TN 9 (09-19)

DI 13015.011 Whereabouts Unknown (WU) Policy for a Continuing Disability Review (CDR) – Field Office (FO)

CITATIONS:

20 CFR sections 404.1579(e)(3); 404.1579(g)(6); 404.1586(e)(3),404.1587; 404.1594(e)(3); 404.1594(g)(7); 404.1596(b)(2)(ii); 416.994(b)(4)(iii); 416.994a(f)(3)

This subchapter provides policy guidance when the FO is unable to locate the beneficiary or recipient during the CDR process and determines that WU applies. The FO, Disability Determination Services (DDS), or Program Service Center (PSC) may identify the WU issue at any point during development. The FO is responsible for developing and processing WU issues.

A. WU CDR policy

1. Overview of WU

WU occurs when there is a question about whether a beneficiary or recipient continues to be disabled and the FO is unable to find him or her after exhausting all reasonable efforts to locate the beneficiary or recipient as described in DI 13015.013 Whereabouts Unknown (WU) Determinations and Reinstatement Procedures for a Continuing Disability Review (CDR)- Field Office (FO). A WU issue may arise at any point during a CDR.

2. WU cessation (Title II) or suspension (Title XVI) month

When there is not enough evidence to justify a continuance, we will stop benefit payments for the first month in which the FO, DDS, or PSC discovers that the beneficiary or recipient's whereabouts are unknown, but no earlier than the month in which the continuing disability issue arose.

  • Title II WU is a non-medical cessation of benefits. Our regulations specifically require benefits to be terminated for Title II WU cases, see 20 CFR 404.1579(e)(3), 404.1586(e)(3), and 404.1594(e)(3). Note: Statutory benefit continuation (SBC) does not apply to Title II WU cases per DI 12027.015 Cases Excluded from Statutory Benefit Continuation (SBC).

  • Title XVI WU is a technical suspension of benefits (pay status S06). Our regulations specifically require Supplemental Security Income (SSI) benefits to be suspended in Title XVI WU cases, see 20 CFR section 416.994(D)(4)(iii) and 416.994(a)(f)(3). Note: Goldberg-Kelly (GK) procedures do not apply, S06 suspensions are an exception to the GK due process procedures. See SI 02301.240 Whereabouts Unknown (S06).

Reminder: The FO must follow the steps in DI 13015.013 Whereabouts Unknown (WU) Determinations and Reinstatement Procedures for a Continuing Disability Review (CDR)- Field Office(FO) before ceasing or suspending payments due to WU.

Example: On 1/27/2018, the FO sends a letter requesting that the Title II beneficiary call by 2/11/2018. The Post Office returns the letter on 2/10/2018 indicating that the addressee is unknown at that address. After following all development steps in DI 13015.013, the FO cannot locate the beneficiary. The FO determines that disability ceased in 2/2018.

3. Title II work issue only

If there is enough information or evidence to make a determination due to work, adjudicate the work determination and annotate the Master Beneficiary Record (MBR) with a special message that WU existed at the time of the work determination.

  • If the determination is a cessation or termination due to work, refer to DI 13010.170 Completing the SSA-833 (Cessation of Continuing Disability or Blindness Determination and Transmittal-Title II) for instructions on preparation of the substantial gainful activity (SGA) determination.

  • If the determination is a continuance, complete the determination and terminate Title II benefits based on WU.

  • If there is not enough evidence to make a cessation determination, proceed with the WU determination.

B. Jurisdiction of medical CDR

1. CDR is pending at the FO

The FO is responsible for initiating the CDR and securing the requested medical information per DI 13005.025 Field Office (FO) Actions to Initiate a Continuing Disability Review (CDR) and DI 13005.030 Field Office (FO) Personal Contact and Exceptions. If, after following the steps in DI 13015.013 Whereabouts Unknown (WU) Determination and Reinstatement Procedures for a Continuing Disability Review (CDR)-Field Office (FO), the FO is unable to locate the beneficiary or recipient, the FO will make a WU determination.

2. CDR is pending at the DDS

If the DDS is unable to locate the beneficiary, the DDS documents their attempt to locate the beneficiary on an SSA-5002 and returns the case to the FO as a "no determination" case. If the FO is unsuccessful in locating the beneficiary or recipient, the FO will prepare a WU determination per DI 13015.013 Whereabouts Unknown (WU) Determination and Reinstatement Procedures for a Continuing Disability Review (CDR)- Field Office (FO).

3. CDR is pending at the PSC

If the PSC cannot complete the CDR because they are unable to locate the beneficiary, the PSC will send the folder to the FO via form SSA-5526-U3 Request for Assistance-Disability or request FO assistance in locating the beneficiary or recipient.


To Link to this section - Use this URL:
http://policy.ssa.gov/poms.nsf/lnx/0413015011
DI 13015.011 - Whereabouts Unknown (WU) Policy for a Continuing Disability Review (CDR) – Field Office (FO) - 01/06/2020
Batch run: 01/06/2020
Rev:01/06/2020