SSA - POMS: DI 13015.013 - Whereabouts Unknown (WU) Determinations and Reinstatement Procedures for a Continuing Disability Review (CDR)

A. WU procedures

1. FO development

Follow the procedures in DI 13005.025 Field Office (FO) Actions to Initiate a Continuing Disability Review (CDR), for contacting the beneficiary or recipient and:

a. Check the Master Beneficiary Record (MBR), Supplemental Security Record (SSR), and other FO records for address and telephone information.

b. Attempt phone contact with the beneficiary or recipient, any authorized person on the record, and auxiliaries (Title II only) who are receiving benefits. Leave a message if unable to speak with the beneficiary, recipient, or other contact.

c. Send an SSA-L2001, Address Information Request to the United States Postal Service (USPS) servicing the mailing address of record unless USPS has returned mail as "undeliverable" or "moved/left no forwarding address" and, at the same time,

d. Send a letter to the financial institution on record to request a current address when direct deposit is involved.

e. Attempt to contact any interested party that may have contact with the beneficiary or recipient based on leads in the folder, such as the payee (if one has been designated), relatives, friends, landlord, employers, shelters for the homeless, city and state welfare agencies, and any medical sources and institutions to which the beneficiary or recipient was previously admitted to. Pursue any available leads.

f. Document all efforts to locate the beneficiary or recipient. Record all efforts to locate the beneficiary or recipient on a SSA-5002 Report of Contact and save in eView for electronic cases, or scanned into NDRed for non-electronic claims and filed in the modular disability folder.

g. For special handling situations, follow the contact procedures in DI 13005.025C.2.

Documentation must include:

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The event that initiated the CDR;
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All efforts made to contact the beneficiary or recipient, including the dates and results. For example, document contacts with the USPS, financial institutions, relatives, employers, etc. (retain copies of the requested letters in the folder); and
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Justification for the determination and cessation month (Title II) or suspension (Title XVI).

Refer to GN 02605.055 Title II Undeliverable Mail-Change of Address for undeliverable correspondence and SI 02301.240 Whereabouts Unknown (S06) for more information.

2. All efforts to locate beneficiary or recipient exhausted

a. Title II medical issue

After the FO has made all efforts listed above in DI 13015.013A.1 and the beneficiary or recipient's whereabouts continue to be unknown, the FO will:

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Send a due process notice to the last known address. (see DI 13015.095 Exhibit--CDR Due Process Letter for a sample notice).
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If after 15 days from the date of the notice the beneficiary or recipient does not contact the FO, prepare form SSA-833 (Cessation or Continuance of Disability or Blindness Determination and Transmittal- Title II) cessation determination.
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  Enter a "W" in Item 11 of the SSA-833 immediately following "Reason for Cessation" and
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  Enter paragraph T23 in Item 29 of the SSA-833. See NL 00720.355 Terminations for paragraph language.

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Annotate the IFOA screen in the DCF indicating WU, see MSOM CDR 001.007 CDR FO Input Screen (IFOA).
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Input the cessation via the Post-Entitlement System (POS). See MSOM T2PE 003.024 Disability Cessation (PEC1).
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Enter the remark "MED CDR WU" in the DCF remarks. See MSOM CDR 001.009 MSOM CDR Remarks Input Screen (IMRK).
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Close out any WU pending tickle on the DCF.

Exception: Paper modular disability folders- If the paper file is not in the FO's possession, do not prepare the SSA-833. Send the due process notice and suspend benefits via POS. Forward the materials to the Program Service Center (PSC) with an SSA-882 and the remark "Whereabouts Unknown".

b. Title II work issue

Whenever possible, prepare a work issue determination based on available evidence as outlined in DI 13015.005E.1. If the work determination does not result in a termination, proceed with the WU cessation.

c. Title XVI medical issue

For WU in a Title XVI case, the FO will:

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Suspend payment by placing the case in pay status S06. The system automatically generates the Notice of Planned Action (SSA-L8155) to the recipient's mailing address on the SSR.
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If the recipient's whereabouts remain unknown after 12 months of suspension, eligibility terminates. Ensure the SSR indicates terminated status and update the DCF by annotating a STOP CDR. Enter a remark on the CDR Remarks Input Screen in the DCF such as "T16 Whereabouts Unknown case. Unable to locate the beneficiary after 12 months of suspension."

B. Title XVI WU reinstatement- recipient is located after WU suspension

If the Title XVI recipient is located and is otherwise eligible, the FO will:

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Reinstate benefits per SI 02301.210 Reinstatement and update the SSR with the recipient's address, telephone number, and direct deposit information, if applicable.
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Reinstatement is effective the first month that there is a correct address (and living arrangement for Title XVI).
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Follow normal CDR processing instructions for completing the medical CDR 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.
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Update the DCF with the current CDR status and transfer the case to the DDS.
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Remove any SSR remarks that may refer to the case as being WU.

Note: The Title XVI recipient does not file an appeal to have benefits reinstated.

C. Title XVI recipient is located, benefits terminated after 12 months of suspension

If the recipient cannot be located and benefits are in suspense for 12 months, eligibility will terminate in the 13th month and no medical determination is necessary. If the determination to terminate benefits is correct because the recipient's whereabouts were unknown for 12 consecutive months, the case cannot be reopened under the rules of administrative finality. See GN 04001.070 Do Not Reopen Correct Determinations- Operating Policy.

The recipient can file a new application for disability. Process the new application following initial disability claims procedures.

If the termination is not correct because the recipient did contact the Social Security Administration (SSA) within the 12-month suspension period, reopen the case to determine if benefits can be reinstated and resume the medical CDR.

D. Title II beneficiary is located after cessation

If the beneficiary is located after we have ceased benefits, the beneficiary may file an appeal (if within the appeal period) or file a new application. Note: the appeal request is for the issue that caused the cessation (in this case for whereabouts unknown). The processing service center (PSC) determines if the appropriate steps were taken that led to the WU cessation. See GN 03102.175 for component responsibilities. If the WU cessation was an incorrect determination, decide if the determination can be reversed or, if outside of the appeal period, reopened under the rules of administrative finality. For more information on reopening a final determination or decision see DI 27505.001 Conditions for Reopening a Final Determination or Decision and GN 04001.001 Reopenings- General Statement.

If the determination can be revised:

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Secure or update an SSA-454 Continuing Disability Review Report and obtain new medical release forms (SSA-827) if needed.
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Conduct the CDR interview in the usual manner.
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Forward the folder to the DDS for a medical CDR determination.

E. Title II beneficiary is located, work issue

Refer to DI 13010.145 Reconsideration or Reopening of Continuing Disability Work Issue Cases- Title II.

Social Security

Program Operations Manual System (POMS)

DI 13015.013 Whereabouts Unknown (WU) Determinations and Reinstatement Procedures for a Continuing Disability Review (CDR) – Field Office (FO)