A medical CDR will not be conducted on title XVI recipients who are ineligible for
either 1611 or 1619 benefits.
A title XVI or concurrent title II/title XVI individual who is in current pay, suspense,
or nonpay status (unless the DDS field on the SSR reflects an initial denial) is entitled
to title XVI due process.
If the PSY field reflects N07, N08, N30-N54, T01, T31, or T51 the individual is not
eligible for payment under title XVI and the case is considered title II only.
With the establishment of the section 1619 provisions, certain suspense and termination
codes took on revised meanings (see SI 02302.030).
Further development may be necessary to determine if a case actually has become a
title II only case. Document on an RC the determination, including the rationale (e.g.,
T5 or T3 status for 12 months, folder reflects no entitlement to benefits, case in
N04 due to an initial excess resources denial or case in M01 but record will not be
reestablished). Attach all documentation to the SSA-454-BK when completed.
NOTE: The FO will include an R/C in every file transmitted to any component including the
DDS which explicitly states whatever disability entitlement exists (e.g., title II
only, HA/DAB, SSI DC, HA/SSI-BI, etc.).