), Disability Processing Branch (DPB), or Disability Quality Branch (DQB)
Effective Dates: 09/11/2012 - Present
- TN 49 (08-08)
- DI 11010.355 Jurisdiction and Routing of Cases after Return from the Disability Determination Services (DDS), Disability Processing Branch (DPB), or Disability Quality Branch (DQB)
- A. Procedure – the official folder is a Certified Electronic Folder (CEF)
- Process as follows:
- * Always verify in eView that the claim is no longer pending in the DQB and has been transferred to the Field Office (FO). Check the Workload Management Information (WMI) queries to verify the initiation of systems processing of the decision; see Internet Workload Management - DI 81007.060 for information on WMI listings. The Electronic Disability Collect Systems (EDCS) Action Lists see Electronic Disability Collect System (EDCS) Actions Page - DI 81010.100 also contains information used in workload management.
- * If the claim is a denial and all systems actions have been taken to update the record, no further action is required.
- * If the claim is an allowance, monitor the case for appropriate Processing Center (PC) action;
- * For special operating instructions involving disability claims resulting from Emergency and Expedited Procedures Related to Military Service Disability Claims, see Field Office (FO) Instructions for Claims Development and Processing for Military Casualty (MC)/Wounded Warrior (WW) Cases - DI 11005.006.
- B. Procedure – the official folder is paper
- Process as follows:
- * Title II denials are held until an appeal is filed or for the 6-month retention period.
NOTE: Appeals of Title II denials with Medicare entitlement at issue (such as Medicare Qualified Government Employees (MQGEs)) are routed to the Health and Human Services’ Office of Medicare Hearings and Appeals (OMHA), not the Office of Disability Adjudication and Review (ODAR).
- * If the claims folder is not a routine allowance, see Routing Concurrent Disability Insurance Benefits-Retirement and Survivor Insurance (DIB-RSI) Claims - DI 11010.300, and Sending Initial Disability Insurance Benefits (DIB), Freeze Claims to the Disability Determination Services (DDS) - DI 11010.255, for specific routing instructions.
- * For routine allowances, send the folder to: Social Security Administration Office of Disability Operations 1500 Woodlawn Drive Baltimore, MD 21241-1500
- * If DDS requests referral of the claim due to policy or adjudicative issues, send the folder to: Social Security Administration Office of Disability Operations PO Box 32901 Baltimore, MD 21241-2901
- If the claim is routed to a servicing Program Service Center (PSC), forward under cover of an electronic routing sheet.
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