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DI 20101.035: Disability Determination Services (DDS) and Social Security (SSA) Jurisdictions when the Claimant Moves

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  • Effective Dates: 04/11/2013 - Present
  • Effective Dates: 02/07/2018 - Present
  • TN 4 (12-09)
  • DI 20101.035 Disability Determination Services (DDS) and Social Security (SSA) Jurisdictions when the Claimant Moves
  • A. Background information for DDS and SSA jurisdiction when the claimant moves
  • The following sections explain how jurisdiction is determined when a claimant moves during the disability process. For information on the definition and requirements to establish a change of residence, see Disability Determination Services (DDS) and Social Security Administration (SSA) Jurisdictions – Initial and Subsequent Cases DI 20101.001.
  • When the field office (FO) is notified that a claimant has moved, they notify the DDS of the address change in the Electronic Data Collect System (EDCS) via an Update-After-Transfer (UAT) Alert. In the event of a systems limitation or exclusion, where the official folder is a Modular Disability Folder (MDF), the FO notifies the DDS by:
  • * fax,
  • * mail, or
  • * email.
  • 1. Claimant contact necessary
  • If contact with the claimant is necessary to secure additional evidence, contact the claimant to request complete address information. If the DDS is unable to obtain complete address information, request assistance from the FO. If the claimant cannot be located, see Whereabouts Unknown and Failure to Cooperate (FTC) DI 23005.000 and Whereabouts Unknown (WU) Cases DI 28075.005.
  • For instruction on determining jurisdiction in CDR cases, see Social Security Administration (SSA) and Disability Determination Services (DDS) Jurisdictions for Continuing Disability Cases DI 20101.015.
  • 2. Procedure for claim transfers
  • For CEF transfers, follow the instructions in:
  • * DI 81020.125 – Electronic Case Routing Before Final Determination
  • * DI 81020.127 – Processing “No Determination” Claims;
  • For MDF transfers, follow the instructions in:
  • * DI 32005.020 – “No Determination” Routing.
  • NOTE: A Supplemental Security Income (SSI) claim must have a Social Security number (SSN) before it can be transferred. If the SSN is still pending, call the FO for status and advise that the SSN is needed before transferring the claim
  • 3. Examples of when a transfer may not be necessary
  • In the following examples, transfer of the case may not be necessary:
  • * Records submitted at the time of application are sufficient to make a determination;
  • * Terminal illness (TERI), Quick Disability Decision (QDD), or Compassionate Allowance (CAL) cases, where records are, or will be, forthcoming;
  • * The allegations indicate that the requested medical records will likely result in an allowance (e.g., intellectual disability, or Down syndrome - Trisomy 21);
  • * Significant processing delays are not anticipated; or
  • * Additional evidence from a foreign source will not be required to adjudicate the case.
  • NOTE: The above guidance may also apply to Military Casualty claims where DDS could retain jurisdiction even if the claimant moves to a foreign country in order to expedite processing of the claim.
  • References:
  • * DI 81020.080 – Certified Electronic Folder (CEF) Alerts
  • * DI 10005.010 – Field Office (FO) and Disability Determination Services (DDS) Exchange of Information and Coordination of Actions.
  • * DI 81010.250 – Beneficiary Moves to Another State before Electronic Continuing Disability Review (eCDR) Determination is Final
  • B. Procedures for determining DDS or SSA jurisdiction when the claimant moves
  • If a claimant moves to a foreign country (including Canada and Mexico) before the DDS makes a determination (including Title II, Title XVI claims, and concurrent Title II/Title XVI claims), process the claim as follows:
  • If a claimant moves to another state before the DDS makes a determination (including Title II, Title XVI claims, and concurrent Title II/Title XVI claims), process the claim as follows:
  • 1. Claimant leaves State before the initial disability determination is completed
  • If the claimant changes his or her permanent residence to another state, the DDS may transfer the claim to the DDS in the new state of permanent residence to prepare the disability determination. Transfer is not mandatory and should be considered on a case-by-case basis. Service to the claimant is the top priority and should always be considered before initiating a transfer.
  • 2. Claimant leaves State before completion of processing and files in another State for a different type of disability benefit
  • When a claimant leaves the State before the DDS makes a disability determination and files in another State for a different type of disability benefit, the DDS in the claimant’s new State of residence has jurisdiction to make a disability determination. However, if the DDS that has jurisdiction of the first claim is ready to make a timely determination:
  • * Retain the case; and
  • * Prepare the disability determination.
