TN 5 (01-16)

DI 14510.025 Office of Disability Operations (ODO) Procedures for Processing Allowances, Closed Periods, and Denials of Section 301 Payments

Document the allowance, closed period, or denial determination on an SSA-553 (Special Determination). The documentation should identify the facts of the case, including:

  • The type of program the beneficiary is participating in;

  • The name and address of the service provider;

  • The basis for the decision; and

  • The diary date for review of the case if benefits are continued.

The diary date is generally one year. If the beneficiary expects to complete the program of services in less than one year, or if there are indications that the beneficiary may not complete the program, it may be earlier. A diary date of less than one year may also be appropriate if there is an indication that the beneficiary will acquire the education, work skills, or work experience that was the basis for the initial likelihood determination, in less than one year and prior to the beneficiary completing the program.

A. Procedure for Section 301 payments allowed

1. Both Title II and Title XVI cases

  • Print the SSA-833 (Cessation or Continuance of Disability or Blindness Determination and Transmittal) or SSA-832 (Cessation or Continuation of Disability or Blindness Determination and Transmittal) from CFRMS or eView and annotate in the remarks section of the document, “DO NOT PROCESS — SECTION 301 PAYMENT CONTINUATION.”

  • Scan the SSA-553 and SSA-833 or SSA-832 into eView or NDRED.

  • Prepare and send a notice of allowance of the Section 301 payment continuation due to participation in a VR or similar program.

  • Complete the Web-Based Section 301 Data Sheet at http://ocoweb/data301.

IMPORTANT: If the beneficiary is participating in a State VR agency program, the State VR agency may be eligible for VR reimbursement under certain circumstances. Fax a copy of the SSA-4290-F5 (Development of Participation in a Vocational Rehabilitation or Similar Program), the SSA-553, and the SSA-833 or SSA-832 to:

ORDES OTOPS VR Claims Processing Unit
Fax: 410-966-3280
ATTN: 301 Processing Unit

2. Title II cases

  • Do not process the disability cessation;

  • Annotate the Master Beneficiary Record (MBR) with a special message: “Section 301 payment case - do not process any reported work;”

  • Post the Section 301 payment continuation event (see MS CDR 001.005 CDR PC Input Screen (IPCA)); and

  • Diary the case for one year from the current month or earlier for review on the Disability Control File (DCF) (see DI 14510.025A).

To post the Section 301 event, the latest event on the DCF should be the medical cessation posted by the Disability Determination Services (DDS). If DDS does not post the cessation to the DCF, review the Disability Determination Service Query (DDSQ/HA04) to determine if DDS reversed the cessation to a continuance. (If DDS reversed the cessation, Section 301 payment continuation is no longer applicable.)

If DDS did not reverse the cessation, manually annotate the cessation determination to DCF (MS CDR 001.005 (CDR PC Input Screen (IPCA)). Once you post the cessation, enter the Section 301 event on the DCF.

  • On the MCDR screen, select 3=PC Update (MS CDR 001.005).

  • On the ECDR screen, select 5=T2 Medical.

  • On the IPCA screen, select 15=301 Case–VOC REHAB.

  • Use the worksheet (CDRW screen) to diary the case for review (MS CDR 001.013 (CDR Development Worksheet (CDRW)).

3. Title XVI cases

  • Add a remark to the DCF: “301 Allowance mm/dd/yy;”

  • Create a Modernized Development Worksheet (MDW) and fax the Section 301 flag to the servicing Field Office (FO) with instructions to annotate the Section 301 approval to the Supplemental Security Record (SSR) remarks and to establish or update the VP diary; and

  • Place the case in Development Hold File (DHF) for 15 days.

  • After 15 days, review the SSR to verify that the FO updated the VP diary.

If the FO has not taken action, follow up by calling the FO’s administrative line.

B. Example of allowance documentation for SSA-553

This is an example of a properly completed SSA-553 for an allowance:

Issue:

Is Richard Martin eligible for continued payments under Section 225(b) of the Social Security Act?

(NOTE: Substitute “section 1631(a)(6)” for Title XVI-only cases and “sections 225(b) and 1631(a)(6)” for concurrent Title II/Title XVI cases.)

Facts:

A period of disability beginning 06/26/2002 was established for Mr. Martin based on hypertensive cardiovascular disease.

The DDS determined his disability ceased effective 05/2015.

Mr. Martin is currently participating in a program of training and services with a vocational goal of engraver apprentice under an individual work plan with the ABC Agency, 123 Street, City, ST 45678. ABC Agency is an employment network under the Ticket to Work Program.

He has been participating in the program since at least 04/2015.

He has not yet completed the required training to be an engraver apprentice. He continues to participate in work skills training under his program and receives counseling and guidance.

Upon completion of his training, he will have the skills to perform the job of engraver apprentice.

He can perform this occupation at the substantial gainful activity level, and he will be able to meet the demands of this occupation despite a possible future reduction in residual functional capacity.

Determination:

We have determined that Mr. Martin is participating in an appropriate program, the completion of which will increase the likelihood that he will be permanently removed from the disability rolls.

