DI 40115: Changing an Initial Disability Determination Services (DDS) Determination in the Processing Center (PC)
BASIC (03-11)
A. DDS determination case is not DDS jurisdiction
For a disability determination that is not the Disability Determination Services (DDS) jurisdiction (e.g., a career railroad case or a case that insured status is not met at the established onset) the disability examiner or disability processing specialist may
either adopt or reject the DDS determination depending on the facts of the case, and
complete the SSA-831 (Disability Determination and Transmittal) then
route the case to the field office or claims authorizer/claims technical examiner for final processing.
Notify the DDS of the correction per GN 04440.220.
B. Determination may be adopted
Enter in item 34 of the SSA-831 “Improper DDS Jurisdiction - Determination Adopted.”
Code the SSA-831 in accordance with instructions for non-DDS cases DI 11011.020.
Delete the DDS code in item 2.
Notify the DDS of the correction per GN 04440.220.
C. Determination may not be adopted
Prepare a new determination and rationale;
Scan or fax the new SSA-831 and rationale into the appropriate sections of the certified electronic folder (CEF);
Place all copies of the DDS SSA-831 in the “Green Section” of the CEF. If a paper folder exists, destroy any copies of the DDS SSA-831 and write “DO NOT PROCESS. SEE ODO OR PC DETERMINATION DATED” on the original;
Sign and date the notation on the original SSA-831 and scan it into the CEF. For paper folders, prong-file the SSA-831 on the right side of the folder; and
Notify the DDS of the correction per GN 04440.220.
D. Onset established prior to date first insured status is first met
When the DDS establishes an onset date prior to the insured status first met date
Enter the correct EOD in item 15A of the SSA-831 to show the first date that both insured status and medical disability are met;
On the SSA-831 the PC will enter remarks in Item 34: “Item 15A is based on the date first insured. Impairment was of a disabling severity, for purposes of the duration requirement, as of [date]”.
See also
DI 20101.001, DDS and SSA Jurisdictions for Initial and Subsequent Cases
DI 44001.105, Jurisdiction of Dual Eligibility Claims