Effective Dates: 09/15/2021 - Present Previous | Next

TN 4 (09-21)

DI 28080.025 Provide Due Process Notification for Title XVI Only Continuing Disability Review (CDR) Cases

A. Provide Due Process

1. Medical Cessation

  • •

    The Disability Determination Services (DDS) provides due process on Title XVI medical cessations (medical improvement determinations) under the statutory benefit continuation (SBC) provisions.

  • •

    The cessation notice provides due process language in Title XVI only cases. Therefore, it is not required to send a pre-determination notice.

NOTE: In initial medical cessations, the reconsideration (pre-hearing) is the first level of appeal.

2. Failure to Cooperate (FTC) and Whereabouts Unknown (WU)

For procedures to follow for FTC and WU cases that arise during the CDR process, see DI 28075.005.

B. Statutory Benefit Continuation (SBC) vs. Goldberg/Kelly (GK) Automatic Payment Continuation

GK automatic payment continuation applies instead of SBC for issues of failure to follow prescribed treatment and fraud or similar fault. GK procedures do not apply to Title XVI WU cases because SSA considers WU (S06) an administrative suspension and does not result in a loss of eligibility.

C. References:

 

To Link to this section - Use this URL:
http://policy.ssa.gov/poms.nsf/lnx/0428080025
DI 28080.025 - Provide Due Process Notification for Title XVI Only Continuing Disability Review (CDR) Cases - 09/15/2021
Batch run: 09/30/2024
Rev:09/15/2021