Electronic Disability Claim File, Social Security Administration, Deputy Commissioner for Disability and Income Security Programs

Effective Date: December 22, 2003

(78 F.R. 71210)

SOCIAL SECURITY ADMINISTRATION NOTICE OF SYSTEM OF RECORDS REQUIRED BY THE PRIVACY ACT OF 1974

System number: 60-0320

System name: 

Electronic Disability (eDib) Claim File, Social Security Administration, Deputy Commissioner for Disability and Income Security Programs

Security classification: 

None.

System location: 

The eDib claim files are virtually established in Social Security field offices when claims for benefits are filed, or a lead is expected to result in a claim, and maintained in the National Computer Center at SSA Headquarters. The computerized records and database are maintained at:

Social Security Administration

Office of Systems

6401 Security Boulevard

Baltimore, Maryland 21235

Other authorized Federal and State agencies that have access to the current paper disability folder will also have electronic access as needed to the eDib claim file.  State agencies process disability and vocational rehabilitation determinations. Contact the system manager for address information.

Categories of individuals covered by the system: 

Claimants, applicants, beneficiaries and potential claimants for disability benefits and payments administered by the Social Security Administration (e.g., Title II and XVI disability claims).   

Categories of records in the system: 

The eDib Claim File contains the name and Social Security number (SSN) of the claimant or potential claimant and may contain the application for benefits; supporting evidence and documentation for initial and continuing entitlement; payment documentation; correspondence to and from claimants and/or representatives; information about representative payees; and leads information from third parties such as social service agencies, Internal Revenue Service, Veterans Administration and mental institutions. 

The eDib claim file also may contain data collected as a result of inquiries or complaints, and evaluation and measurement studies of the effectiveness of claims policies.  Separate files may be maintained of certain actions, which are entered directly into the electronic processes.  These relate to reports of changes of address, work status, and other post‑adjudicative reports.  Separate abstracts also are maintained for statistical purposes (i.e., disallowances, technical denials, and demographic and statistical information relating to disability decisions). 

Authority for maintenance of the system: 

Sections 202‑205, 223, 226, 228, 1611, 1631, 1818, 1836, and 1840 of the Social Security Act (42 U.S.C. §§ 402-405, 423, 426, 428, 1382, 1383, 1395i-2, 1395o and 1395s).

Purpose(s): 

The electronic disability claim file contains material related to the request for or continuation of benefit payments under Titles II and XVI of the Social Security Act.  eDib claim file information is used throughout SSA for purposes of pursuing claims; collecting, documenting, organizing and maintaining information and documents for making determinations of eligibility for disability benefits, the amount of benefits, the appropriate payee for benefits; reviewing continuing eligibility; holding hearings or administrative review processes; ensuring that proper adjustments are made based on events affecting entitlement; and answering inquiries.

eDib claim files may be referred to State Disability Determination Service agencies or vocational rehabilitation agencies. They may also be used for quality review, evaluation, and measurement studies, and other statistical and research purposes.  Extracts may be maintained as interviewing tools, activity logs, records of claims clearance, and records of type or nature of actions taken.

Routine uses of records maintained in the system, including categories of users and the purposes of such uses:

Disclosure may be made for routine uses as indicated below.  However, disclosure of any information defined as "return or return information" under 26 U.S.C. § 6103 of the Internal Revenue Code (IRC) will not be disclosed unless authorized by a statute, the Internal Revenue Service (IRS), or IRS regulations.

1.  To the Office of the President for the purpose of responding to an individual pursuant to an inquiry received from that individual or from a third party on his or her behalf.

2.  To a congressional office in response to an inquiry from that office made at the request of the subject of a record.

3.  To the Department of Justice (DOJ), a court or other tribunal, or another party before such tribunal when:

a) SSA, or any component thereof; or

b) any SSA employee in his/her official capacity; or

c) any SSA employee in his/her individual capacity where DOJ (or SSA where it is authorized to do so) has agreed to represent the employee; or

d) the United States or any agency thereof where SSA determines that the litigation is likely to affect the operations of SSA or any of its components is party to litigation or has an interest in such litigation, and SSA determines that the use of such records by DOJ, a court or other tribunal, or another party before such tribunal is relevant and necessary to the litigation, provided, however, that in each case, SSA determines that such disclosure is compatible with the purpose for which the records were collected.