  • C. Claimant moves to a foreign country before the disability determination is completed
  • If the claimant changes his or her permanent residence to a foreign country, the DDS may transfer the claim to the FO to forward to OIO to prepare the disability determination. Transfer is not mandatory and should be considered on a case-by-case basis. Service to the claimant is the top priority and should always be considered before initiating a transfer.
  • 1. Examples of when a transfer may not be necessary
  • In the following examples, it may not be necessary to transfer a claim:
  • * Records submitted at the time of application are sufficient to make a determination;
  • * TERI, QDD, or CAL cases, where records are, or will be, forthcoming;
  • * The allegations indicate that the requested medical records will likely result in an allowance (e.g., intellectual disability, or Down syndrome - Trisomy 21)
  • * Significant processing delays are not anticipated
  • * Additional evidence from a foreign source will not be required to adjudicate the case.
  • The above guidance may also apply to Military Casualty/Wounded Warrior cases where DDS could retain jurisdiction, even if the claimant moves to a foreign country, in order to expedite processing of the claim.
  • NOTE: DI 43510.055 – DDS Assistance for Certain Canadian Claims states the DDS makes proposed determinations for some Canadian claimants before forwarding them to the Office of International Operations (OIO) for final medical decision and processing of the claim. DI 43510.060 – Consultative Examinations for Residents of Northern Mexico states that the DDSs in California and Arizona assist with consultative examinations requests.
  • 2. Title II - only claim – Move to a foreign country will be permanent, or for 6 months or more
  • NOTE: For Certified Electronic Folders (CEFs), follow the instructions in Routing Electronic Cases Before Final Determination DI 81020.125 and Processing “No Determination” (ND) Claims DI 81020.127.
  • * Annotate the file with the complete foreign address, including foreign postal codes, where applicable;
  • * Annotate the file that the claimant will be in a foreign country for at least 6 months;
  • * Transfer jurisdiction to OIO (DDS code V22);
  • * Route a paper disability folder (MDF) to the FO, with instructions to forward the completed file to OIO. See DI 20101.035C.5. for mailing address.
  • OIO then completes development of the claim and prepares the determination.
  • 3. Title XVI-only claim – Move to a foreign country will be permanent, or for 6 months or more
  • * The DDS in the claimant’s last State of U.S. residence retains jurisdiction when a Title XVI determination is still needed;
  • * U.S. residency requirements must be met for at least the month of filing. If this information is not in file, contact the FO to see if U.S. residency requirements are readily available. If not readily available, return the case to the FO for further development regarding residency requirements.
  • 4. Concurrent Title II/Title XVI claim – Move to a foreign country will be permanent, or for 6 months or more
  • * Annotate the file with the complete foreign address, including foreign postal codes, where applicable;
  • * Annotate the file that the claimant will be in a foreign country for at least 6 months;
  • * Route the claim (MDF) to the FO; and
  • * Instruct the FO to forward the completed file to OIO.
  • OIO then completes development of the claim and prepares the determination.
  • NOTE: For CEF transfer instructions see Routing Electronic Cases Before Final Determination DI 81020.125 and Processing “No Determination” (ND) Cases DI 81020.127.
  • 5. Title II, Title XVI, or concurrent Title II/Title XVI claims – Move to a foreign country for 3 months, but less than 6 months
  • Retain jurisdiction and, if a consultative examination (CE) or other medical development is necessary, request the assistance of the OIO. To arrange a CE in a foreign country for a CEF case, initiate an electronic assistance request (AR) according to the instructions in Electronic Assistance Requests (AR) DI 81020.100.
  • For MDFs, there is no need to send the file with these requests, but include copies of pertinent medical reports to assist OIO in preparing the request.
  • Address the requests to: OCO, OIO, DIO International Disability Unit (IDU) Disability Determination Section (DDS) Code V22 P.O. Box 17787 Baltimore, Maryland 21235
  • 6. Title II, Title XVI, or concurrent Title II/Title XVI claims – Move to a foreign country for less than 3 months
  • DDS retains jurisdiction until the claimant returns to the United States, as OIO cannot complete a medical development request within 3 months.
  • 7. Claimant moves from a foreign country to the U.S. before the claim is adjudicated
  • When a claimant moves from a foreign country to the U.S. before his or her claim is adjudicated, jurisdiction for the disability determination may be transferred to the DDS in the State where the claimant currently resides. If jurisdiction of a Title II claim is transferred to the DDS, notify the corresponding FO in EDCS.
