TN 7 (08-09)

A. Overview for reactivating claims in EDCS

Electronic Disability Collect System (EDCS) provides the ability for FOs to reuse most EDCS records for cases closed as:

• FO Determinations; or

• No Determinations.

To differentiate between reactivations on medical denials, reactivations on FO Determinations (technical denials) are called “Technical Reactivations.”

For details on FO Determinations or No Determinations, see Processing Field Office (FO) Determinations - DI 81010.140. For information on processing medical reactivations in eView, see Processing Medical Reactivations – DI 81010.143.

EDCS allows technical reactivations on a case or on individual claim within a case. Reactivating FO Determination or No Determination claims allows FOs to update and transfer these EDCS claims to the Disability Determinations Service (DDS) for an initial medical determination. For more information on processing reactivations for appeals, see Processing Reconsideration Request of Field Office Determinations - DI 81010.145 and Processing a Reconsideration Request of an Initial Denial Based on Non-medical Issues - DI 12005.010.

NOTE: Once the FO reactivates a claim with an FO Determination or No Determination, a record of the prior closed EDCS case is stored and is viewable in eView (see Viewing EDCS Case Technical Reactivation Information – DI 81010.110C. of this section).

1. EDCS requirements for technical reactivation

The following rules apply to EDCS technical reactivations:

• Only initial-level claims can be reactivated;

• Claims to be reactivated must be in the most recent case in EDCS;

• Claims to be reactivated must have been closed with an FO Determination or No Determination;

  NOTE: If one title of a concurrent claim is transferred to the DDS and an FO Determination is made on the other title, the claim with the FO Determination can be reactivated through EDCS. If the most recent FO Determination is performed while the claim is still pending in the DDS, the FO will not reactivate the case until notification is received on the EDCS Actions Page that the claim has been closed in the DDS or the FO will allow up to 5 business days before reactivating the claim, whichever occurs first. This allows the DDS to close the claim on their system. This only applies if no medical determination has been made on any claim in the case.

  NOTE: Although collateral estoppel (“FA” determination code) is an allowance based on a prior medical determination, it is not considered a medical determination for reactivations.

• There must be at least one closed mainframe (i.e., Modernized Claim System (MCS) or Modernized Supplemental Security Income Claim System (MSSICS)) claim for the EDCS case being reactivated.

  NOTE: MCS exclusion claims cannot be reactivated in EDCS. This includes concurrent and multiple entitlement claims where one of the claims is a MCS exclusion.

2. Mainframe requirements for technical reactivation

For each technically denied EDCS claim being reactivated, the FO must establish a new open mainframe claim that:

• Matches the claim type(s) of the FO determined claim(s);

• Matches the Number Holder (NH) name; and

• Has the same filing date(s) as the FO determined claim(s).

  NOTE: If any claims within the case cannot be reactivated, follow Certified Electronic Folder (CEF) Exclusions - DI 81010.030D, for processing appeals of SGA and other technical denials.

B. Processing technical reactivations

1. Reactivating the case

To reactivate an FO Determination or No Determination (technical denial) claim in EDCS:

• Verify that the claim meets the criteria in Overview – DI 81010.110A. of this section;

• Select the “Reactivate Claim(s)” button on the Disability Case Selection screen;

• Complete the Reactive Claim(s) screen;

• Select the appropriate claim type; and

• Select the “OK” button.

  NOTE: After selecting the “OK” button, claim status displays “Reactivated”. If the “Cancel” button is selected, the reactivation is terminated and the user returns to the page where the reactivation was initiated.

2. Updating EDCS after technical reactivation

After reactivating the EDCS claim:

• All actions needed to process an initial claim can be taken on the reactivated claim, including repropagation and the Update-After-Transfer (UAT) Utility.

• All disability reports and data that existed in the case at the time of the FO closure are available and can be edited as needed.

• Update all reports and add any new ones as necessary (e.g., an Adult Disability Report (SSA-3368) if one was not completed already) to prepare the case for transfer to the DDS.

• All of the functionality for that case (e.g., the ability to update the data, editing, transfer capability, etc.) is exactly the same as an initial non-reactivated case that is pending in the FO. An FO determination can be made on the reactivated case.

3. Transferring the case to the DDS

After all updates are complete, follow normal transfer procedures to transfer the case to the DDS per Transferring Cases in Electronic Disability Collect System (EDCS) - DI 81010.085.

4. Inputting another FO determination or no determination

If it is later decided that the reactivated claim requires an FO Determination or No Determination, close the claim by adding another FO Determination or No Determination via the Claims Action page. For more information on FO determinations, see Processing Field Office (FO) Determinations - DI 81010.140.

C. Viewing EDCS case technical reactivation information

1. EDCS

Effective with the reactivation of FO determined cases, the Claims Action screen in EDCS displays the:

• Reactivated claim(s) in “Pending” status;

• Previous FO Determination under the “Determination/Disposition/Decision” column;

• Claim(s) type and claim status as the case is processed;

• Most recent determination when claim(s) has multiple FO determinations.

2. Use eView to see previous FO determinations

To view previous FO determinations, access the Case Data Tab in eView. The previous FO determination is located under Record of Change.