I-3-8-25.Routing Paper Files

Last Update: 5/26/17 (Transmittal I-3-160)

A. Fully or Partially Favorable Decisions

1. HA-505

The Appeals Council (AC) will attach a form HA-505, “Transmittal By Office of Disability, Adjudication, and Review,” to the front of a paper claim(s) 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.

NOTE:

If a claimant filed concurrent title II and XVI claims and lives in Delaware, New Jersey, Pennsylvania, or the US Virgin Islands, the AC must annotate “Mazza Case” in the remarks section of 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(s) file and decision for effectuation, as follows:

Favorable title II disability claim(s) files for claimants age 53 or under go to Office of Disability Operations (ODO) via the mailroom shuttle. The location code for ODO is 0PC7.
Favorable title II disability claim(s) 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 Program Operations Manual System 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 claim(s) files go to the appropriate PSC, as described above for claimants age 54 or older.
Favorable title XVI claim(s) files go to the servicing Social Security office. Consult DOORS for the appropriate office, address, and location code.

NOTE:

When sending a claim(s) file via express mail, staff must use the street address in DOORS, rather than a P.O. Box.

3. Other Considerations for 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 claim(s) file. If the claimant submitted any of the following information to the AC, or it is part of the title II claim(s) file, staff will associate copies with the paper SSI claim(s) file:

SSI application,
Disability Determination Service (DDS) title XVI determinations,
SSI notices,
Administrative law judge and AC decisions,
Statement of income and resources,
Bankbooks,
Insurance policies,
Reports of Contact or statements regarding living arrangements,
Rent receipts,
Utility bills,
Assessment of property forms,
Proof of age,
Proof of marital status,
Proof of citizenship,
Microfiche records,
Leases,
Work history during claimed disability,
Worker's Compensation decisions,
Department of Veterans Affairs award letters, and
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 claim(s) file of the denied claim so that they will be available in the event of further appeal.

B. Unfavorable Decisions

OAO staff will ensure the hearing recording is retained in the claim(s) file. OAO staff will place an “Active Appeal Period” flag, which states “Please Follow NRC 'K File' Process,” on the top of the claim(s) file. OAO staff will send the claim(s) file to the Social Security Administration' National Records Center at the following address: