POMS Reference

DI 13015: Special CDR Issues

TN 1 (01-01)

Procedure

DO NOT request the Title II medical folder prior to or during the initial pull period (see DI 13015.050B. and DI 13015.050C.).

See DI 13015.055 ff. and the chart in DI 13015.100C. for a quick overview of the FO actions in a Title II CDR folder, e.g., INTRN FOUT TTRN location.

1. Prior Title II Folder or Wrong Title II Folder Received

There are situations in which an FO may need to obtain a Title II folder. These situations are usually related to disability issues, such as CDRs, appeals and reopening. (See MSOM CDR 001.014 the Disability Control File (DCF) informational screen (CDRWI)). Enter a “Y” in the prior folder block of the CDRI to establish a tickle control for receipt of your folder.

Retrieve the proper Title II CDR medical folder ONLY in the following situations:

  • the folder received from the Megasite/Caves/PSC is not a medical folder ; or,

  • the folder received from the Megasite/Caves/PSC is for the wrong claimant, i.e. HA folder received and the DAC is due the CDR; or,

  • the folder received has the wrong account number (WAN); or,

  • the Title II folder is in a FO (see DI 13015.040E. and DI 13015.040F.)

  • the SSI recipient previously filed for Title II, such as CDB benefits, which have been denied or terminated. Look for the medical evidence, which could be housed in the Title II denied folder.

  • The Megasite/Caves storage facilities will not associate folders from other locations. For example, if processing center action control system (PCACS) shows a folder in an operational site, such as, PSC module location, a folder in a Caves location, a folder in PC7 AUXRH location, the Caves will pull and send only the Caves location folder but not the other two. In these cases, the FO must retrieve the folders if the Megasite/Caves folder does not contain the current medical evidence. Recall the Title II folder, following normal PCACS procedures.

NOTE: Beginning February 2000, OCO began mailing feedback letters to offices that request folders through the PCACS folder request facility. The goal is to provide timely information about the status of a folder request.

Successfully locating a folder often requires detective work. Use all resources available to avoid time-consuming and costly folder reconstruction. See DI 13015.080A. - DI 13015.080C. for helpful hints that can also be applied to TII folders.

2. Title II Folder Received:

  • Review the folder received to determine whether the necessary prior medical information is in the file. See DI 13015.080 if no medical evidence is received.

  • Contact the DRS/Module Manager for any original or duplicate folder received that has not been updated in PCACS to your location.

  • Update folder location in PCACS and the DCF when transferring folders from one FO to another FO.

  • Use the diary/request screen to update the folder locations on PCACS. This includes transferring a folder from a FO to another FO or to a DDS, or an ODAR location.

  • Update the DCF CDR FO Input (IFOA) screen when the Title II folder reaches their office.

  • Concurrent case: If the Title II folder contains only post-entitlement information or a duplicate folder is received, obtain (see DI 13015.035 and DI 13015.040) the Title XVI folder(s) to determine if the medical information is available in that folder.