Social Security Administration (SSA) regulation 20 C.F.R. § , which is largely based
on the U.S. Supreme Court’s holding in Goldberg v. Kelly (1970), provides due process protections when SSA plans to suspend, reduce, or terminate
an individual’s Supplemental Security Income (SSI) payments for non-medical eligibility
reasons. Specifically, SSA will not take an adverse action (i.e., suspend, terminate,
or reduce SSI payments) without providing advance written notice, the opportunity
to appeal, and the opportunity to receive unreduced benefits called Goldberg Kelly
(GK) payment continuation pending an appeal determination. These due process protections
only apply to initial non-medical determinations that result in a reduction, suspension,
or termination of SSI benefits.
Separate due process protections related to continuing disability determinations for
Title II and Title XVI recipients, referred to as statutory benefit continuation (SBC),
arise from an amendment of the Social Security Act. Follow the SBC instructions in
DI 12027.000 which provide due process in continuing disability cases.
SSA must first issue an advance notice when it intends to take an adverse action for
non-medical reasons. The advance notice explains that the individual has 60 days after
receiving the notice to file for a reconsideration, which is the first level of appeal.
The notice explains that if the individual files the appeal request within 10 days
after receiving the notice, SSI payments will continue at the same amount until there
is a determination on the reconsideration. The notice also explains that if the individual
files the appeal request within 60 days after receiving the notice, SSI payments will
be continued or reinstated at the same amount until there is a determination on the
reconsideration.
When individuals respond to the advance notice or want to appeal, field office (FO)
technicians must fully explain the determination, appeal rights and right to GK payment
continuation (see SI 02301.310 for explanations). Individuals, on their own initiative, may choose to waive their
automatic right to GK payment continuation, but must do so in writing . However, technicians
must NEVER suggest waiver of GK payment continuation or ask specifically if they want
to waive GK payment continuation during appeal. Individuals who waive GK payment continuation
may change their decision and request reinstatement (including any retroactive payments,
if due) as long as the reconsideration determination is pending.
When individuals contact the FO and question or disagree with a determination after
the 60-day time limit has expired, technicians will assist them if they want to appeal
and will develop good cause for extending the time limits for appeal and GK payment
continuation. (For good cause instructions, see GN 03101.020A - Good Cause for Extending the Time Limit to File an Appeal and SI 02301.310 - Appeal and the Right to Goldberg Kelly (GK) Payment Continuation.
As long as an individual remains otherwise eligible (but for the issue under appeal),
GK payment continuation ends the month there is determination on the reconsideration.
SI 02301.325 - How to Correct the PPL During Appeal (Including COLA) explains how to adjust protected
payments due to changes in circumstances that are not under appeal. SI 04020.020B - Requests for Supplemental Security Income (SSI) Reconsideration.)