TN 11 (11-12)

A. Policy for establishing an interim EOD

1. Definition of interim EOD

An interim EOD is an EOD established when current medical documentation permits payment of benefits while the Disability Determination Services (DDS) develops evidence to establish an earlier EOD that is more advantageous to the claimant.

2. DDS rules for establishing an interim EOD

If the evidence establishes a claimant is currently disabled, and there is a possibility that additional development will support an earlier EOD, the adjudicator establishes an interim EOD, if all of the following criteria are met:

1. The adjudicator anticipates a lengthy delay (i.e., 30 days or more) in obtaining evidence of the possible earlier onset date or the adjudicator already encountered such a delay and timely resolution is not expected.

2. The disabled claimant is alive.

3. At least five full calendar months elapsed since the interim EOD for Disability Insurance Benefit (DIB) and Disabled Widow(er)’s Benefits (DWB) claims, or the FO indicated on an SSA-5002 (Report of Contact), or other appropriate form, that the claimant does not need to meet a waiting period .

4. For DWB cases, the claimant is under age 60 and the earlier onset date we are developing is within the latest of the following.

   • 17 months before the month of filing (or 12 months if we do not require a waiting period).

   • Five months before the month in which the prescribed period begins.

   • Five months before the month of the claimant's 50th birthday.

3. Processing center (PC) returns claim for consideration of a different EOD

The PCs review cases and may establish an interim EOD. If evidence indicates a different EOD may be appropriate, the PC may revise the determination and effectuate payments.

If the interim EOD established by the PC affects the claimant’s benefit, or benefits rights, the PC will return the case to the adjudicator to resolve any outstanding issue(s) regarding establishing the EOD. (See DI 40115.000 and DI 42001.015.)

B. Component roles for establishing an interim EOD

1. Field office (FO)

When DDS establishes an interim EOD, the FO effectuates the claim and returns jurisdiction of the claim to DDS. The FO also forwards any modular disability folders in their possession, associated with the claim, to the DDS.

2. Disability Determination Services (DDS)

The DDS establishes an interim EOD when the claimant meets the criteria in DI 25501.270A.2. in this section. When the FO returns jurisdiction of the claim to the DDS, the adjudicator undertakes additional development to determine a final EOD.

C. Component instructions for establishing an interim onset

1. Field office (FO)

When the DDS prepares an interim EOD, take the following actions.

• Effectuate the claim.

• Determine whether an earlier EOD could affect present or future benefits or benefit rights, and

• If an earlier EOD could affect the benefit or benefit rights, return jurisdiction of the claim along with any Modular Disability Folder (MDF) claims in your office to the adjudicator following payment effectuation for consideration of an earlier EOD, or

• If the establishment of the earlier EOD would not affect present or future benefits or benefit rights, advise the adjudicator of your findings on an SSA-5002, or similar form, and return jurisdiction of the claim to DDS so they can prepare a final Personalized Disability Notice (PDN), see DI 26530.001.

2. Disability Determination Services (DDS)

When establishing an interim EOD take the following actions.

• Enter, “Possible earlier date of established onset (insert date) to be developed,” in item 34 of the SSA-831 (Disability Determination and Transmittal).

• Prepare and send a change of onset notice. If the change of onset is not fully favorable, prepare a personalized disability explanation (PDE) and send it with an SSA-L1157-DI or SSA-L1157-SI.  (See DI 25501.280 Notifying Claimants of Partially Favorable Allowances. )

• Return jurisdiction of the claim to the FO to effectuate payment.

When the claim is returned from the FO take the following actions.

• Develop and evaluate the EOD.

• If there is a change in the EOD, prepare a new SSA-831. If the new EOD is partially favorable, prepare a PDE clearly explaining the basis for the new EOD determination and send it with an SSA-L1157-DI or SSA-L1157-SI.  (See DI 25501.280 Notifying Claimants of Partially Favorable Allowances.)

• If there is no change in the EOD, in the eCat Determination Page, enter the EOD in the “Established onset date” field, explain your EOD in the EOD explanation block, and prepare a personalized disability notice clearly explaining the basis for the EOD determination. If you are not using eCat, process the claim as a “No Determination (ND) using reason “Original Decision Not Changed” as described in DI 81020.127. Explain your EOD on an appropriate medical assessment form.

When a Processing center (PC) returns a case, take the following actions.

• Redevelop or reevaluate the EOD.

• If there is a change in the EOD, prepare a revised determination. If the new EOD is partially favorable, prepare a PDE clearly explaining the basis for the new EOD determination and send it with an SSA-L1157-DI or SSA-L1157-SI. (See DI 25501.280 Notifying Claimants of Partially Favorable Allowances.)

• If there is no change in the EOD enter, “No change in established onset date,” in item 34 of the SSA-831 and return jurisdiction of the claim to the PC.

• If you have not prepared a revised determination because you have not obtained additional evidence or there is no change in the original determination, transmit the case to the PC with the following remark, “No change in determination dated ____: revised determination not necessary.” (Insert date of prior determination in blank).

D. References

• DI 11010.120 Partial Award Determination

• DI 81010.143 Processing Medical Reactivations