BASIC (10-09)

DI 23530.001 Prerelease Case Processing

A prerelease agreement is a written or verbal agreement between an institution and SSA to cooperate in the processing of Supplemental Security Income (SSI) applications under the prerelease procedure. For a complete description of prerelease agreements see SI 00520.910 – Prerelease Agreements – Institutionalization.

A. Prerelease policy principles

1. SSA’s responsibilities

SSA actively pursues formal prerelease agreements with all appropriate institutions as described in SI 00520.910. All applications received under the prerelease procedure, or other applications identified as meeting the prerelease criteria, are processed using expedited procedures. Accept all applications from such institutions under the prerelease procedure without regard to whether an agreement exists with the institution.

SSA, as represented by the field office (FO), agrees to:

  • Provide guidelines for the information requested from the institution. For a model SSI prerelease agreement see Exhibit 2 in SI 00520.930;

  • Help institutional and social services staff learn how to use the prerelease procedure;

  • Provide an FO contact to assist the institution in applying prerelease procedures;

  • Process claims and reinstatements timely in the FO, and identify cases sent to the disability determination services (DDS) for prompt handling;

  • Obtain a consent form (SSA 3288, Social Security Administration Consent for Release of Information) to permit release of the applicant’s information to the facility; and,

  • With the claimant’s authorization, promptly notify the institution of the determination.

2. Institution’s responsibilities

Institutions using the prerelease program agree to:

  • Identify individuals who can be released within 30 days after potential eligibility has been established;

  • Only refer individuals who appear to meet the SSI categorical income and resources criteria;

  • Provide nonmedical information necessary for development of potential SSI eligibility;

  • Submit current medical evidence;

  • Advise whether the individual is capable of filing an application and handling his or her own funds;

  • Provide the FO with the anticipated release date and any change which would result in release over 30 days after notice;

  • Notify the FO when the individual is released;

  • Provide institution contact to assist with claim;

  • Provide updated address and contact information to FO upon release of the individual; and

  • Obtain a consent form (SSA 3288) to permit release of the applicant’s information to the facility.

B. FO processing of prerelease cases

For complete FO processing instructions, see SI 00520.920 – Processing Prerelease Cases.

1. FO actions upon receipt of referral

When the FO receives a referral, or identifies a case that meets the prerelease criteria, the FO:

  • Arranges completion of application and other necessary forms, including a signed release from the individual allowing the FO to discuss the case with the institution’s staff. Use form SSA-3288 for this purpose.

  • Develops for capability and representative payee when required.

  • Obtains medical evidence if not submitted with referral form.

  • Transfers case to the DDS for a medical disability determination.

  • Initiates nondisability development.

  • Does not use deferred development procedures.

  • Adds institution contact information to the 3368 contact information page in the electronic disability collect system (EDCS).

  • Provides the anticipated release date in Item 5 of the SSA-3367.

NOTE: Concurrent title II claims may need to be evaluated under the “prisoner provisions.” For instructions on identifying “Prisoner Cases” see DI 23501.005 – Identifying Prisoner Cases.

2. FO actions upon notification of a favorable medical disability determination

When the FO receives notice of a favorable medical disability determination take the following actions:

  • Notify the institution of a favorable disability determination.

  • When an individual is not released from the institution within a specified time period (preferably 30 days) but release within the life of the application is likely, the FO holds the claim (placing the SSI record in payment status H10 – living arrangement change in progress) until release.

  • If release is not likely within the life of the application, FO takes final action to deny the case on a technical basis.

NOTES:

  • For more information regarding the life of an SSI application, see SI 00601.010C.

  • For complete processing instructions see SI 00520.920 – Processing Prerelease Cases.

3. New application or appeal filed after technical denial of favorable DDS disability determination

There are some situations in which the DDS makes a determination establishing disability or blindness, but the FO must deny the case for non-medical reasons (i.e., not released from an institution within 30 days of notification of decision (prerelease), or other technical denial). If the claimant files an application later and meets all non-medical factors, another DDS decision is not always necessary, as there are some situations in which the prior favorable DDS medical allowance is used. For complete instructions, see DI 11055.075 – Using the Previous SSI Favorable Medical Determination or Decision to Reestablish or Reinstate SSI Benefits.

The FO may use a prior favorable DDS medical allowance when:

  • A claimant previously denied for non-medical reasons (e.g., non-release from institution, income and resources) now meets all non-medical factors and:

  • No issues of intervening work or medical improvement is involved.

The FO refers the case to the DDS for a new disability determination for situations where:

  • The previous claim was denied by the DDS on a substantive basis or:

  • There are intervening work or medical improvement issues.

C. DDS processing of prerelease cases

1. Prerelease case identification

Cases received from the FO are identified by the remarks Prerelease Casein item 5 of the Form SSA-3367 (Disability Report – Field Office); and the “Prerelease” electronic (or paper) case flag. If the FO does not flag the file, the DDS should add the flag. For electronic flagging instructions, see DI 81020.085 – Certified Electronic Folder (CEF) Flags.

2. Expedited processing

The prerelease procedure was designed to promote deinstitutionalization by assuring eligible individuals timely SSI payments when they reenter the community. Use locally established expedited processing procedures to ensure a timely determination.

NOTE: Contact the institution representative (provided by the FO) for assistance with development; e.g., scheduling consultative examinations, securing medical evidence.

3. Case evaluation

Evaluate using the same criteria as for other Title XVI claims. Concurrent Title II claims may need an evaluation under the “prisoner provisions.” For instructions on evaluating Title II claims, see DI 23501.010 – Evaluating Impairment(s) in Prisoner Cases.

NOTE: A finding of Presumptive Disability or Presumptive Blindness (PD/PB) is not considered for the purpose of the prerelease program.

4. Capability development necessary

When the file does not contain a statement about the individual's capability to manage his or her own payments; and, additional medical development is necessary to determine the extent of the individual's impairment, follow the guidelines in DI 23001.005B – When to Develop Capability.

NOTE: The FO develops for capability when a disability determination can be made without further medical development.

5. FO notification

For non-EDCS cases, notify the FO immediately of the final determination on all prerelease cases (i.e., allowances and denials) by telephone, email, or other electronic means. Additional notification is not required for EDCS cases.


To Link to this section - Use this URL:
http://policy.ssa.gov/poms.nsf/lnx/0423530001
DI 23530.001 - Prerelease Case Processing - 12/03/2013
Batch run: 12/03/2013
Rev:12/03/2013