TN 1 (11-21)

DI 13006.030 Field Office (FO) Procedures after the Disability Determination Services (DDS) Makes A Determination on an Age-18 Redetermination Case

The DDS must process a case that attains age 18 using the initial standards for adults, but use the same forms (for example, the form SSA-832) and systems for processing as used for a continuing disability review (CDR).

A. Fully favorable determinations

The DDS will process fully favorable determinations in the same manner as CDR continuances. The DDS will only return folders to the FO if there are any unresolved non-disability issues. If the case involves paper folder(s), the DDS will forward the folder to the National Records Center (SSANRC) following usual procedures.

B. Unfavorable determinations and cessation dates

Disability ceases as of the date of the age-18 redetermination decision. Eligibility ends the last day of the second month following the month of cessation. During the period between the month of cessation and the last month of payment, the disabled individual must otherwise be eligible for benefits. Non-disability actions (for example, income and resource changes, etc.) are still appropriate.

NOTE: If the case involves a DDS failure to cooperate (FTC) or whereabouts unknown (WU) determination, see DI 28075.005.

C. Procedures for unfavorable determinations

Use the following procedures to process an age-18 determination based on the case type.

1. Age-18 redetermination cases

When the case returns from the DDS or the Office of Disability Operations (ODO), follow normal processing procedures for processing cessations in CDR cases. For cases involving participation in a vocational rehabilitation (VR) or similar programs see DI 14510.003.

2. Concurrent cases

If the DDS examiner, the disability hearing officer (DHO) or administrative law judge (ALJ) did not address the need for a Title II CDR, the FO will initiate a CDR or consider an adverse reopening of the Title II determination whenever there is an unfavorable action on an age-18 redetermination. Normally, the DDS, DHO, or ALJ will address this issue. The FO will not delay implementation of the Title XVI determination due to pending action on the Title II CDR issue.

The standard for continuing disability is different from the standard applied during an age-18 redetermination. It is not unlikely that disability will cease on the Title XVI case while disability is continued under Title II. Once eligibility continues based on an age-18 redetermination, treat the case, for all purposes, as an adult disabled individual (DI) claim. An age-18 redetermination cessation will act as a permanent bar to the cross title adoption of any favorable determination that pre-dates the cessation action.

NOTE: The DDS must never adopt a pre-age 18 determination to a Title II claim.

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DI 13006.030 - Field Office (FO) Procedures after the Disability Determination Services (DDS) Makes A Determination on an Age-18 Redetermination Case - 11/16/2021
Batch run: 11/07/2023