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DI 20505.015: Disability Determination Services (DDS) Actions to Obtain a Prior Paper Folder

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  • Effective Dates: 05/16/2012 - Present
  • Effective Dates: 10/31/2017 - Present
  • TN 2 (11-01)
  • TN 3 (10-17)
  • DI 20505.015 DDS Actions In Obtaining Prior Folder
  • DI 20505.015 Disability Determination Services (DDS) Actions to Obtain a Prior Paper Folder
  • A. Procedure - Title II
  • If DDS reviews the current claims folder and determines the prior folder is necessary, take the following actions to obtain a Title II or Title XVI folder.
  • 1. Use of Queries
  • See DI 20505.010 for instructions on when to request the prior folder.
  • Locate the prior folder using the following queries:
  • * AACT
  • * PCACS
  • * CPMS query
  • * Prior claims notice.
  • NOTE: Follow instructions for retrieving each type of folder. Usually, the field office (FO) separates concurrent Title II and Title XVI paper folders after the initial determination. It is important to remember that in concurrent cases, the DDS files medical evidence in the Title II folder. The Title XVI folder has the SSA-831 in such cases.
  • 2. Actions - Folder in FO or Another DDS Location
  • A. How to locate and request Title II folders
  • Telephone or E-mail the FO or DDS and request the prior folder to be sent to the DDS.
  • 1. Title II folder query search
  • 3. Actions - Folder in PSC/OCO Location
  • Many systems queries can provide information on the folder location. Review the following queries to determine the location of the Title II paper folder:
  • * Abbreviated Master Beneficiary Record Query (AACT)
  • * Payment Center Action Control System (PCACS)
  • * Automated Folder Location Website
  • Title II folder requests are established using PCACS (See MSOM PCACS 009.001 , Part 18).
  • * If you want to keep a record of the request, make a copy of the DIFR print screen before you enter it.
  • * Your request will stay on PCACS for 28 days. During this time no one else can request the folder. PSC employees can only send a folder located in the PSC. If the folder is located outside of the PSC (FO/DDS/ODAR), they do not have access to the folder.
  • 2. Contacting a field office (FO), Office of Hearing Operations (OHO), the Appeals Council (AC) or another DDS to request a Title II folder
  • NOTE: The PCACS folder control will clear if there is a folder location change.
  • * PSCs and ODO will not release the folder until they complete all adjudicative actions. If you do not receive the folder or a response to your folder request after 28 days, you should:
  • * Review the standard query (SQRY) to determine the folder status. An explanation of the SQRY can be found in MSOM PCACS 008.001 .
  • * If the folder is in transit, the query location will read “FOUT” (file out). A folder query should be obtained to see the “TO LOCATION”. The query will reflect the office code where the folder is being sent. Retain any related material for association when the folder is received.
  • * If the folder is not in transit and the need for it is a judgment issue, carefully reassess that need. If a folder is still needed, contact the office where the folder is located to request it. Recontact as necessary until the folder is received or until you receive a response that it cannot be located.
  • * The system does not have a built in diary alert to let you know that the folder was not received after 28 days. Therefore, it is recommended that you monitor the system for control of the folder.
  • After determining the location of the Title II folder, take the following actions to request the folder:
  • * If the folder is in a FO or another DDS - contact the FO or DDS and request the prior folder. See DI 81020.100 Electronic Assistance Requests (AR) for AR system inputs.
  • * If the folder is at OHO - contact the OHO site and request that OHO send copies of pertinent materials to the DDS (OHO will not release folders with pending hearings or decisions);
  • * If the folder is at the AC- Contact the Appeals Council Megasite at (703) 605-8930. When you request a folder, be sure to give the name and Social Security number of the claimant and any cross-reference numbers, your name, your location (office code), address, and phone number.
  • * If the AC can release the folder, request the entire folder. If the AC cannot release the folder, request that the AC send photocopies of the necessary medical evidence to the DDS.
