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Reopening Notice Instructions

TN 1 (09-09)

DI 27540.001 Due Process Requirements

A. What is due process?

Due process includes providing necessary information to the beneficiary before taking any action that adversely affects his or her previously established right to receive Title II disability or Title XVI disability/blindness benefits. Certain legally established prerequisites must be included in every instance. Fully inform the beneficiaries that their benefits may be stopped or they may be overpaid if:

  • They are no longer disabled (cessation);

  • They are no longer entitled to disability benefits/payments on the current application (adverse reopening);

  • They received erroneous payments after a decision of denial; or

  • The onset date is changed to a later date.

The beneficiary must be given an opportunity to offer rebuttal evidence and to respond to the proposed adverse action before a final decision is rendered. Extend due process to the beneficiary in writing and store a copy of the notice in the official folder. Resolve any doubts regarding the need to provide due process in favor of providing it. The requirements of due process are not completely satisfied merely by advising the beneficiary that his or her benefits may stop as a result of the disability review.

B. Types of due process notices

Due process in the disability program is achieved by sending either a due process predetermination notice or a due process decision notice.

1. Predetermination notices for adverse reopenings

The Disability Determination Services (DDS) prepares and releases a predetermination notice prior to the processing of the SSA-831, or SSA-833. The predetermination notice applies only in those reopening cases that do not require benefit continuation language (the determination is not considered to be a medical cessation, e.g., failure to follow prescribed treatment).

2. Due process decision notice

The processing component (e.g., DDS or the Office of Disability Operations (ODO)) prepares or releases a Decision Notice when statutory benefit continuation language (SBC) applies (i.e., a medical cessation). The determination notice is released following processing of the SSA-831, SSA-832, or SSA-833. The DDS does not hold the case awaiting a claimant response.

See Details:

For a discussion of due process policy and due process notices, see Policy - Due Process for Adverse Reopenings, DI 27525.001.

For additional information on the types of cases excluded from statutory benefit continuation, see Cases Excluded from Statutory Benefit Continuation (SBC) DI 12027.015.

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DI 27540.001 - Due Process Requirements - 09/22/2009