DI 11010: Initial Disability Claims Processing
TN 49 (08-08)
The field office (FO) is responsible for determining the type of official folder in processing all disability-related cases.
A. Process -- determining the official folder
Disability claims are processed in Certified Electronic Folders (CEFs) unless an exclusion applies. See Certified Electronic Folder (CEF) Exclusions and Limitations - DI 81010.030. If all the claims in a case are entered into Electronic Disability Collect System (EDCS) and there are no EDCS exclusions or limitations, the case is a Certified Electronic Folder (CEF) and the official folder is electronic. See Creating Electronic Disability Collect System (EDCS) Cases - DI 81010.020 and Transferring Cases in Electronic Disability Collect System (EDCS) - DI 81010.085.
If any of the claims in a case is an EDCS exclusion or limitation, a paper Modular Disability (MDF) Folder must be created. The official folder is the paper MDF. EDCS can be used to enter information on any non-exclusion claims in the case. All information associated with the claim entered into EDCS must be printed and placed in the official paper MDF.
B. Procedure – assembling and transmitting the official paper folder
The official paper folder is called the Modular Disability Folder (MDF). The steps for processing disability cases using the MDF are as follows:
See Forms Used in Disability Claims - DI 11005.016 for completing forms used in a disability claim.
If there is a prior filing and the paper folder is located in the FO, associate the prior file with the new filing using the current MDF.
NOTE: In order to associate the folder contents, the previous and current filings must be the same Title (Title II only, Title XVI only, or Concurrent). Prepare a new MDF if the new claim is under a different Title than the prior filing.
If there is a prior filing and the paper folder is located in another FO, then request the file from that FO. Locate the prior filing using a Processing Center Action Control System (PCACS) query. See Online Queries – Overview - MSOM PCACS 008.001 for instructions on obtaining a PCACS query and a Disability Determination Services Query (DDSQ), by selecting #18 from the SSA Main Menu. See Parts of a Full Query Response - SM 06002.200 for instructions on reading the DDSQ or through the Case Processing and Management System (CPMS) http://ihs.ssaprd1.sspf.ssa.gov:792/cpms/ for prior cases that are under appeal at the hearing level or the Office of Analytics, Review, and Oversight (OARO) for cases pending before the Appeals Council.
See Field Office (FO) Instructions for Claims Development and Processing for Military Casualty (MC)/Wounded Warrior (WW) Cases DI 11005.006 for special processing instruction for disability for all military service casualties that occurred 10/01/01 or later. For multiple claim types, prepare separate folders for each claim filed. The MDF is used for the Disability Insurance Benefits (DIB) claim. Attached to the back of the MDF is a separate two-part brown folder for each additional claim type (e.g. Title XVI claim, Disabled Widow(er)s Benefits DWB, or Childhood Disability Benefits CDB).
See The Disability Interview, Identifying Terminal Illness Cases - DI 11005.601 for special processing of terminal illness.
For delayed cases, see Preparation of Folder for Transmittal of DIB and Freeze Claims - GN 01050.165.
Transmit and route the official folder to DDS after reviewing the MDF for accuracy. See Completing the SSA-831 - DI 11010.205 for instructions on the SSA-831 (Disability Determination and Transmittal).