  • NOTE: The Office of Disability Operations (PC7) has started a PCACS folder request feedback program to notify requesters when a folder is unavailable (See AM-00011 dated 01/13/00).
  • 3. Contacting the Program Service Center (PSC)/ Office of Central Operations (OCO) to request a Title II folder
  • B. Procedure - Title XVI
  • If the Title II folder is located at the PSC/OCO, request the Title II folder using the Payment Center Action Control System (PCACS). See MSOM PCACS 009.011 Diary Folder Request for folder request inputs.
  • 1. Use of Queries
  • If you want to keep a record of the request, make a copy of the Diary Folder Request (DIFR) screen before you enter it. PCS employees can only send a folder located in the PSC. They do not have access to folders located outside of the PSC. The Program Service Center/Office of Disability Operations (PSC/ODO) will not release the folder until all adjudicative actions are complete. Your request will stay on PCACS for 28 days. During this time, no one else can request the folder. If you do not receive the folder or a response to your folder request after 28 days and the folder is not in transit, use your judgment to determine if you still need the folder. If you still need the folder, contact the PSC/OCO to submit another request. Re-contact the PSC/OCO as necessary until you receive the folder or until the PSC/ODO informs you that they cannot locate the folder.
  • Determine the location of the prior folder by obtaining the following queries:
  • * SSID online query; or
  • * SSI2 online query with the CCTL segment; and
  • * AR 25 offline query
  • B. How to locate and request Title XVI folders
  • Use the folder location information on these queries to simultaneously request the prior folder(s) from all possible locations.
  • 1. Title XVI query search
  • 2. Actions Depending on Folder Locationa. Location of the Title XVI Prior Folder
  • Review the following queries to determine the Title XVI prior folder location:
  • * SSI Display Query (SSID) or Supplemental Security Income (SSI) online query; or
  • * SSI Query (select segments) (SSI2) online query with the Case Control Data (CCTL) segment; and
  • * Use Alert Response (AR) 25 to request the SSI Control System offline query.
  • Review the CCTL segment of the SSID or SSI2 query which provides the location of the Title XVI prior folder. If the Federal Records Center (FRC) shows the National Records Center (SSANRC) location (L0E) or an FRC location (LNN e.g. L96, L97, L98), request the folder from SSANRC or FRC using the SSA-8028 procedure with the AR code of 33. (See POMS SM 01201.055 and SM 01201.210.)
  • * As a result of the DDS AR 33 transaction, the SSANRC will retrieve all SSI folders stored in the SSANRC and the FRC for the requested SSN, consolidate the material, and send it to the requesting DDS.
  • * If the current folder location (CFL) field shows L50 or L51 (unable to locate in SSANRC or FRC), do not request the folder.
  • * It can take from two to six weeks for the DDS to receive the prior folder(s), depending on the number of prior folders the SSANRC must obtain and where they are stored; e.g., when prior folders are stored in the FRCs the retrieval time greatly increases.
  • * When the SSANRC/FRC is unable to locate the requested folder(s), the DDS receives an alert message “FOLDER/PE REQUESTED FROM SSANRC UNABLE TO LOCATE”. The DDS should take no further action to obtain the prior folder(s) from the SSANRC/FRC since after a thorough search, no material could be located.b. Location of the Current Folder and Up to 5 Prior Locations
  • 2. Contacting the Federal Records Center or the National Records Center to request a Title XVI folder
  • See POMS SM 01201.110C. If the prior location is shown for an FO or another DDS, telephone the FO or the DDS that last had the prior folder and ask them to search for the folder and send it to the DDS.
  • Review the CCTL segment of the SSID or SSI2 query, which provides the location of the Title XVI prior folder. If the query shows the National Records Center (SSANRC) location (L0E) or an FRC location (LNN e.g. L96, L97, L98), request the folder from SSANRC or FRC using the SSA-8028 SSI Claims Control procedure with the AR code of 33. The SSANRC will retrieve all SSI folders stored in the SSANRC and the FRC for the requested SSN, consolidate the material, and send it to the requesting DDS. For additional instructions, see SM 01201.055 and SM 01201.210.
