First determine if any impairment arose, or if any pre-existing impairment is aggravated,
“in connection with” the commission of the felony for which the individual is convicted.
If after exclusion of any felony-related impairment an allowance is still warranted
by the evidence, the medical evidence must then be further considered to determine
the significance of any impairment arising or aggravated (but only to the extent of
the aggravation) in connection with confinement in a jail, prison, or other penal
institution or correctional facility for the conviction of the felony.
An impairment is considered to arise in connection with confinement, even though the
impairment is not attributable to the confinement, when it first occurs during confinement
(i.e., the impairment is diagnosed to have begun during confinement and there is no
evidence showing that signs and symptoms occurred prior to confinement). Similarly,
medical conditions that began prior to confinement and then increase in severity during
confinement are considered to be “aggravated” in connection with confinement, regardless
of whether the course of the condition was altered by the confinement.
Indicate consideration of any confinement-related impairment(s) as follows:
When disability is established based solely on impairment(s) not associated with the
commission of the felony or with confinement, include the following statement in the
rationale: “Disabling impairment(s) not felony-related or confinement-related.” For
example, medical evidence establishes statutory blindness prior to commission of the
When disability cannot be established without considering impairment(s) associated
with confinement, a disability freeze is established for a DIB claimant (only to protect
future benefit rights). For example, medical evidence establishes the diagnosis of
Mesothelioma while incarcerated, with no evidence of prior respiratory issues.
When a disability freeze is established:
Change item 7 (TYPE CLAIM (Title II)) of the SSA-831 (Disability Determination and
Transmittal) to indicate it is a freeze only claim. (The Disability Determination
Service (DDS) intake and closure unit normally needs to perform this function.)
Include the following statement in the rationale: “Determination of allowance justified
only when consideration is given to impairment associated with confinement. FREEZE
ONLY – Not under a disability for cash benefit purposes during any month confined”.
Enter “623” (Prisoner Case - Freeze Only) in item 26 (List No.). For listing code
descriptions see DI 23501.015B.
NOTE: Current system limits require that the DDS convert the Certified Electronic Folder
(CEF) to a paper Modular Disability Folder (MDF) prior to closing to allow for the
change in case type from “DIB” to “FZ”. For instructions on closing a CEF that was
converted to paper in the DDS see, DI 81020.130F.
The possibility of a freeze does not apply to CDB and DWB claimants. If disability
cannot be established without consideration of an impairment associated with confinement,
prepare a formal denial determination. Include the following statement in the rationale:
“Disabling impairment is confinement-related.”
Although a confinement-related impairment may not be considered in determining disability
for benefits payable during confinement, it may be considered for benefit purposes
after the individual has been released from prison if the individual files an application
for DIB, CDB, or DWB at that time. Entitlement to benefits based on a new application
can begin as early as the first full month the individual is no longer confined, provided
the individual is determined to be under a disability after release from prison.