I-3-8-15.Routing Paper Files
Last Update: 10/31/13 (Transmittal I-3-57)
A. Fully or Partially Favorable Decisions
The Appeals Council (AC) will attach a Form HA-505, Transmittal By Office of Disability, Adjudication, and Review, to the front of a paper file, with the following remark in capitalized, bold and highlighted letters: EFFECTUATION NECESSARY. A Form HA-505 can be generated from the Document Generation System (DGS) at http://odar.ba.ssa.gov/linkservid/B738D2F2-5056-A10A-3CE7DDDF46C48C72/showMeta/0/.
If the claimant filed concurrent titles II and XVI claims and lives in Delaware, New Jersey, Pennsylvania, or the Virgin Islands, the AC must annotate “Mazza Case” in the remarks section on the HA-505. See Acquiescence Ruling 92-1(3), Mazza v. Secretary of Health and Human Services.
2. Where to Send the Claim(s) file
Staff will forward the claim file and decision for effectuation, as follows:
Favorable title II disability claim files go to Office of Disability Operations (ODO) via the mailroom shuttle, unless the claimant is age 54 or older. The location code for ODO is 0PC7.
Favorable title II disability claim files for claimants age 54 or older go to the appropriate Program Service Center (PSC). The appropriate PSC is determined by the first three digits of the claimant's Social Security number, as indicated in POMS GN 01070.245. Consult the Detailed Office/Organization Resource System (DOORS) for the PSC's address, telephone number and fax numbers.
All favorable title II non-disability claims files go to the PSC, as described above for claimants age 54 or older.
Favorable title XVI claim files go to the servicing Social Security Office. Consult DOORS for the appropriate office, address, and location code.
When sending a claim file(s) via express mail, staff must use the street address in DOORS, rather than a P.O. Box.
3. Other Considerations When Concurrent Claims
In order to effectuate payment, the effectuating component needs any information bearing on Supplemental Security Income (SSI) eligibility and payment to be part of the SSI file. If the claimant submitted any of the following information to the AC, or it is part of the title II file, staff will associate copies with the paper SSI file:
Disability Determination Service (DDS) title XVI determinations
Administrative law judge and AC decisions
Statement of income and resources
Reports of Contact or statements regarding living arrangements
Assessment of property forms
Proof of age
Proof of marital status
Proof of citizenship
Work history during claimed disability
Worker's Compensation decisions
Department of Veterans Affairs award letters
Railroad Retirement Board award letters
If one claim is denied and the other is favorably decided, staff will place the original copies of the medical exhibits in the folder of the denied claim so they will be available in the event of further appeal. Staff will place the photocopies of the medical exhibits in the allowed file.
B. Unfavorable Decisions
The branch will hold the case file during the appeal period in case the claimant files a civil action. The branch will forward the file to the Division of Civil Actions if the claimant files a civil action. If the claimant does not file a civil action in Federal court, staff will send the file to the Megasite.