TN 3 (04-12)
DI 28080.025 Providing Due Process Notification for Title XVI Only Continuing Disability Review Claim
A. Providing due process
2. Medical cessation
The Disability Determination Services (DDS) provides due process on title XVI medical cessations (medical improvement determinations) under the statutory benefit continuation (SBC) provisions.
Send a cessation notice rather than a pre-determination notice.
NOTE: In initial medical cessations, the reconsideration disability hearing is the first level of appeal.
3. Failure to cooperate (FTC) and whereabouts unknown (WU)
For procedures to follow for FTC and WU cases that arise during the continuing disability review process, see DI 28075.005.
B. Statutory benefit continuation (SBC) vs. Goldberg/Kelly (GK) automatic payment continuation
GK automatic payment continuation applies instead of SBC for issues of failure to follow prescribed treatment and fraud or similar fault. GK procedures do not apply to title XVI WU cases because we consider WU (S06) an administrative suspension and does not result in a loss of eligibility.
C. See Also: