TN 11 (01-17)

DI 13005.018 Field Office (FO) Actions for Section 1619 Cases

A. Procedure for an A1 diary

When the FO receives an A1 diary, regardless of payment status, delete the A1 diary by inputting a Z1 diary with the current date using the update diaries (UDIA) screen in the Direct Supplemental Security Record (SSR) Update, see MSOM BUSSR 002.019. Send the data to the SSR using the Build Transaction SSR (BTS) process, see MSOM BUSSR 001.001.

NOTE: Cases in current pay status with an A1 diary will receive selection for a medical review under the normal continuing disability review (CDR) process, but cases with an A1 diary that in a non-pay status will not require a CDR.

B. Procedure for an A2 diary

1. Non-pay status

When the FO receives an A2 diary and the case is in non-pay status, delete the A2 diary according to DI 13005.018B.3. Cases in non-pay status do not require a Section1619 CDR. A subsequent A2 diary generates when the case enters into current payment status.

2. Current pay status

Section 1619 of the Social Security Act requires us to make a determination of continuing disability to qualify for Section 1619 benefits. A Section 1619 CDR is not subject to the screen-out rules in DI 13005.020 and DI 13005.022. Exclude cases in non-pay status from a Section1619 CDR. The FO may exclude a Section 1619 CDR case in current pay status as follows:

a. CDR exclusions

If the case is in current pay status, take the following steps to determine if exclusions to initiating the CDR exist. If one of the following exclusions exist, delete the A2 diary per DI 13005.018B.3 and determine if:

  • A CDR is in progress or completed within the last 12 months by reviewing the Disability Control File (DCF) and the disability determination service query (DDSQ). If a CDR is in progress or a continuance was processed within the last 12 months, delete the A2 diary;

  • The beneficiary has a ticket “assigned” or “in use” through the Ticket to Work program by following the procedures in DI 55025.001C. If the beneficiary has a ticket in use, delete the A2 diary; or

  • The case has concurrent Title II disability involvement and if Section 111 CDR protection applies per DI 13010.012C. If CDR protection applies to the concurrent Title II disability claim, it will also apply to the Title XVI disability claim. Delete the A2 diary.

b. CDR not excluded for income below the breakeven point test

If the case is in current pay status and you cannot exclude the CDR based on reasons in DI 13005.018B.2. in this section, determine if you must initiate a CDR with the following steps:

  • Verify all wages for the prior period and conduct a redetermination (RZ) if a scheduled RZ is pending or if an unscheduled RZ is required, see SI 02305.022.

  • Determine if earned income for any month in the prior 12 months is equal to or over the breakeven point (2xFBR+$85). Count back beginning with the last payment status of an “N01” month.

  • If all earned income is below the breakeven point, no CDR is required. Delete the A2 diary per DI 13005.018B.3.

c. Earned income over the breakeven point test

If you cannot exclude the case from a CDR based on the criteria in DI 13005.018B.2.b. in this section, and there was a month with earned income equal to or over the breakeven point, conduct a test computation for each of those months to:

  • determine if countable earned income for any one month is over the full federal benefit rate (FBR); and

  • determine if the countable earned income would cause the benefit payment to reduce to zero.

To conduct the test computation:

  1. Use the recipient’s total income (wages and self-employment); and

  2. Do not consider the spouse's earned income or any other deemed or unearned income.

  3. Apply all income exclusions and any work incentives applicable to the earned income, see SI 00820.500 (for example, student earned income exclusion (SEIE), impairment-related work expense (IRWE), blind work expenses (BWE), and plan for ach