  • C. Procedure - Folder Location ALJ or AC
  • If the Current Folder Location (CFL) field shows L50 or L51 (unable to locate in SSANRC or FRC), do not request the folder. It can take from two to six weeks for the DDS to receive the prior folder(s), depending on the number of prior folders the SSANRC must obtain and where they are stored; e.g., retrieval time increases when prior folders are stored in the FRCs.
  • Telephone the appropriate Hearing Office or the Appeals Council Megasite to request the file. ALJ telephone numbers are located in each regional area phone directory or can be obtained on the system using DOORS. The Appeals Council Megasite phone number is (703) 605-8930. If the file can not be released, request photocopies of the necessary medical evidence if possible.
  • When the SSANRC/FRC is unable to locate the requested folder(s), the DDS receives an alert message “FOLDER/PE REQUESTED FROM SSANRC UNABLE TO LOCATE”. The DDS should take no further action to obtain the prior folder(s) from the SSANRC/FRC.
  • If a request for review on a prior claim is pending at the Appeals Council and a subsequent claim has been filed, see DI 20101.025 for development and request for evidence from the prior file.
  • Use the folder location information on these queries to request the prior folder(s) from all possible locations simultaneously.
  • D. Procedure - Concurrent (Title II/Title XVI) Folders
  • 3. Contacting a Field Office (FO), Office of Hearing Operations (OHO), the Appeals Council (AC) or another DDS to request a Title XVI folder
  • Follow instructions for retrieving each type of folder. Normally concurrent title II/title XVI folders are separated by the FO once the initial decision has been made. It is important to remember that in concurrent cases, the medical evidence generally is filed in the title II folder if a title II medical decision was made. (An SSA-831-U5 for the SSI claim would be in the SSI folder in such cases.)
  • After determining the location of the Title XVI prior paper folder, follow DI 20505.015A.2 in this section to request the folder.
  • C. Procedures when you do not receive a response to your Title II or XVI folder request
  • Take the following actions if you do not receive the folder or a response to your folder request after 28 days:
  • * Review the standard query (SQRY) to determine the folder status. MSOM PCACS 008.001 explains the SQRY folder status.
  • * If the folder is in transit, the query location will read “FOUT” (file out). View the folder query to see the “TO LOCATION”. The query reflects the destination office code of the folder. Retain any related material for association when you receive the folder.
  • * If the folder is not in transit and the need for it is a judgment issue, carefully reassess that need. If you determine you still need the folder, contact the office where the folder is located to request it. Re-contact the PSC as necessary until you receive the folder or until you receive a response that it cannot be located.
  • * The system does not have a built in diary alert to let you know that the folder was not received after 28 days. Therefore, monitor the system for control of the folder.
  • D. Procedures for associating the prior and current paper folders
  • If the current disability claim is in a modular disability folder (MDF) and the prior claim is a two-part folder, the DDS should staple the prior claim to the back of the current claim.
  • When the prior folder is a disabled widow(er)’s benefit (DWB) or childhood disability benefit (CDB) (beneficiary on another number holder’s record)), staple its front flap to the back flap of the current paper folder.
  • E. DDS determines the prior folder is unnecessary
  • If the DDS determines the requested prior folder is not necessary, prepare a determination on the current claim and forward it per DI 32001.010B.
  • If the DDS receives the prior folder after the denial determination, the DDS forwards the folder to the FO to be associated with the current claim and retained for 6 months.
  • If the DDS allows the current claim, DDS sends the prior folder for association with the current folder.
  • In some situations, the FO will recall both the current folder and a related folder that the PSC/ODO may have sent to the DDS. In this instance, stop development and return the entire claims folder to the FO. If the DDS later receives a prior folder, send it to the appropriate or corresponding FO.
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