TN 31 (10-10)

A. Create the certified electronic folder (CEF) via EDCS

Once the claimant files the necessary application(s) (e.g., SSA-10), completion of the Disabled Widow(er)’s Benefit (DWB) claim follows the same process as a Disability Insurance Benefit (DIB) claim. Establish the DWB case in EDCS under the claimant’s own Social Security number (SSN) to create the CEF to house specific disability-related claim information.

NOTE: Also establish cases that do not require a new application (i.e., conversion from widow’s benefits to DWB) in EDCS as MCS-exclusion cases per DI 81010.020B.

EDCS computes the required fields for the prescribed period and the controlling date on the “Prior Filing” page of the 3367 Disability Report - Field Office. However, for widow(er)s (“E beneficiaries”) who are filing for DWB, do not use the EDCS computation. Instead, use the chart in DI 11005.050C to manually compute the controlling date and then enter it in EDCS.

References:

• DI 11005.016 – Forms Used in Disability Claims

• DI 81010.025 – Completing Electronic Disability Collect System (EDCS) Forms for Initial Claims

• RS 00207.005 – Widow(er)’s Benefits – Conversion of Benefits – Policy

B. Make a substantial gainful activity (SGA) determination for any work issue

The FO has primary responsibility to determine whether a claimant’s work activity is at an SGA level.

Develop work activity in the usual manner, recording the SGA determination on the appropriate eForm, i.e., SSA-821 (Work Activity Report – Employee), or SSA-820 (Work Activity Report – Self Employed Person), and store it in the CEF.

If the FO is alerted to SGA after the DWB claim has been transferred to the Disability Determination Services (DDS), the FO:

• Develops the SGA issue (e.g., verify wages, subsidy, special considerations, unsuccessful work attempt (UWA), closed period of disability);

• Contacts the DDS and requests return of jurisdiction;

• Processes the FO denial in EDCS;

• Adjudicates the SGA denial in Modernized Claims System (MCS); and

• Creates the personalized SGA denial notice in the Document Processing System (DPS).

References:

• DI 10500.000 – Substantial Gainful Activity (SGA)

• DI 10505.035 – Documenting Employment Cases Using the SSA-821-BK (Work Activity Report-Employee) and the SSA-823 (Report of SGA Determination-For SSA Use Only)

• DI 11010.345 – Preparing Notices in Disability Claims

• DI 81010.120 – Using Form Attestation for Work Activity Reports

• DI 81010.140 – Processing Field Office (FO) Determinations

C. Transfer the DWB case to the office of jurisdiction for a medical determination

The FO must ensure the accurate completion of EDCS forms prior to transferring jurisdiction to the DDS for medical development. Annotate the CEF with a flag, message, or remark concerning any special instruction for the DDS.

NOTE: If the DWB claimant has 120 months (or 60 months after 1995) of railroad (RR) service, or is entitled to a disability survivor’s annuity with RRB, the Great Lakes Program Center (GLPSC) has jurisdiction for the disability determination. V32 is the office code for the GLPSC-DPB.

References:

• DI 81010.080 – Alerts, Flags, and Messages in Electronic Disability Collect System (EDCS)

• DI 81010.085 – Transferring Cases in Electronic Disability Collect System (EDCS)

• DI 11010.255 – Sending Initial Disability Insurance Benefits (DIB), Freeze Claims to the Disability Determination Services (DDS)

• DI 23545.001 – Foreign Cases - Determining Jurisdiction and Processing Transfers

• GN 01701.005 – International Social Security (Totalization) Agreements

• GN 01702.000 – DO Development and Routing of Totalization Claims

• DI 11050.015 – Jurisdiction of Disability (DIB) and Freeze Applications for Career Railroad (RR) Employee and Surviving Dependent RR Annuitant

• DI 11050.060 – Transferring Non-Electronic Disability Collect System (EDCS) Cases to the State DDS or Great Lakes Program Service Center - Disability Processing Branch (GLPSC-DPB)