4.  Disclosure of any information defined as “return or return information” under 26 U.S.C. § 6103 of the Internal Revenue Code (IRC) will not be disclosed unless authorized by a statute, the Internal Revenue Service (IRS), or IRS Regulations.

5.  To third party contacts in situations where the party to be contacted has, or is expected to have, information relating to the individual’s capability to manage his/her affairs or his/her eligibility for or entitlement to benefits under the Social Security program when:

-The individual is unable to provide information being sought.  An individual is considered to be unable to provide certain types of information when:

-He/she is incapable or of questionable mental capability;

-He/she cannot read or write;

-He/she cannot afford the cost of obtaining the information;

-He/she has a hearing impairment, and is contacting SSA by telephone through a telecommunications relay system operator;

-A language barrier exists; or

-The custodian of the information will not, as a matter of policy, provide it to the individual; or

-The data are needed to establish the validity of evidence to verify the accuracy of information presented by the individual, and it concerns one or more of the following:

-His/her eligibility for benefits under the Social Security program;

-The amount of his/her benefit payment; or

-Any case in which the evidence is being reviewed as a result of suspected abuse or fraud, concern for program integrity, or for quality appraisal, or evaluation and measurement activities.

6.  To third party contacts where necessary to establish or verify information provided by representative payees or payee applicants.

7. To a person (or persons) on the rolls when a claim is filed by an individual which is adverse to the person on the rolls, i.e.,

-An award of benefits to a new claimant precludes an award to a prior claimant; or

-An award of benefits to a new claimant will reduce the benefit payments to the individual(s) on the rolls; but only for information concerning the facts relevant to the interest of each party in a claim.

8.  To employers or former employers for correcting or reconstructing earnings records and for Social Security tax purposes only.

9.  To the Department of Treasury for:

-Collecting Social Security taxes or as otherwise pertinent to tax and benefit payment provisions of the Act (including SSN verification services); or

          -Investigating alleged theft, forgery, or unlawful negotiation of Social Security checks.

10.  To the United States Postal Services for investigating the alleged forgery, theft or unlawful negotiation of Social Security checks.

11.  Information may be disclosed to DOJ for:

-Investigating and prosecuting violations of the Act to which criminal penalties attach,

-Representing the Commissioner, or

-Investigating issues of fraud by agency officers or employees, or violation of civil rights.

12.  To the Department of State and its agents for administering the Act in foreign countries through facilities and services of that agency.

13.  To the American Institute of Taiwan and its agents for administering the Act in Taiwan through facilities and services of that organization.

14.  To the Department of Veterans Affairs, Philippines Regional Office and its agents for administering the Act in the Philippines through facilities and services of that agency.

15.  To the Department of Interior and its agents for administering the Act in the Northern Mariana Islands through facilities and services of that agency.

16.  To State Social Security Administrators for administration of agreements pursuant to section 218 of the Act.

17.  To private medical and vocational consultants for use in making preparation for, or evaluating the results of, consultative medical examinations or vocational assessments which they were engaged to perform by SSA or a State agency acting in accord with sections 221 or 1633 of the Act.

18.  To specified business and other community members and Federal, State, and local agencies for verification of eligibility for benefits under section 1631(e) of the Act.

19.  To institutions or facilities approved for treatment of drug addicts or alcoholics as a condition of the individual’s eligibility for payment under section 1611(e)(3) of the Act and as authorized by regulations issued by the Special Action Office for Drug Abuse Prevention.

