Effective Dates: 02/12/2026 - Present Previous | Next

TN 12 (02-26)

DI 12027.010 Processing Statutory Benefit Continuation

When an individual receives a medical cessation notice (or notice of an adverse medical reopening/revision determination), the notice will provide information about how to request an appeal and statutory benefit continuation (SBC) (if SBC applies).

A. Who may sign the SSA-792 (Statutory Benefit Continuation Election Statement)

  • •

    The individual eligible for SBC must be the person to sign the SSA-792 (unless that individual is legally incompetent or a minor child).

  • •

    Once an appeal of the medical cessation (or adverse medical reopening/revision) determination is filed, the eligible individual’s representative payee may sign the SSA-792.

NOTE: 

No authorized representative (attorney or non-attorney) may sign the SSA-792 on the individual’s behalf. If an authorized representative improperly signs the SSA-792 but it is filed timely, it will serve as a protective writing for SBC if a properly signed SSA-792 is later submitted within the 65-day appeal period.

B. When the individual contacts us

When the individual receives the medical cessation (or adverse medical reopening/revision) determination notice and contacts the field office (FO):

1. Explain benefit continuation and appeal information for the appropriate appeal level

2. Explain the time limits for appeal and benefit continuation requests

3. Provide the SSA-792 to the individual

Separate election statements are required at the reconsideration and ALJ hearing levels.

An individual can obtain the SSA-792 in the following ways:

  • •

    Directly from the SSA website at www.ssa.gov/forms.

  • •

    Through Upload Documents (which can be accessed with a MySSA account or a link on the SSA webpage).

  • •

    By contacting SSA over the telephone or visiting the FO in person to request the SSA-792 (if the individual visits in person, obtain the SSA-792 from inForm).

NOTE: 

The individual may submit a written statement other than the SSA-792 to elect or decline SBC. In this situation, recontact that individual and explain that we would like the individual to complete and sign the SSA-792 to document the SBC decision. Provide additional assistance when necessary.

4. Provide appeal forms to the individual

The individual must appeal the medical cessation (or adverse medical reopening/revision) determination to have the SBC option.

The appeal forms are specific to the individual’s level of appeal. For forms used in disability claims and appeals, see DI 11005.016 and sections in DI 12026.000.

NOTE: 

Do not delay in processing an appeal to wait for an SSA-792.

5. Help the individual to complete forms

If the individual needs or requests help in completing any of the forms, help the individual with completing the form(s). For more information on completing and reviewing forms in disability claims, see DI 11005.022.

6. Document the contact

a. Contact made by telephone, fax, or mail - forms sent to individual

Prepare a report of contact to document the discussion and what forms were provided to the individual.

If the individual submits a reconsideration request without required forms, request the forms following instructions in DI 12026.020B.

If the individual submits a request for an ALJ hearing to appeal a reconsidered determination, do not delay in processing the appeal. Complete additional development upon request of the ALJ.

b. Contact made by office visit

Process the appeal and provide a copy of the completed appeal and SBC requests to the individual at the end of the interview. If the individual cannot finish completing the forms during the FO visit, follow the above instructions in DI 12027.010B.6.a in this section.

7. Systems inputs

The Electronic Disability Collect System (EDCS) has functionality to:

  • •

    automate benefit terminations,

  • •

    communicate record updates to the Disability Control File (DCF), and

  • •

    initiate Title II SBC payment and Medicare actions in medical cessation appeals.

NOTE: 

The Post-entitlement Online System (POS) is no longer used to initiate SBC. SBC reinstatements may require assistance from the Processing Center (PC) in Medicare-only continuations and other Title II cases when EDCS inputs do not update the payment status. For modes of requesting PC assistance, see GN 01070.228.

For Title XVI and concurrent cases, follow instructions in DI 81010.230.

a. Electronic process

Establish the appeal and SBC requests in applicable processing systems, following instructions in DI 81010.230.

b. System limitations and exclusions

SBC requests involving a Title II EDCS exclusion will require inputs on the EDCS Exclusion Appeal (EEAI) screen in DCF. For an explanation of the system inputs, see CDR 001.025.

SBC requests involving Title XVI will require a direct SSR update. For an explanation of the system inputs, see MSOM BUSSR 002.010, MSOM BUSSR 002.020, MSOM MSSICS 020.015, SM 01305.580, SM 01305.585, and SM 01601.685.

8. Folder documentation

Upon processing the appeal, use evidence portal (EP) or eView to enter the signed and completed SSA-792 into the electronic file.

If the official folder is paper, place the signed and completed SSA-792 in the blue section (E) of the modular disability folder (MDF).

To Link to this section - Use this URL:
http://policy.ssa.gov/poms.nsf/lnx/0412027010
DI 12027.010 - Processing Statutory Benefit Continuation - 02/12/2026
Batch run: 02/12/2026
Rev:02/12/2026