TN 20 (09-90)
DI 28055.035 Due Process and Notice Requirements for DDS Impairment Severity Cases
A. Policy- Due Process
1. Predetermination Notice Not Required
Predetermination notice is generally not required for title II impairment severity cessation determinations which are subject to benefit continuation rights as discussed in DI 28080.115B. The few exceptions are discussed in 2. below.
2. Predetermination Notice Required
A predetermination notice is required when:
benefit continuation rights do not apply.
a retroactive cessation is permitted by regulations - commonly “whereabouts unknown” cessations.
The same predetermination due process notice procedure applicable to other whereabouts unknown CDR cases should be followed. However, notice language should be geared to the EPE aspect of the case (e.g.,“impairment severity” rather than “disability” cessation).
The month/year that impairment severity is determined to have ceased will be included. However, the month/year of benefit termination will not be included since the latter does not form a part of the DDS determination.
B. Policy - Determination Notice
Written notice will be provided to persons who have completed 9 TWP months and who, based solely on medical/vocational grounds (or failure to cooperate or whereabouts unknown), are determined to have an impairment which remains of disabling severity (EPE continuance) or which is no longer of disabling severity (EPE cessation) although disability may have ceased previously due to SGA.
Written notice will be provided auxiliaries in EPE medical cessation
1. General Preparation
Prepare the continuance/cessation notices for title II only and the title II portion of concurrent title II/title XVI impairment severity cases according to these instructions. See DI 28075.625 for the title XVI portion of concurrent title II/title XVI cases.
An auxiliary notice is not required in impairment severity continuance cases.
If a legally competent beneficiary has a representative payee, address and send the notice to the beneficiary at his or her mailing address. Send a modified copy to the payee as explained in DI 28095.040A.3., “Note”.
Address and send the notice to the authorized representative of a legally incompetent beneficiary (i.e, representatvie payeee, legal council, guardian, etc.)
3. Notice Language
Impairment Severity Continuance - Use the model language in DI 28055.045 on form notice SSA-L951-U2/C2.
Impairment Seveirty Cessation - Use the model language in DI 28055.050 (for the disabled person) and DI28055.055 (for auxiliaries) on form notice SSA-L951-U2/C2.
4. Notice Release
Continuance - Do not release. (ODIO/PSC-DRS will release title II and concurrent title II/title XVI notices unless a preeffectuation review is necessary.)
Cessation - Release the notice unless the case is selected for QA review.