20.  To applicants, claimants, prospective applicants or claimants, other than the data subject, their authorized representatives or representative payees to the extent necessary to pursue Social Security claims and to representative payees when the information pertains to individuals for whom they serve as representative payees, for the purpose of assisting SSA in administering its representative payment responsibilities under the Act and assisting the representative payees in performing their duties as payees, including receiving and accounting for benefits for individuals for whom they serve as payees.

21.  In response to legal process or interrogatories relating to the enforcement of an individual’s child support or alimony obligations, as required by sections 459 and 460 of the Act.

22.  To Federal, State, or local agencies (or agents on their behalf) for administering cash or non-cash income maintenance or health maintenance programs (including programs under the Act).  Such disclosures include, but are not limited to, release of information to:

-RRB for administering provisions of the Railroad Retirement and Social Security Acts relating to railroad employment and for administering the Railroad Unemployment Insurance Act;

-The VA for administering 38 U.S.C. § 412, and upon request, information needed to determine eligibility for or amount of VA benefits or verifying other information with respect thereto;

-The Department of Labor for administering provisions of Title IV of the Federal Coal Mine Health and Safety Act, as amended by the Black Lung Benefits Act;

-State agencies for making determinations of Medicaid eligibility; and

-State agencies for making determinations of food stamp eligibility under the food stamp program;

23.  To State audit agencies for auditing State supplementation payments and Medicaid eligibility considerations; and expenditures of Federal funds by the State in support of the Disability Determination Services (DDS);

24.  To State welfare departments pursuant to agreements with SSA for administration of State supplementation payments; for enrollment of welfare recipients for medical insurance under section 1843 of the Act; and for conducting independent quality assurance reviews of SSI recipient records, provided that the agreement for Federal administration of the supplementation provides for such an independent review; and

-To State vocational rehabilitation agencies or State crippled children’s service agencies (or other agencies providing services to disabled children) for consideration of rehabilitation services per sections 222 and 1615 of the Act.

25.  To the Social Security agency of a foreign country, to carry out the purpose of an international Social Security agreement entered into between the United States and the other country, pursuant to section 233 of the Act.

26.  To the IRS, Department of the Treasury, for the purpose of auditing SSA’s compliance with the safeguard provisions of the IRC of 1986, as amended.

27.  To third party contacts (including private collection agencies under contract with SSA) for the purpose of their assisting SSA in recovering overpayments.

28.  To the Department of Homeland Security (Bureau of Citizenship and Immigration Services (BCIS)), upon request, to identify and locate aliens in the United States pursuant to section 290(b) of the Immigration and Nationality Act (8 U.S.C. § 1360(b)).

29.  To contractors and other Federal agencies, as necessary, for the purpose of assisting SSA in the efficient administration of its programs.  We contemplate disclosing information under this routine use only in situations in which SSA may enter a contractual or similar agreement with a third party to assist in accomplishing an agency function relating to this system of records.

30.  Addresses of beneficiaries who are obligated on loans held by the Secretary of Education or a loan made in accordance with 20 U.S.C. § 1071, et seq. (the Robert T. Stafford Student Loan Program) may be disclosed to the Department of Education as authorized by section 489A of the Higher Education Act of 1965.

31.  To student volunteers and other workers, who technically do not have the status of Federal employees, when they are performing work for SSA as authorized by law, and they need access to personally identifiable information in SSA records in order to perform their assigned Agency functions.

32.  To Federal, State and local law enforcement agencies and private security contractors as appropriate, information necessary:

-To enable them to protect the safety of SSA employees and customers, the security of SSA workplace and the operation of SSA facilities, or

-To assist investigations or prosecutions with respect to activities that affect such safety and security or activities that disrupts the operation of SSA facilities.

33.  Non-tax return information which is not restricted from disclosure by Federal law to the General Services Administration (GSA) and the National Archives Records Administration (NARA) under 44 U.S.C. § 2904 and § 2906, as amended by NARA Act of 1984, for the use of those agencies in conducting records management studies.’