  

Expected Completion Date of Training Program: 03/31/2017

Diary for review: 05/01/2016

C. Procedure for Section 301 payments closed period

1. Both Title II and Title XVI cases

  • Print the SSA-833 or SSA-832 and update the termination date;

  • Annotate “301 Closed Period Payment” to the notes field of the SSA-833 or SSA-832;

  • Scan the SSA-553 and the SSA-833 or SSA-832 into eView or NDRED;

  • Prepare and send a notice of the closed period of the Section 301 participation;

  • Complete the Web-Based Section 301 Data Sheet in http://ocoweb/data301.

2. Title II cases

  • Forward the folder to the benefit authorizer for termination action; and

  • Annotate the “301 Closed Period Payment” to the special message field of the MBR.

3. Title XVI cases

  • Add a remark to the DCF “301 Closed Period mm/dd/yy-mm/dd/yy;”

  • Create an MDW and fax the flag to the servicing FO to instruct them to delete the VP diary; and

  • Place the case in DHF for 15 days.

  • After 15 days, review the SSR to verify that the FO deleted the VP diary.

If the FO has not taken action, follow up by calling the FO’s administrative line.

D. Example of closed period documentation for SSA-553

This is an example of a properly completed SSA-553 for an allowance.

Issue:

Is Richard Johnson eligible for payments under section 225(b) of the Social Security Act?

(NOTE: Substitute “section 1631(a)(6)” for Title XVI-only cases and “sections 225(b) and 1631(a)(6)” for concurrent Title II/Title XVI cases.)

Facts:

A period of disability beginning 06/26/2002 was established for Mr. Johnson based on hypertensive cardiovascular disease.

The DDS determined his disability ceased effective 05/2014.

Mr. Johnson has completed the program of training and services with a vocational goal of engraver apprentice under an individual work plan with the ABC Agency, 123 Street, City, ST 45678. ABC Agency is an employment network under the Ticket to Work Program.

He was participating in the program from 04/2013 through 04/2015.

He completed the required training to be an engraver apprentice.

He can perform this occupation at the substantial gainful activity level, and he will be able to meet the demands of this occupation despite a possible future reduction in residual functional capacity.

Determination:

We determined that Mr. Johnson is eligible for a closed period of Section 301 benefits since he was participating in an appropriate program before his disability ceased and through the grace period.

  

Graduation date: 04/2015

Termination date: 05/2015

E. Procedure for Section 301 payments denied

1. Both Title II and Title XVI cases

  • Print the SSA-833 or SSA-832 and annotate with the termination date;

  • Scan the SSA-553, and the SSA-833 or SSA-832 eView or NDRED.

  • Prepare and send a notice of the denial of the Section 301 participation.

  • Complete the Web-Based Section 301 Data Sheet in http://ocoweb/data301.

2. Title II cases

  • Forward the folder to the benefit authorizer for termination action; and

  • Add a special message to the MBR stating “Section 301 denial mm/dd/yy.”

3. Title XVI cases

  • Add a remark to the DCF: “Section 301 denial mm/dd/yy;”

  • Create an MDW and fax the flag to the servicing FO to instruct them to delete the VP diary; and

  • Place the case in DHF for 15 days.

  • After 15 days, review the SSR to verify that the FO deleted the VP diary.

If diary is still pending, follow up by calling the FO’s administrative line.

F. Example of denial documentation for SSA-553

This is an example of a properly completed SSA-553 for a denial:

Issue:

Is Richard Smith eligible for continued payments under section 1631(a)(6) of the Social Security Act? (NOTE: Substitute “section 225(b)” for Title II-only cases and “sections 225(b) and 1631(a)(6)” for concurrent Title II/Title XVI cases.)

Facts:

Mr. Smith was determined to be under a disability beginning 02/01/00 based on chronic pulmonary insufficiency and determined eligible for Supplemental Security Income (SSI) payments.

The DDS determined his disability ceased effective 07/2015.

On 01/10/15, we found Mr. Smith eligible for services with the Illinois State VR agency at 245 Street, City, ST 67890, and a rehabilitation plan was developed for him. He stopped participating in the rehabilitation plan on 07/25/15.

Determination:

It is determined that Mr. Smith is not eligible for Section 301 payments because he was not in an appropriate program after 07/2015, the month his disability ceased.

G. Exhibit of flag for transmitting title XVI case to the FO

  

SECTION 301 CASE APPROVAL

Immediate Action Required

    

To FO____________________________

FO Fax __________________________

ATTN: Title XVI Claims Representative

    

    

SSN: ______________________________

Section 301 payments approved.

  • Annotate 301 approval to SSR Remarks.

  • Establish/update VP diary per DI 14510.007B.2.

  • Diary date:________________________

  • Retain folder until Section 301 payments terminate.

    

    

From ODO Unit ___________________

Name ___________________________

Phone ___________________________

H. Exhibit of cover sheet for transmitting title XVI case to FO

  

SECTION 301 CASE for CLOSED PERIOD

Immediate Action Required

  

To FO____________________________

FO Fax