TN 4 (10-15)

DI 28040.230 Determination Notice Preparation Chart in Medical Improvement Not Expected (MINE) or MINE-Equivalent Cases

A. Continuing disability review (CDR) determination notices

The disability determination services (DDS) will prepare and release the applicable notices, unless the case is selected for quality assurance (QA) or pre-effectuation review (PER). For instructions on preparation of the notice, see NL 00603.100.

The two standard continuation notices are the SSA-L1013 (Social Security Notice Of Continued Disability), and the SSA-L1014 (Supplemental Security Income Disability Information). The chart in DI 28040.230B, in this section, provides information on completion of these notices in MINE cases.

B. Notice chart

Title II, Title XVI, and Concurrent Title II/Title XVI Claims Continuances

 

NOTICES & FILL-INS1

 

Type of Case

Title II
SSA-L1013

Title XVI
SSA-L1014

Disability Continues - No Work Activity - No Medical Reexamination Scheduled (Title XVI and Title II DIB, CDB and DWB Claims)

Check Block None

Fill-in (Disabled)
Check Block None

Disability Continues - No Work Activity - Medical Re-exam Scheduled (Title XVI and Title II DIB and CDB Claims)

Check Block 6

Fill-in (Disabled) Check Block 6

Disability Continues - Trial Work Period Less Than 9 Months -Work Stopped - Medical Re-exam Scheduled (Title XVI and Title II DIB and CDB Claims)

Check Block 2, 6

Fill-in (Disabled) Check Block 2, 6

Disability Continues - Trial Work Period Less Than 9 Months -Work Stopped - No Medical Re-exam Scheduled (Title XVI and Title II DIB and CDB Claims)

Check Block 2

Fill-in (Disabled)
Check Block 2

Disability Continues - Trial Work Period Less Than 9 Months -Work Continuing - No Medical Reexamination Scheduled (Title XVI and Title II DIB and CDB Claims)

Check Block 3

Fill-in (Disabled)
Check Block 3

Disability Continues - Trial Work Period Completed - Work Stopped - Medical Re-exam Scheduled (Title XVI and Title II DIB, CDB Claims)

Check Block 2, 6

Fill-in (Disabled)
Check Block 2, 6

Disability Continues - Trial Work Period Completed - Work Stopped-No Medical Re-exam Scheduled (Title XVI and Title II DIB and CDB Claims)

Check Block 2

Fill-in (Disabled)
Check Block 2

Disability Continues - Trial Work Period Completed - Currently Working (Work Not SGA) - Medical Reexamination Scheduled (Title XVI and Title II DIB and CDB Claims)

Check Block 4, 6

Fill-in (Disabled)
Check Block 4, 6

Disability Continues - Trial Work Period Completed - Currently Working (Work Not SGA) - No Medical Reexamination Scheduled (Title XVI and Title II DIB and CDB Claims)

Check Block 4

Fill-in (Disabled)
Check Block 4

Blindness Continues - Medical Reexamination Scheduled (Title XVI and Title II DIB, DWB, CDB Claims)

Check Block 6

Fill-in (Blind)
Check Block 6

Blindness Continues - No Medical Reexamination Scheduled (Title XVI and Title II DIB, DWB, CDB Claims)

Check Block None

Fill-in (Blind)
Check Block None

Disability Continues - Not Entitled to a Trial Work Period -Currently Working (Work Not SGA) - No Medical Re-exam Scheduled (Title II DIB, CDB, and DWB Claims)

Check Block 5

Fill-in (Disabled)
Check Block 5

Legend of fill-ins for check blocks (NOTE 1):

Check Block 6 - Month and year of medical reexamination diary.

Check Block 2 - Number of trial work service months tallied. (Never indicate more than 9 months)

Check Block 3 - Month and year of projected 9th month of trial work period.

Check Blocks 4, 5 and 6 - No fill-ins.

Suffix Instructions (for instructions on use of suffixes, see NL 00603.100D):

Suffix “A” - Indicates a copy of the notice is to be sent to the representative identified in the Remarks portion of the SSA-832.

Suffix “Z” - Indicates a copy of the notice is to be sent to the authorized organization who has requested a copy.

Suffix “C25” - Indicates the claimant requests the return of a document that has been submitted.

C. References:


To Link to this section - Use this URL:
http://policy.ssa.gov/poms.nsf/lnx/0428040230
DI 28040.230 - Determination Notice Preparation Chart in Medical Improvement Not Expected (MINE) or MINE-Equivalent Cases - 10/13/2015
Batch run: 10/13/2015
Rev:10/13/2015