**  We may disclose information to appropriate Federal, State, and local agencies, entities, and persons when (1) we suspect or confirm that the security or confidentiality of information in this system of records has been compromised; (2) we determine that as a result of the suspected or confirmed compromise there is a risk of harm to economic or property interests, identity theft or fraud, or harm to the security or integrity of this system or other systems or programs of SSA that rely upon the compromised information; and (3) we determine that disclosing the information to such agencies, entities, and persons is necessary to assist in our efforts to respond to the suspected or confirmed compromise and prevent, minimize, or remedy such harm. SSA will use this routine use to respond only to those incidents involving an unintentional release of its records.

Disclosure to Consumer Reporting Agencies:

Disclosure pursuant to 5 U.S.C. § 552a(b)(12) may be made to consumer reporting agencies as defined in the Fair Credit Reporting Act (15 U.S.C. § 1681a(f)) or the Federal Claims Collection Act of 1966 (31 U.S.C. § 3701, et seq.) as amended.  The disclosure will be made in accordance with 31 U.S.C. § 3711(e) when authorized by sections 204(f), 808(e), or 1631(b)(4) of the Social Security Act (42 U.S.C. §§ 404(f), 1008(e), or 1383(b)(4)).  The purpose of this disclosure is to aid in the collection of outstanding debts owed to the Federal government, typically, to provide an incentive for debtors to repay delinquent Federal government debts by making these debts part of their credit records.  The information to be disclosed is limited to the individual's name, address, SSN, and other information necessary to establish the individual's identity, the amount, status, and history of the debt and the agency or program under which the debt arose.

Policies and practices for storing, retrieving, accessing, retaining, and disposing of records in the system:

Storage: 

Records are maintained electronically. 

Retrievability:

eDib claim files are retrieved electronically by SSN and alphabetically by name.

Safeguards: 

eDib claim files are protected through limited access to SSA records.  Access to the records is limited to those employees who require such access in the performance of their official duties.  All employees are instructed in SSA confidentiality rules as a part of their initial orientation training.

Safeguards for automated records have been established in accordance with the Systems Security Handbook.  For computerized records, electronically transmitted between SSA's central office and field office locations (including organizations administering SSA programs under contractual agreements), safeguards include a lock/unlock password system, exclusive use of leased telephone lines, a terminal oriented transaction matrix, and an audit trail.

Retention and Disposal: 

The retention schedule for the new eDib Claim File will be incorporated in the Social Security media neutral claim file retention schedule. The schedule includes authoritative instructions for the retention or destruction of existing and future disability claim file records under Title II and Title XVI of the Social Security Act. 

The retention periods for disability claim file records are as follows:

A.  Title II Domestic Disability Insurance Claim Files

Files for Title II claims based on disability will be deleted/destroyed 7 years after the date of adjudication of the most recently awarded claim if: 1) the person has attained full retirement age; or 2) the medical reexamination date is scheduled to occur after attainment of full retirement age.

Files for Title II DI claims denied or terminated for medical reasons will be deleted/destroyed 5 years after the Agency’s final denial or termination decision.  Title II DI files denied or terminated for non-medical reasons, including death, will be deleted/destroyed 2 years after the Agency’s final denial or termination decision.

B.  Title II International DI Claim Files

Files for Title II DI claims based on disability for persons receiving payments will be retained until the claim is terminated. Title II DI files for persons not receiving payments (denied or terminated) will be deleted/destroyed (including underpayment records) 5 years after the Agency’s final denial or termination decision.

Files for Title II DI claims not based on disability for persons receiving payments will be retained until the claim is terminated. Title II DI files for persons not receiving payments (denied or terminated) will be deleted/destroyed (including underpayment records) 5 years after the Agency’s final denial or termination decision.

C.  Supplemental Security Income Claim Files

Files for SSI disability claims will be deleted/destroyed 7 years after the adjudication date of the most recently awarded claim if: 1) the person attains age 65; or 2) the medical reexamination date is scheduled to occur after attainment of age 65.

