TN 49 (08-08)

A. Procedure - Disability Insurance Benefits/Childhood Disability Benefits (DIB/CDB)

If a claimant files a DIB claim and lists an auxiliary who is a potential CDB, transmit the DIB claim to the appropriate Disability Determination Services (DDS), Office of Central Operations/Office of Disability Operations (OCO/ODO), Office of Central Operations/Office of International Operations (OCO/OIO), or Program Service Center/ Disability Processing Branch (PSC/DPB). Since entitlement to CDB depends upon an allowance of the DIB claim, take no action on the CDB claim until a determination is made on the DIB claim. However, if the claimant also filed for Retirement Insurance Benefits (RIB) and is insured, and the critical non-medical requirements are met on the CDB claim, forward it to the appropriate DDS or OCO/ODO, OCO/OIO, PSC/DPB, based on the residence address of the child auxiliary at the time the transmittal is forwarded. This may be different if the child and claimant are living in different States. Cross-refer each file by entering “(CDB or DIB) application for (name of claimant or disabled child) forwarded to (DDS, OCO/ODO, OCO/OIO, or PSC/DPB) on (date)” in the Remarks section on the SSA-831 (Disability Determination and Transmittal) for paper cases. For electronic cases, annotate the aforementioned in Transfer remarks on the Title II/Title XVI Information page. Preparation of Folder for Transmittal of CDB Cases - DI 11020.055 contains instructions on processing claims for DIB and CDB for the same individual. For claims to be processed electronically, see Creating Electronic Disability Collect System (EDCS) Cases - DI 81010.020.

B. Procedure – Disability Insurance Benefits/Disabled Widow(er)s Benefits (DIB/DWB)

If a claimant files a DIB claim as well as a DWB claim, transmit the claims together. If one of the claims does not require a DDS determination, prepare an SSA-5002 (Report of Contact) and place it in, or upload to, the official DIB folder. See Preparation of Folder for Transmittal of Disabled Widow or Widower (DWB) Claims - GN 01050.175, Unsuccessful Work Attempt (UWA) - DI 11010.145 and General Overview of the MDF - DI 70005.005. For claims entered into EDCS see Transferring Cases in Electronic Disability Collect System (EDCS) - DI 81010.085.

C. Procedure – End Stage Renal Disease (ESRD) claim involved

A claim for a disability benefit (DIB, Freeze, DWB, or CDB), which is DDS jurisdiction, see Disability Determination Services (DDS) and Social Security Administration (SSA) Jurisdictions-Initial and Subsequent Cases - DI 20101.001, may be filed concurrently with an ESRD claim. In this situation, place medical evidence obtained in connection with the ESRD claim in the official folder, and forward to the DDS. If the official folder is paper, place the medical evidence in section F Medical Evidence (Yellow Back) of the Modular Disability Folder (MDF). If the official folder is electronic, fax the medical evidence to section F of the Certified Electronic Folder (EF), and then mail the original to the DDS.

Route separately a concurrently filed Retirement Survivor Insurance (RSI) claim that does not require a disability determination to the appropriate PSC.

In all multiple claims situations, after adjudication, route all ESRD claims material to:

NOTE: This procedure applies to disability-related claims, and technical denials.

Use the Modernized Claims System Earnings Computation (MCS EC) process to adjudicate most ESRD claims when the claimant is filing on his/her own SSN. When an individual files on a spouse’s or parent’s SSN and the claim is allowed, adjudicate using an A101 (Automated Determination of Award). If the claim is denied, manually clear the case in MCS and complete all entries on the MADCAP Direct Data Entry (MACADE) screens for a Determination of Disallowance.

D. Procedure – Retirement Insurance Benefits/Disability Insurance Benefits (RIB/DIB)

Special care must be taken when a RIB claim is clearly advantageous to the DIB claim. The RIB claim may be more advantageous if the claimant receives Workers Compensation (WC) or the special disability maximum applies. The effects of either of these issues and future entitlement to health insurance must be considered and discussed with the claimant. See Reduced RIB as Affected by DIB (A - HA) - RS 00615.110 for additional information on RIB/DIB.