POMS Reference

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.

  • See General Overview of the MDF - DI 70005.005 and Modular Disability Folder (MDF) - Field Office (FO) Procedures - DI 70010.001 for preparing and assembling the MDF.

  • 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).