TN 1 (05-10)

DI 27030.015 Title XVI - Allowances

A. Fully favorable allowances

Title XVI allowance notices are computer generated based on input of the regulation basis code by the Disability Determination Services (DDS). The DDS makes no entry in item 29 of the SSA-831 (Disability Determination and Transmittal) and does not prepare the notice except in situations where an interim notice is warranted. For further instructions, see DI 26535.036 - Special Situations, and DI 81020.130 - Electronic Case Closure. The Field Office (FO) prepares and issues the notice to the claimant after it has been uploaded to the certified electronic folder and stored in the appropriate section. However, if the FO identifies the case as Electronic Disability Collect System (EDCS) exclusion, resulting in a modular disability folder (MDF), the DDS must:

  • attach an SSA-408 (Route Slip) to the MDF; and

  • forward the MDF to the FO, advising the FO to prepare and release the notice.

If the case is selected for Quality Assurance (QA) review, process according to the instructions in DI 26535.036- Special Situations

B. Partially favorable allowances

1. Initial Denial to Partially Favorable Reconsideration Allowance

The DDS prepares an SSA-L1157-U2-SI (Supplemental Security Income Notice Disability Contact Discourse), and releases the interim notice according to the instructions in DI 26535.036 – Special Situations. The DDS alerts the FO that further processing is needed via EDCS for certified electronic folders or by attaching an SSA-408 (Route Slip) to the paper folder. If the case is selected for Quality Assurance (QA) review, process according to the instructions in DI 26535.036 – Special Situations.

For additional certified electronic folder instructions see, DI 81020.130- Electronic Case Closure.

2. Remarks for field office notice preparation

Claimants must be given written notice of all determinations; therefore, the DDS must take special measures to ensure that a notice is promptly prepared and mailed.

a. Modular Disability Folder

When a favorable determination is made and the claim is an EDCS exclusion, the DDS must enter the following remark on the transmittal Form SSA-408 (Route Slip) and attach it to the modular disability folder when the FO prepares the final notice:

“Title XVI allowance on reopening/reconsideration: FO must prepare allowance notice. Systems data input on (mo./day/year).”

b. Certified Electronic Folder

For certified electronic folders (CEF), the DDS adds a message to the CEF immediately prior to case closure, including detailed instructions to the FO to release the notice. When the case is closed on the DDS case processing system, the completed notice attachments not released by the DDS, are uploaded to the CEF and stored in the appropriate section. The FO is responsible for printing, date stamping, and releasing the notice attachments. If the FO believes a paragraph has been omitted or improperly designated, the FO contacts the DDS to resolve the matter.

NOTE: The DDS case processing systems electronically date the PDNs when the PDNs print upon case closure. The date appears on the paper and electronic versions of the PDN. However, due to system limitations, there are times when no date appears on the paper or electronic image versions of the PDN.

For additional CEF notice instructions see, DI 81020.130 – Electronic Case Closure.

C. Affirmation of Closed Period and Unfavorable Onset Date Allowance

When a closed period or unfavorable onset date allowance is affirmed, the DDS prepares and releases a modified notice on preprinted form SSA-1130-U2 with a personalized explanation. The DDS must delete the phrase “denying your claim” from the third sentence of the first paragraph. Include paragraph 841 (Title II disclaimer) on concurrent Title II/Title XVI claims when the SSA-1130-U2 is not preprinted.


To Link to this section - Use this URL:
http://policy.ssa.gov/poms.nsf/lnx/0427030015