  • 8. Claimant moves from a foreign country to the U.S. before the claim is adjudicated
  • Both the Program Service Center/Disability Processing Branch (PSC/DPB) (the DDSs responsible for Puerto Rico, the U.S. Virgin Islands, Guam, and American Samoa) and OIO (who prepares Title II disability determinations for foreign claimants) do not routinely prepare SSI disability determinations. SSI does not apply outside the 50 States, the District of Columbia, and the Northern Mariana Islands. Therefore, you must follow certain instructions if the claimant files a Title XVI-only claim, or a concurrent Title II/Title XVI claim and then moves to, or from, Puerto Rico, the U.S. Virgin Islands, Guam, or American Samoa.
  • a. Title II/Title XVI concurrent claim - Claimant moves to Puerto Rico, the U.S. Virgin Islands, Guam, or American Samoa from the U.S.
  • * Contact the FO to determine whether U.S. residency requirements are met for at least the month of filing (i.e., Title XVI eligibility exists).
  • * If no Title XVI eligibility exists, return the Title XVI file to the FO serving the last U.S. residence, and transfer the Title II file for the medical decision to the DDS serving the new address in Puerto Rico, the U.S. Virgin Islands, Guam, or American Samoa. Notify the FO of the Title II claim transfer.
  • * If Title II and Title XVI eligibility exists, the DDS in the State of last residence (where the claimant filed the Title XVI claim) develops the medical evidence, makes a concurrent Title II/Title XVI medical determination, and returns both files to the FO serving the last U.S. residence.
  • b. Title XVI-only claim - Claimant moves to Puerto Rico, the U.S. Virgin Islands, Guam, or American Samoa from the U.S.
  • * Contact the FO to determine whether U.S. residency requirements are met for at least the month of filing (i.e., Title XVI eligibility exists).
  • * If no Title XVI eligibility exists, return the file to the FO serving the last U.S. residence for denial.
  • * If Title XVI eligibility exists for at least one month, the DDS in the State (where the claimant filed the Title XVI claim) develops the medical evidence, makes a final determination, and returns the file to the FO serving the last U.S. residence.
  • c. Title II claim with a subsequent Title XVI claim - Claimant moves from Puerto Rico, the U.S. Virgin Islands, Guam, or American Samoa to the U.S.
  • In Title II claim situations:
  • * If the DDS serving Puerto Rico, the U.S. Virgin Islands, Guam, or American Samoa receives notice that the claimant has moved to the U.S., they transfer the Title II claim to the DDS serving the claimant’s current U.S. residence.
  • * If the DDS chooses to complete their determination prior to transfer of the Title II claim, and the determination results in an allowance, the U.S. FO adopts the allowance for any subsequent Title XVI claim. If the Title II decision is a denial, send any subsequent Title XVI claim to the DDS serving the current U.S. residence for a determination.
  • NOTE: Since SSI applies only in the 50 States, the District of Columbia, and the Northern Mariana Islands, Title XVI claims are not filed in Puerto Rico, the U.S. Virgin Islands, Guam, or American Samoa. Claimants must file any Title XVI claims after moving to the United States.
  • 9. The Disability Quality Branch (DQB) returns case to DDS for review of an earlier determination and the claimant has moved
  • If, at the time DQB returns the case to the DDS for further consideration of an earlier DDS determination, the claimant no longer resides in the state, the DDS takes the following actions:
  • * Reviews the file;
  • * Develops vocational and medical evidence of record, as appropriate;
  • * Affirms, modifies, or revises its determination;
  • * Annotates the file with the new address, if not completed; and
  • * Returns the case to DQB.
  • 10. Reconsideration of Title XVI-only and concurrent Title II/Title XVI when a claimant moves to or from Puerto Rico, the U.S. Virgin Islands, Guam, or American Samoa
  • a. Claimant requests reconsideration in Puerto Rico, the U.S. Virgin Islands, Guam, or American Samoa of Title XVI-only claim or concurrent Title II -Title XVI claims filed in a State
  • The DDS that made the initial determination(s) has jurisdiction for preparing the reconsideration disability determination(s).
  • b. Claimant requests reconsideration of Title II claim filed in Puerto Rico, the U.S. Virgin Islands, Guam, or American Samoa.
  • If the claimant resides in Puerto Rico, Guam, or American Samoa, the State that made the initial Title XVI determination has jurisdiction for preparing both reconsideration disability determinations. If the claimant currently resides in the United States, the DDS in that State has jurisdiction.
  • c. Claimant requests reconsideration of Title II claim filed in Puerto Rico, the U.S. Virgin Islands, Guam, or American Samoa and files initial Title XVI claim in the United States.
  • The State where the claimant currently resides has jurisdiction for preparing both disability determinations.
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