Do not conduct a medical CDR in the following situations:
For a Title XVI recipient who is ineligible for Section 1611 or Section 1619 benefits;
A Title XVI or concurrent (Title II and Title XVI) individual who is in current suspense
or non-pay status (unless the DDS field on the SSR reflects an initial denial); the
individual is entitled to Title XVI due process.
For additional information on the conditions to screen out a medical CDR, see DI 13005.020D.
NOTE: For medical CDR processing instructions for beneficiaries whose ticket to work status
is “Assigned” or “In Use SVR”, see DI 55025.001 and DI 55025.010.
If the payment status (PSY) field reflects the codes “N07,” “N08,” “N30”-“N54,” “T31,”
or “T51,” the individual is not eligible for payment under Title XVI. Consider the
case a Title II case only. With the establishment of the Section 1619 provisions,
certain suspense and termination codes took on a revised meaning, see SI 02302.030.
Further development is necessary to determine if a case has become Title II only.
Document on an SSA-5002 (Report of Contact) the determination, including the rationale.
For example, a case that has the following status:
“T5” or “T3” for 12 months,
“N04” due to an initial excess resources denial, or
“M01” but we will not reestablish the record. Attach all documentation to the completed
SSA-5002 (Report of Contact).
NOTE: The FO will include an SSA-5002 (Report of Contact) in every folder transmitted to
any component including the DDS, which explicitly states whatever disability entitlement
exists (for example, Title II only, Supplemental Security Income (SSI) disabled child