POMS Reference

DI 32005: Routing - Initial/Reconsideration/Reopening Cases

TN 1 (09-10)

The following are the general principles affecting routing of initial and reconsideration paper cases from the Disability Determination Services (DDS). For electronic cases, follow the instructions in DI 81020.000.

  • Initial and reconsideration title II allowances are routed directly to the Field Office (FO), with the following exception: Disabled Widow(er) Benefit (DWB) Medicare only allowances are routed directly to the appropriate Program Service Center (PSC). To determine the appropriate PSC, see DI 32005.015. Cases selected for Office of Quality Performance (OQP) sample review or pre-effectuation (PE) reviews are sent directly to the Disability Quality Branch (DQB). Upon completion of their action, the FO or DQB routes the case to the Office of Disability Operations (ODO) or the PSC for payment action.

  • Initial and reconsideration title II denials are routed from the DDS to the FO. For exceptions in the routing charts, see DI 32005.035. The FO retains the file for six months and then sends the file to the SSA National Records Center (SSANRC).

  • Title XVI allowances are routed to the FO for payment action. Cases sent to DQB are forwarded to the FO by DQB. The case is forwarded to the NRC, after the FO or DQB has completed its action.

  • Title XVI denials are sent to the FO to be retained for the appeals period. After that period, the FO forwards the folder to the NRC for storage.

  • Concurrent title II and title XVI claims have the same routing procedures that apply to each claim separately.

NOTE: When the DDS prepares a notice or personalized explanation and the case is selected for Pre-effectuation Review (PER) or Quality Assurance (QA) review, DDS prepares an undated notice or explanation, according to the procedures outlined in DI 81020.130. After review, DQB prints a copy of the notice, date stamps it, and releases it to the claimant and any appointed representative (e.g., attorney or non-attorney representative) at the conclusion of the review.

Reference

DI 11010.370 Field Offices (FO) Retaining and Shipping Paper Modular Disability Folders (MDF)