Item 22 -- Reg. Basis Code
Enter denial code N33-920(b) for Title XVI SGA denials.
Item 24 - Mob. Code
Determine the mobility status by referring to the disability background information
contained on the SSA-3820 (Disability Report – Child) or SSA-3368 (Disability Report
– Adult), SSA-3369 (Work History Report), function reports, or any other (later) information
recorded in file.
Enter one of the following codes, which reflect the claimant’s mobility status at
the time the SSA-831 is prepared:
A- Confined in a medical institution other than a general hospital
B- Patient in a general hospital
C- Confined in bed at home
D- Confined in a chair (including wheel chair)
E- None of the above, but unable to go outside
F- Able to go outside, but only with the help of another person or device
G- Able to go outside without help
M- Claimant is deceased
Item 26 - List No.
See DI 33530.000 - Index of Disability-Related List Code Numbers (Table of Contents).
Item 27 - Rationale
See DI 26515.000 - Rationale Preparation (Initial Claims) (Table of Contents).
Item 29 - Ltr./Par. No.
Complete this item in accordance with Preparing Notices in Disability Claims DI 11010.345.
Item 37 - SSA Representative
The claims representative or other designated FO employee signs his or her name.
Item 38 - Date
Enter the date the SSA-831 is signed by the claims representative or other designated