DI 11010: Initial Disability Claims Processing
TN 49 (08-08)
A. Field Office (FO) Procedure for partial awards
The Disability Determination Services (DDS) may find that a period of disability can be established based on the medical evidence in file but that an earlier onset date may be possible with further development. The DDS may use the "partial-award determination" procedure permitting immediate payment of Disability Insurance Benefits (DIB) or Disabled Widow(er) s Benefits (DWB). The additional development for an earlier onset date is deferred until after the DIB or DWB award has been processed.
The purpose of the partial award determination is to expedite payment to the claimant. The procedure is not used if:
The claimant is in payment status; or
The claimant is paid almost immediately on the basis of a Retirement Insurance Benefits (RIB) or RIB-DIB award; or
A claim for monthly survivor's benefits (other than DWB) has been filed on the Number Holder’s (NH's) Earnings Record (E/R).
B. Procedure - when a partial disability award determination is appropriate
Partial award determinations are made only in DIB claims where immediate payment is due. They are identified by the DDS in the remarks portion of the SSA-831 (Disability Determination and Transmittal) by the statement, "Return folder to DDS after award payment--possible date of onset (date) to be developed."
All the following conditions must be met:
The DDS is satisfied, based on evidence in file, that the claimant is under a disability at least by a certain date; and in DIB claims, as of the date of disability insured status and in DWB cases before the end of the prescribed period; and
It is possible that after additional development, an earlier onset date may be established. The NH has disability insured status in the earlier month and the earlier date would increase the Primary Insurance Amount (PIA) or change the first month of entitlement; and
A DIB claim can be awarded no later than the month after the month in which the partial award determination is triggered. Thus, in a case requiring a waiting period, at least 4 full calendar months must have elapsed between the date in item 15 on the SSA-831(onset date) and the month the partial award determination is triggered to payment.
C. Example
Tania filed a DIB claim in 03/05 alleging she had done no work since 03/03. She is insured. The DDS determined that she had become disabled at least by 08/24/03. However, there is a possibility that with additional evidence, an earlier onset date could be established.
Since Tania has disability insured status in and before 08/03 and more than 5 full months have elapsed since the latter date, a partial disability award can be awarded.
See Common Partial Adjudication Situations -GN 01010.110 - GN 01010.120 for instructions regarding a partial award involving non-disability issues. Currently reopenings of certified electronic folder (CEF) cases cannot be processed electronically. The CEF must be converted to a paper MDF. See Certified Electronic Folder (CEF) Exclusions and Limitations - DI 81010.030F.