DI 12045: Special Situations
TN 3 (08-13)
A. Title XVI claims filed outside of the United States (U.S.)
Entitlement to title XVI benefits does not apply outside the 50 States, the District of Columbia, and the Northern Mariana Islands. Therefore, the field office (FO) must give special consideration and apply the following procedures when a claimant moves to or from Puerto Rico, the U.S. Virgin Islands, Mexico, or Canada.
B. FO actions before the disability determination services (DDS) adjudication
1. Claimant requests reconsideration in Puerto Rico, the U.S. Virgin Islands, Mexico, or Canada of title XVI-only claim or concurrent title II-title XVI claim denied in the U.S.
The servicing or border FO will forward the reconsideration to the FO servicing the last U.S. address.
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The FO servicing the last U.S. address will:
request and associate folders, and
send the folders to the DDS that made the initial determination.
2. Claimant files an initial title XVI claim in the U.S. after title II claim denied in Puerto Rico, the U.S. Virgin Islands, Mexico, or Canada and reconsideration pending
The servicing DDS will send the title II folder to the DDS servicing the claimant’s current U.S. address.
The FO in the U.S. will consolidate and escalate the title XVI folder and forward to DDS.
3. Claimant requests reconsideration of title II claim denied in Puerto Rico, the U.S. Virgin Islands, Mexico, or Canada and files initial title XVI claim in the U.S.
The FO servicing the U.S. address:
obtains the title II folder from the DDS or Office of International Operations (OIO), and
associates the title II folder with the title XVI folder, and
forwards both folders to the DDS servicing the U.S. address.
C. FO actions after DDS makes a disability determination on the request for reconsideration
1. DDS denial
If the DDS affirms the initial denial, the servicing FO must retain the title XVI folder or concurrent title II-title XVI folders for the required appeal period. (For appeal period, see GN 03101.120.)
2. DDS allowance
If the DDS reverses the initial denial, the servicing FO must:
Title XVI - process payment for the time period the claimant met U.S. residency requirements, and
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Title II - trigger payment via Modernized Claim System and forward the folder to OIO. Route the claim to the following address:
OIO
P.O. Box 17769
Baltimore, MD 21235-7769
System Destination Code: PC8
D. References
DI 20101.035 Disability Determination Services (DDS) and Social Security (SSA) Jurisdictions when the Claimant Moves
DI 81010.085 Transferring Cases in the Electronic Disability Collect System (EDCS)
DI 12030: ALJ Hearings