BASIC (06-10)

A. Railroad Retirement Board (RRB) actions

RRB makes their disability decision and prepares a joint freeze SSA-831(Disability Determination and Transmittal), allowing or denying the freeze. They then forward the paper file to the Great Lakes Program Service Center-Disability Processing Branch (GLPSC-DPB).

B. GLPSC-DPB actions

GLPSC-DPB disability processing specialists (DPS) review the joint freeze cases and approve or question the RRB disability determination.

1. Upon initial receipt

Take the following action upon receipt of a disability claim:

a. Check for a claim with SSA

Check the SSA Modernized Claims System (MCS), Master Beneficiary Record (MBR), and Supplemental Security Income Record (SSR) to see if a claim has been filed with SSA.

If a disability claim (Title 2, Title 16, or concurrent) that covers the same period as the freeze case exists, take the following actions:

• Return the freeze folder to RRB via Form GLPSC-38 (Joint Freeze Transmittal), checking the box marked “Not a Joint Freeze Case”. Inform RRB that since the claimant also filed for disability with SSA, the case will be coordinated as a dual eligibility case, which is explained in DI 44001.115.

• Prepare Form SSA-415 (Notice of Disability Determination and Transmittal) to inform RRB of the SSA determination per DI 44001.125E, and fax the form into the SSA certified electronic folder (CEF).

• Burn a CD to include copies of the SSA-415, SSA-831, and any medical evidence of record (MER) not already in the joint freeze folder, and return it to RRB with the joint freeze folder.

• Make copies of any significant MER in the joint freeze folder and fax them into the SSA CEF, or file the copies in the SSA modular disability folder (MDF), unless the material duplicates existing SSA evidence.

• For MDF folders, request the folder. Send a copy of the GLPSC-38 to the RRB via email advising them that we will forward the JF folder and additional documents when our MDF is received. Send copies of the disability determination and MER not already in the joint freeze folder to RRB via SSA-415 when the MDF is received. (Do not delay the return of the joint freeze folder to RRB pending receipt of the SSA MDF folder for more than two weeks. If MDF is not received, copy the material in the JF folder to place in MDF when it arrives. If the JF folder contains a significant amount of information, DPS has the option of waiting until MDF folder is received, requesting return of the JF folder from RRB, and copying only the information not already contained in the MDF).

• Additional information can be found in DI 44001.105E “Inappropriate DDS determinations on dual eligibility claims” and DI 44001.125C.3., Coordination of Dual Eligibility Cases with Railroad Retirement Board (RRB)”.

NOTE: An End Stage Renal Disease (ESRD) claim is not considered a disability claim for purposes of this instruction.

b. Check for insured status for both a disability freeze and for cash Disability Insurance Benefits (DIB) benefits

• If the claimant is not insured for a disability freeze at the alleged onset date, return the folder to RRB advising them that GLPSC-DPB review is not required, due to lack of freeze insured status.

• If the claimant is insured for SSA cash DIB benefits, annotate Item 34 of the SSA-831: “20/40 FOR DIB” if not already annotated by the RRB.

c. Review the assessment

Review RRB’s disability assessment to see if their proposed decision (allowance or denial) would be correct if the GLPSC-DPB doctor agrees with the RRB medical assessment.

d. Prepare forms

Prepare an SSA-448 (Request for Medical Advice) with a summary of the medical evidence. Paperclip or tag any evidence you think is important for the doctor to see (consultative examination (CE) reports, x-rays, lab reports, surgical reports, etc.). If RRB’s decision would be correct if the doctor agrees with RRB’s medical assessment, ask the doctor to sign the SSA-831. Route the case for Medical Consultant/Psychological Consultant (MC/PC) referral.

2. When the case is returned from the doctor

a. Determination agrees with RRB

Follow the instructions for completion of the SSA-831 in DI 44005.010 (or DI 44005.020 for 20/40 Allowance cases).

b. Determination disagrees with RRB (insufficient medical or vocational evidence, different Residual Functional Capacity (RFCs), etc.)

Prepare Form GLPSC-38 advising RRB of the disagreement, including any pertinent SSA Program Operations Manual System (POMS) references.

c. Additional evidence is needed, including the purchase of a CE

Prepare Form GLPSC-38 advising RRB to obtain the necessary evidence.

NOTE: If we disagree with RRB’s determination, or we believe additional evidence is needed, do not complete any items on the SSA-831.

d. Determination agrees with RRB decision to allow or deny, but disagrees only with the onset date, regulations basis code, or vocational rule

Complete the SSA-831 per DI 44005.010 or DI 44005.020, correcting the RRB entries as necessary. Prepare Form GLPSC-38 advising RRB of the corrections, and that no additional case return is necessary unless they disagree.