DI 11010: Initial Disability Claims Processing
TN 49 (08-08)
A. Procedure - official folder in Office of Disability Operations (ODO)
Use the following procedure:
The Field Office (FO) notifies ODO with a Modernized Development Worksheet (MDW) when a claimant dies and the claim is pending in ODO. For Certified Electronic Folder (CEF) cases see Alerts, Flags, and Messages in the Electronic Disability Collect System (EDCS) - DI 81010.080.
If a Master Beneficiary Record (MBR) is established and direct input is not possible, place a special message on the MBR. See Special Message Data (SMS1) - MSOM T2PE 007.008 for instructions on entering special messages.
Follow the instructions set out in Sending Subsequent Disability Insurance Benefits (DIB) or Freeze Claims to the Disability Determination Services (DDS) - DI 11010.260 for development regarding the cause of and circumstances surrounding the claimant's death.
If the auxiliary(ies) are entitled for the month prior to the month of the disabled claimant's death, ODO makes an automatic conversion to survivor benefits and forward the file to the PSC that has jurisdiction if the official folder is a MDF. For CEFs, ODO transfers the file to the appropriate PSC.
If there is no entitlement to auxiliary benefits for the month prior to the month of death, ODO forwards the file to the PSC upon notification of the claimant's death if the official folder is a Modular Disability Folder (MDF). For CEFs, ODO transfers the file to the appropriate PSC. The PSC makes payment of survivor benefits based on the auxiliary(ies) claim in file.
If the cause of, or circumstances surrounding, the claimant’s death cause ODO to reevaluate a medical denial on a claim; then ODO forwards the auxiliary application and non-medical material for the claim to the PSC without waiting for the final disability determination.
After the revised disability determination is completed, OCO/ODO forwards the disability claim to the PSC for association with the Retirement Survivors Insurance (RSI) folder if the official folder is a MDF. For CEFs, ODO transfers the file to the appropriate PSC.
B. Procedure – official folder in PSC
Use the following procedure:
If the claim is pending in a PSC when the claimant dies, the FO notifies the PSC and forwards any necessary survivor development.
The PSC converts entitled auxiliary(ies) to survivor benefits, or processes the auxiliary(ies) claims.
The DPB initiates action to reevaluate the medical determination if the cause of or circumstances surrounding the death of the claimant requires reevaluation of the medical denial determination.