POMS Reference

DI 81020: DDS Procedures - Electronic Process

BASIC (01-08)

A. General

When documents are scanned or faxed into the Certified Electronic Folder (CEF), indexing data in the Document Management Architecture (DMA) barcode contains information that:

  • Associates the document with a specific case;

  • Identifies the Document Type;

  • Identifies the section of the CEF in which the document is filed; and

  • Provides specific information about the document, including office information (site ID), disposition information (e.g., to print or store in the image repository), and scanning contractor information (e.g. store or forward the paper document).

For example, medical evidence requested by a Disability Determination Services (DDS) from a claimant’s treating source has a document type of Medical Evidence of Record, Document Type 0001 and is stored in section F of the CEF.

This document type tells the system to:

  • Label the imaged document as “Medical Evidence of Record” in the CEF case document tab; and

  • Place the imaged document in Section F “Medical Records” (Yellow Back) of the CEF.

It is essential that the correct Document Type be assigned when DMA barcodes are generated and when documents are casually scanned and manually indexed into the CEF.

B. Selecting document type

1. General

When designating the Document Type, use the exact name of the form or document. This ensures the form or document is correctly identified and displayed in the appropriate section of the CEF.

For a complete list of Document Types identified in the CEF, refer to the Electronic Folder Document Type Chart.

NOTE: Do not use the Miscellaneous Document Types (e.g., 7010, 7011, 7012, 7013, 7014, and 7015) unless none of the specific document types apply.

2. Case development requests to the claimant from DDS

Follow procedures in Documenting the Disability Folder - DI 20503.001B and Folder Preparation - DI 32001.020B, to determine when case development and evidence requests are stored in the disability folder.

The Electronic Folder Document Type Chart provides several options for indexing letters, requests, and follow-up correspondence to the claimant. These documents are generally stored in Section E (Blue Section) of the CEF.

Use Copy of Case Development Correspondence, Document Type 0190, which is stored in section E, when storing copies of the case development request letter to the claimant in the CEF.

The DDS case processing system automatically images and indexes these letters to the CEF after DDS creates and prints the letter. Do not use Claimant Correspondence – Document Type 5020 to index a copy of the outgoing request letter to the CEF.

NOTE: If the letter is requesting that the claimant complete and return a specific questionnaire or form, a separate barcode must be placed on the letter to the claimant (if used as the return cover sheet) or on the questionnaire or form. Include in this barcode the appropriate document type for the form or questionnaire per Document Types - DI 81020.040B.3.

3. Documents returned from the claimant to the DDS

If the DDS requests a claimant to complete and return a form or questionnaire, the DDS must use a separate Document Type in the barcode for each form/questionnaire. The Document Type in the barcode must be different than the Document Type used for the request letter. DDS must place this barcode on the request letter (if used as the return coversheet) or on the form/questionnaire itself. When the returned form/document is scanned, it is automatically indexed and added to the correct section of the CEF. For more information on the Document Type used for the request letter to the claimant, see Document Types - DI 81020.040B.2.

a. Specific document type available

Use the specific Document Type if it is available in the Electronic Folder Document Type Chart. (See Document Types - DI 81020.040B.1.) For example, if the return questionnaire is an SSA-3369 (Disability Report - Work History), use Disability Report – Work History, Document Type 1080, which is stored in section E of the CEF.

b. No specific document type available

If no specific Document Type is available in the Electronic Folder Document Type Chart. (See Document Types - DI 81020.040B.1.) Use the Claimant Correspondence, Document Type 5020, which is stored in section E of the CEF.

c. Activities of daily living (ADL) questionnaires

Use the generic Document Type Activities of Daily Living, Document Type 0050, which is stored in section E of the CEF, for documents or forms for which there are multiple iterations, such as ADL questionnaires (e.g., Function Report – Child age 1 to 3, Function Report – Child age 3 to 6, and Function Report – Adult).

NOTE: There are also specific codes for each form to be used if the DDS case processing system allows it. Regardless of whether a generic or form-specific code is used, each form must be clearly indexed and stored as a separate document.

d. School records

Use the generic Document Type of Educational Records Medical, Document Type 3157, which is stored in section F of the CEF, for documents or forms that contain IQ scores or medical information. For example, the school sends a copy of an Individualized Education Program (IEP) that contains the claimant’s IQ scores.

Evidence that does not contain medical information, such as a written report about conduct, use the generic Document Type Educational Records Non Medical, Document Type 3158, which is stored in section E of the CEF.

Additional Document Types for School Records are shown in the following chart:

DOC_TYP

DOC ID

DOCUMENT NAME

MDF

0150

5665

Teacher Questionnaire

E

0155

5666

Request Administrative Information

F

e. State specific questionnaires

Use the Document Type Claimant Correspondence, Document Type 5020, which is stored in section E of the CEF, for state specific claimant questionnaires if there are no specific corresponding Document Types in the Electronic Folder Document Type Chart. (See Document Types - DI 81020.040B.1.)

4. Unsuccessful medical development requests

Document the CEF to show unsuccessful medical development requests (see Modular Disability Folder (MDF) – Disability Determination Services (DDS) - DI 70015.001B and Documenting the Disability Folder – Disability Determination Service (DDS) - DI 20503.001B). Use Copy of Evidence Request, document type 0185, which is stored in section F of the CEF, to add a copy of the MER request.

5. Unsolicited medical evidence

Use the Document Type Claimant-supplied Evidence, Document Type 0180, which is stored in section F of the CEF, or Attorney/Representative-Supplied Evidence, Document Type 5032, which is stored in section F of the CEF, for medical evidence received from the claimant or the claimant’s representative.

6. Unsolicited claimant correspondence

If no specific Document Type is available in the Electronic Folder Document Type Chart. (See Document Types - DI 81020.040B.1.) Use the Document Type Claimant Correspondence, Document Type 5020, which is stored in section E of the CEF.

NOTE: If the claimant correspondence includes medical evidence, treat the claimant correspondence as unsolicited medical evidence and follow the instructions in Document Types - DI 81020.040B.5.

7. SSA-4268

When using the SSA-4268 (Explanation of Determination) as a personalized attachment to the Personalized Disability Notice (PDN), use the following Document Types so it can be “filed” in Section B “Jurisdictional Documents and Notices” (Red) of the CEF:

DOC_TYP

DOC ID

DOCUMENT NAME

MDF

6001

L442

Notice of Disapproved Claim - Concurrent

B

6002

L443

T2 Notice of Disapproved Claim

B

6003

L444

T16 Notice of Disapproved Claim

B

When using the SSA-4268 as a technical rationale, use Explanation of Determination, Document Type 0125, which is stored in section A “Payment Documents/Decisions” (Yellow Front) of the CEF.

8. Rebuttal documentation

Refer to Federal Quality Review (QR) - DI 81020.135, for the Document Types used in the Federal Quality Review first and second-level rebuttal process.

9. Policy referrals

When the Centers for Disability (CD) refers a case to the Office of Disability Policy (ODP) for a policy clarification or resolution, index the policy clarification memo as “Policy Request to OD” - Document Type 2135 which is stored in section E of the CEF.

NOTE: This procedure applies to policy referral cases that are not involved in the rebuttal process described in Federal Quality Review (QR) - DI 81020.135.