BASIC (10-15)

DI 28084.010 Adjudicative Level, Determination Findings, and Basis for Determination (Items 8 to 10)

A. Introduction to completing Items 8 to 10

Follow the instructions to complete Items 8 through 10 when processing continuing disability review (CDR) on the Forms SSA-832 (Cessation or Continuance of Disability or Blindness Determination and Transmittal –Title XVI) or SSA-833 (Cessation or Continuance of Disability or Blindness Determination and Transmittal – Title II).

B. Item 8 - adjudicative level

Enter an "X" in the appropriate block. Also, enter an "X" in a block to show the adjudicative level of the reopen determination if, "REOPENING" (Block G) is checked.

C. Item 9 - determination findings

Complete Item 9 as follows:

The National Disability Determination Service System (NDDSS) requires a day entry for all date entries in Item 9. Use six-digit entries for all date entries (01/15/10).

  • For the SSA-832, use the 15th day of the month as the day entry unless a specific day of the month is required; and

  • For the SSA-833, the day entry is immaterial to the actual cessation of benefits, use the first day of the month as the day entry unless a specific day of the month is required.

NOTE: The field office (FO), Office of Disability Operations (ODO), Office of Earnings International Operations (OEIO) and Program Service Center (PSC)- Disability Processing Branch (DPB) will complete Blocks 9D, 9E, 9F, 9G and 9H, according to DI 13010.170.

1. Disability blocks

Check the block that applies to the case:

  • enter an "X" in the "Disability" block unless the case involves work incentive;

  • enter an “X” in the “Impairment Severity” block in a work incentive case; and

  • complete Block 9A or 9B. If the case involves a statutory blindness, complete Block 9J instead.

2. Block 9A (continues)

Enter the following information:

  • an "X" in Block 9A when eligibility continues under the Federal criteria;

  • an "X" in Block 9A when eligibility continues in a conversion case under the State plan and the Federal criteria are not met; and

  • do not complete the drug addiction and alcoholism (DA & A) blocks in Block 9A.

3. Block 9B (ceased)

Enter the following information:

  • an "X" in Block 9B when disability is ceasing and enter the month, day and year of medical cessation, if disability or impairment severity ceased; and

  • in conversion cases using the SSA-832, enter in the second section of Block 9B the month, day, and year the State criteria are met. (Disability must cease under both Federal and State criteria in conversion cases.)

NOTE: For determining the cessation month, see DI 28005.205. Use these exceptions when determining the cession month, if applicable:

  1. the last day of the month prior to death or the attainment of full retirement age and enter the year in the “Ceased” block if cessation is due to death or attainment of full retirement age, see DI 28030.001C, DI 32005.020G, and DI 23510.000;

  2. the month, day and year specified by the FO or DDS in which the individual fails, without good cause, to do what SSA or DDS has requested and the individual was aware that he or she had to cooperate and the repercussions of failing to do so, see DI 28075.005F and DI 28005.205; or

  3. the date the CDR arrived in the FO or the month, day and year the individual's whereabouts became unknown, if later, if cessation is due to whereabouts unknown. Disability ceases in the month that the individual's whereabouts were unknown, but no earlier than the month in which the CDR issue arose, see DI 28075.005, DI 28001.015, and DI 28005.205.

4. Block 9C (eligibility terminated at the close of the last day of) and (upon consideration of all facts, it is determined)

Enter an "X" in Block 9C if disability or impairment severity will terminate. In Block 9C, enter the month, day, and year entry of the cessation, which is (Block 9B) plus two additional months. In this block, use the last day of the month as the entry day. The month of termination is the second month after the month in which cessation occurs, e.g., cease in 12/01/14, terminate 02/28/15. Use a six-digit date format for both show the cessation and termination dates. The termination date entry is the last day of the month.

NOTE: Do not enter a termination date for “301” Cases, see DDS Procedures for Cases Involving Participation in a VR or Similar Program in section DI 14510.010.

5. Block 9D – FO entry (EPE begin month) (SSA-833 only)

Enter an "X" in Block 9D to indicate the beginning of an extended period of eligibility (EPE). The "EPE Begin Month" begins with the month, day and year immediately following completion of the 9th month of trial work. For more information on how EPE works, see DI 28055.005.

6. Block 9E – FO entry (EPE reinstatement month) (SSA-833 only)

Enter an "X" in Block 9E to indicate the allowance of EPE reinstatement. The "EPE" Reinstatement Allowed" date is the month, day and year that substantial gainful activity (SGA) ceased during an EPE.

7. Block 9F – FO entry (EPE reinstatement denied) (SSA-833 only)

Enter an "X" in Block 9F to indicate the denial of EPE reinstatement.

