Program Operations Manual System (POMS)
   TN 34 (10-21)
   
   
   
   
      
      
      The Date You Became Disabled
      
    
   
      
      
      The Basis For Our Decision
      
    
   
   
      DIB001 5 Month Waiting Period – Month of Entitlement
      
      
      To qualify for disability benefits,  (1)  must be disabled for five full calendar months in a row. The first month  (2)  entitled to benefits is  (3)  .
      
      
      
      Fill-ins:
         
         (1) “you”/“FN”
            
         
         (2) “you are”/“he is”/“she is”
            
         
         (3) date of entitlement to disability
            
         
       
    
   
      DIB002 Lead-in Language for Closed Period and Later Onset Date Allowance
      
      
      We recently told you that  (1)  met the medical requirements to receive Social Security benefits. Now we are writing
         to tell you that  (2)   (3)  the other requirements. Therefore,  (4)   (5)  for  (6)  beginning  (7)  .
      
      
      
      Fill-ins:
         
         (1) “you”/FN
            
         
         (2) “you”/“she”/“he”
            
         
         (3) “meet”/“meets”
            
         
         (4) “you”/“she”/“he”
            
         
         (5) “qualify”/“qualifies”
            
         
         (6) “period of disability”/“monthly disability benefits from Social Security”
            
         
         (7) date of entitlement to disability
            
         
       
    
   
      DIB003 DIB/DWB/CDB Closed Period
      
      
      We determined that  (1)  disability ended  (2)  . The first month that we could pay  (3)  benefits was  (4)  . We could pay  (5)  through the month  (6)  disability ended and the next two months. This means that the last month for which
          (7)  entitled to benefits was  (8)  .
      
      
      
      Fill-ins:
         
         (1) FN possessive/”her”/”his”/”your”
            
         
         (2) effective date (Date beneficiary went into T8/T6 LAF status in the format “Month
            YYYY”)
            
         
         (3) ”her”/“him”/“you”
            
         
         (4) date of entitlement in the format “Month YYYY)
            
         
         (5) ”her”/“him”/“you”
            
         
         (6) “her”/“his”/“your”
            
         
         (7) “she was”/“he was”/“you were”
            
         
         (8) effective date (Date beneficiary went into T8/T6 LAF status - 3 months in the
            format “Month YYYY”)
            
         
       
    
   
      DIB004 State Agency and Medical Doctor Participation in Decision
      
      
      Doctors and other trained personnel made the disability decision for us. They work
         for  (1)  State but used our rules to make their decision.
      
      
      
      Fill-in:
         
         (1) “your”/FN possessive
            
         
       
    
   
      DIB005 Medical Doctor Participation in Non-State Decision
      
      
      Our doctors and other trained personnel made the disability decision in  (1)  case.
      
      
      
      Fill-in:
         
         (1) “your”/FN possessive
            
         
       
    
   
      DIB006 Benefits Payable up to 12 Months before DIB Filing Date
      
      
      By law, we can pay benefits no earlier than 12 months before the month of filing.
         Since  (1)  filed for benefits on  (2)  , monthly payments will begin  (3)  .
      
      
      
      Fill-ins:
         
         (1) “you”/FN in format “Mr. Jack Jones”
            
         
         (2) DOF in format “January 10, 1993”
            
         
         (3) DOEC in format “April 1994”
            
         
       
    
   
      DIB014 Benefits Terminated – DIB Cessation
      
      
      The last month for which  (1)   (2)  entitled to benefits was  (3)  .
      
      
      
      Fill-ins:
         
         (1) Number holder's name, possessive/your
            
         
         (2) family was/wife was/husband was/child was/children were
            
         
         (3) effective date minus one month in format April 1997
            
         
       
    
   
      
      
      The trained staff who decided this case work for the state but used our rules.
      
    
   
      DIB075 DIB (NH only) - ALS Legislation - No 5 Month Waiting Period Applies
      
      
      Benefits based on  (1)  begin the first full month after that date we found  (2)  became disabled. The first month  (3)  entitled to benefits is  (4)  .
      
      
      
      Fill-ins:
         
         (1) amyotrophic lateral sclerosis (ALS)
            
         
         (2) Beneficiary Full Name is/you
            
         
         (3) Beneficiary First name is/you are
            
         
         (4) Date of Entitlement in format "Month YYYY"