Files for claims denied or terminated for medical reasons will be deleted/destroyed 5 years after the Agency’s final denial or termination decision.  Files for claims denied or terminated for non-medical reasons will be deleted/destroyed 2 years after the Agency’s final denial or termination decision.

All paper claim files are disposed of by shredding or the application of heat when the retention periods have expired.

System manager(s) and address: 

Deputy Commissioner

Disability and Income Security Programs

Social Security Administration

6401 Security Boulevard

Baltimore, MD 21235

Notification procedure: 

When requesting notification, the individual should provide the type of claim he or she filed (DI and/or SSI).  If more than one claim is filed, each should be identified, whether he/she is or has been receiving benefits, whether payments are being received under his or her own SSN, and if not, the name and SSN under which received, if benefits have not been received, the approximate date and place the claim was filed, and his/her address and/or telephone number.  (Furnishing the SSN is voluntary, but it will make searching for an individual's record easier and prevent delay.)

An individual can determine if this system contains a record about him/her by writing to the system manager(s) at the above address and providing his/her name, SSN or other information that may be in the system of records that will identify him/her.  An individual requesting notification of records in person should provide the same information, as well as provide an identity document, preferably with a photograph, such as a driver’s license or some other means of identification.  If an individual does not have any identification documents sufficient to establish his/her identity, the individual must certify in writing that he/she is the person claimed to be and that he/she understands that the knowing and willful request for, or acquisition of, a record pertaining to another individual under false pretenses is a criminal offense.

If notification is requested by telephone, an individual must verify his/her identity by providing identifying information that parallels the record to which notification is being requested.  If it is determined that the identifying information provided by telephone is insufficient, the individual will be required to submit a request in writing or in person.  If an individual is requesting information by telephone on behalf of another individual, the subject individual must be connected with SSA and the requesting individual in the same phone call.  SSA will establish the subject individual’s identity (his/her name, SSN, address, date of birth and place of birth along with one other piece of information such as mother’s maiden name) and ask for his/her consent in providing information to the requesting individual.

If a request for notification is submitted by mail, an individual must include a notarized statement to SSA to verify his/her identity or must certify in the request that he/she is the person claimed to be and that he/she understands that the knowing and willful request for, or acquisition of, a record pertaining to another individual under false pretenses is a criminal offense.  These procedures are in accordance with SSA Regulations (20 C.F.R. § 401.40).

An individual who requests access to his or her medical records shall be given direct access to those records unless SSA determines that it is likely that direct access would adversely affect the individual.  If SSA determines that direct access to the medical record(s) would likely adversely affect the individual, he or she must designate a responsible representative who is capable of explaining the contents of the medical record(s) to him or her and who would be willing to provide the entire record(s) to the individual.  These procedures are in accordance with SSA Regulations (20 C.F.R. § 401.55).

A parent or guardian who requests notification of or access to a minor’s medical record shall at the time he/she makes the request designate a physician or other health professional (other than a family member) who is capable of explaining the contents of the medical record(s) to him or her and who would be willing to provide the entire record(s) to the individual.  These procedures are in accordance with SSA Regulations (20 C.F.R. § 401.55).

Record access procedures: 

Same as Notification procedures.  Requesters should also reasonably specify the information they are seeking. These procedures are in accordance with SSA Regulations (20 C.F.R. §§ 401.40(c) and 401.55).

Contesting record procedures: 

Same as Notification procedures.  Requesters should also reasonably identify the record, specify the information they are contesting and state the corrective action sought and the reasons for the correction with supporting justification showing how the record is incomplete, untimely, inaccurate or irrelevant. These procedures are in accordance with SSA Regulations (20 C.F.R. § 401.65).

Record source categories: 

Information in this system is obtained from claimants, beneficiaries, applicants and recipients; accumulated by SSA from reports of employers or self‑employed individuals; various local, State, and Federal agencies; claimant representatives and other sources to support factors of entitlement and continuing eligibility or to provide leads information.

Systems exempted from certain provisions of the Privacy Act

None.