8. Block 9G – FO entry (EPE suspension after reinstatement) (SSA-833 only)

Enter an "X" in Block 9G to indicate that EPE benefits and payments are suspended after reinstatement. The "EPE Suspension after Reinstatement" date is the month, day and year a reinstated beneficiary/recipient returns to SGA during an EPE.

9. Block 9H – FO entry (EPE benefit termination month) (SSA-833 only)

Enter an "X" in Block 9H to indicate the benefit termination month (BTM) for EPE cases. The BTM is the first month, day, and year that disability benefits cannot be paid after the EPE, i.e., the first month, day and year after the month day and year in which the EPE ends.

NOTE: For Title II beneficiaries, the "EPE-Benefit Termination Month" ends with the earlier of the second month following the month in which:

  • the person's impairment is not disabling; or

  • the second month following the earliest month in which the person engages in SGA or is able to do so; but

  • no earlier than the month preceding the first month of SGA after a period of 36 consecutive months following the ninth month of trial work, see DI 28055.000.

10. Block 9I (301 case)

Enter the following information:

  • an "X" in Block 9I for "301" cases; and

  • “301 Case” in Item 24 (Remarks).

NOTE: For instructions on Vocational Rehabilitation “301” cases, see DI 14510.010.

11. Block 9J (statutory blindness)

Complete Block 9J only when the individual has been or continues to be statutorily blind.

a. Statutory blindness continues or began (9J1)

Enter the following information:

  • an "X" in the "Continues" or "Began" block as appropriate.

  • the month, day and year if, “Began” contains an “X” in Block 9J1.

NOTE: Prepare an SSA-4648-U3 (Title II/Title XVI Disability Claims Control and Determination Input) form to change the case category to blindness, if appropriate. Also, be sure to enter an “X” in Item 1B for blind individual (BI), blind spouse (BS) or blind child (BC) on the SSA-832.

  1. Individual is not engaging in SGA (SSA-833 only)

    • Enter an “X” in Block 9J(1)(a) (Disabled for Cash Benefits Purposes) and enter the month, day, and year the individual became disabled for cash benefit purposes. Enter the date disabled for cash benefits purposes from the latest SSA-831-U3 form in file, if the date was previously established.

  2. Blind individual entitled to a trial work period (TWP) engages in SGA (SSA-833 only)

    Enter the following information:

    • complete the determination in accordance with the procedures for work determinations for non-blind individuals; i.e., complete appropriate blocks in 9A through 9H;

    • an "X" in Blocks 9J and 9J1; and

    • draw a line through "Period of Disability" and write in "Benefits" if an entry in Block 9C is required (paper cases only).

  3. Blind individual not entitled to a TWP or TWP previously expired engages in SGA (SSA-833 only)

    1. Individual under age 55 engages in SGA or age 55 or over engages in comparable SGA enter:

      • an "X" in Blocks 9J and 9J(1)(b);

      • the first month, day, and year of SGA in Block 9J(1)(b); and

      • an "X" in Block 9c and enter the month, day, and year of the second month after the month, day, and year shown in Block 9J(1)(b) (use the last day of the month for the day entry).

    2. Individual age 55 or over not entitled to a TWP or TWP previously expires engages in non-comparable SGA:

      Do not complete an SSA-833. ODO, OEIO, and PSC-DPB will prepare an SSA-553 (Special Determination) per DI 41005.020.

b. Statutory blindness ceased and no other disabling impairment (9J2)

Enter the following information:

  • an "X" in Blocks 9J and 9J2 and enter the month, day and year blindness ceased in 9J2; and

  • an "X" in the block and complete Block 9C.

c. Statutory blindness ceased and another disabling impairment began (9J and 9J3)

Enter the following information:

  • an "X" in Blocks 9J and 9J3 entering the month, day and year blindness ceased in 9J3; and

  • the month, day and year the other impairment(s) became disabling in the space following "Other Impairment Began."

NOTE: Be sure that the type of case in Item 1B is checked DI, DC, or DS on the SSA-832. Prepare an SSA-4648-U3 (Title II/Title XVI Disability Claims Control and Determination Input) or use another direct input process also to change the case category, if blindness ceased.

D. Item 10 -- basis for determination

Enter the following information:

  • an "X in Block 10A (Medical/Medical Voc.) unless the basis for a determination is "Other"; and

  • explain in Item 24 (Remarks), if the determination is "OTHER".

NOTE: Blocks 10B and 10C do not require an entry.


To Link to this section - Use this URL:
http://policy.ssa.gov/poms.nsf/lnx/0428084010
DI 28084.010 - Adjudicative Level, Determination Findings, and Basis for Determination (Items 8 to 10) - 10/27/2015
Batch run: 10/27/2015
Rev:10/27/2015