BASIC (10-15)

DI 28084.045 Remarks and Multiple Impairments (Items 24 to 24B)

A. Introduction to completing Items 24 to 24B

Follow these instructions to complete Items 24 through 24B when processing a 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 24 – remarks

Use Item 24 to alert the Social Security personnel to any special circumstance or situation in previous Items on the SSA-832 or SSA-833.

NOTE: This chart includes only a few examples of special situations that might be annotated in Item 24. It is not a complete list.

1. Remarks for both the SSA-832 and SSA-833

Enter the appropriate remark when completing a SSA-832 or SSA-833 from the following list, if applicable:

Situation Enter in Remarks

Present determination is a revision of a previous determination or is a reconsideration determination.

"This revises determination approved (show date of prior approved determination)" i.e., date of physician's signature and Annotate the prior determination in remarks with the following "See revised determination of" (show date of present approved determination)." Enter "Based on decision of ALJ (name of ALJ) or AC, and date of decision” in ALJ or AC cases.

A revised favorable determination is prepared under the informal remand process.

"Informal Remand Case"

Forms SSA-832 or SSA-833 are reviewed by the disability determination services (DDS) quality assurance.

"DDS-QA"

Capability issue is raised during a Title II or Title XVI CDR.

"Payee Question Raised"

Expedited reinstatement determination finds the individual under a disability, also enter "MOE MMYY". This date is the new expedited reinstatement month of entitlement date.

"Expedited Reinstatement"

A case is identified as a 301 Case, see DI 28060.001.

"301 Case"

Enter appropriate capability statement, if applicable. See DI 26510.095 for capability statements.

 

Possible Fraud or Similar Fault in a Prior ALJ decision. Forward to ODO after effectuation of cessation for possible reopening and revision.

"Possible Fraud/Similar Fault Issue in Prior ALJ Decision"

2. Remarks for the SSA-832

Enter the appropriate remark when completing a SSA-832 from the following list, if applicable:

Situation Enter in Remarks

Processing a cessation on a Title XVI case involving resumption of payment after a period of non-eligibility.

"Period of Payment Non-eligibility"

Case is a Title XVI State conversion case.

"State Conversion"

A cessation case when an individual moved from a conversion State, see DI 28075.010D.2.

"State Conversion Case - determination under (show appropriate State) State plan required"

A case is identified as a 1619 case.

"1619(a) Initial Eligibility CDR", or "1619(b) Initial Eligibility CDR" or "1619 Status Change CDR"

Childhood and Age 18 Disability redeterminations

"P.L. 104-193"

List code "281" is input.

"Child In Treatment"

List code "282" is input.

"Child Not In Treatment/Has TS/No Treatment Prescribed"

List code "283" is input.

"Child Not In Treatment/Condition Not Amenable To Treatment" or "Child Not In Treatment/No TS/Treatment Not Medically Necessary"

List code "284" is input.

"Child Not In Treatment/Medically Necessary Treatment Unavailable Or Other Good Cause"

List code "285" is input.

"Child Not In Treatment/Has TS/Treatment Prescribed/No Good Cause For Failing To Obtain Treatment/Additional Payee Action Necessary"

List code "286" is input.

"Child Not In Treatment/No TS/Treatment Is Medically Necessary and Available/Additional Payee Action Necessary"

Childhood case continuance - medical evidence indicates that maternal drug or alcohol addiction is an underlying cause of impairment (i.e. child born addicted) and FO not previously alerted by the DDS, or situation not previously indicated.

"Possible rep. payee issue - impairment related to maternal drug or alcohol abuse see medical report from _____ dated _____."

Childhood case continuance - medical evidence indicates the child's mother or father is an alcoholic or drug addict and FO not previously alerted by the DDS, or situation not previously indicated.

"Possible rep. payee issue - mother/father suffers from drug /alcohol abuse - see medical report from _____ dated _____."

Childhood case continuance - medical evidence indicates that the child may suffer from abuse and FO not previously alerted by DDS, or situation not previously indicated.

"Possible rep. payee issue - medical evidence indicated child abuse - see medical report from ______ dated ______."

3. Remarks for the SSA-833

Enter the appropriate remark when completing a SSA-833 from the following list, if applicable:

Situation Enter in Remarks

A Title II statutorily blind case, age 55 or over, and the individual is engaging in non-comparable substantial gainful activity (SGA). If work is continuous, show “MO/YR – ON”. If work is not continuous, show each month and year of SGA.

"Stat Blind Non-comparable SGA" and "Stat Blind WK -- (Mo. & Yr.)" (month and year individual engaged in SGA)

Title II dual entitlement determinations, (childhood disability beneficiary (CDB) or disabled widow(er) beneficiary (DWB)) – (DWB SSN 000-00-0000).

"SSN on which the beneficiary has other entitlement"

The disabled or blind individual is legally competent, but has a representative payee.

"Disabled (Blind) Individual's Address: _______________":

The case is a 1619 CDR concurrent Title II determinations.

"1619 CDR-Concurrent Title II Determination"

C. Items 24A and 24B

DDS will not complete Items 24A and Items 24B.


To Link to this section - Use this URL:
http://policy.ssa.gov/poms.nsf/lnx/0428084045
DI 28084.045 - Remarks and Multiple Impairments (Items 24 to 24B) - 10/27/2015
Batch run: 10/27/2015
Rev:10/27/2015