A partially favorable Medicare waiting period determination exists when you determine
that the current impairment is not the same as or directly related to the prior impairment.
If you make a partially favorable Medicare waiting period determination, enter the
following in Item 34 (Remarks) on the SSA-831: “Do not count prior months of benefit
entitlement toward Medicare waiting period.”
The DDS prepares a personalized paragraph explaining that the current impairment is
not the same as or directly related to the prior impairment.
Follow these steps to prepare the personalized paragraph:
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Prepare the personalized paragraph on an SSA-4268-U4/C4 (Explanation of Determination).
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Add a statement to describe the prior and current impairments.
NOTE: The FO prepares the notice that explains the Medicare waiting period determination.
The FO-prepared notice will include the DDS personalized paragraph, and it will include
appeal rights information.