TN 53 (08-95)

DI 32521.040 Notice Instructions -- Revision of Denial to Partially Favorable Allowance

A. Policy

There will be situations where a subsequent decision has already been made prior to the Dixon review (see DI 32521.015A.2.). If the Dixon review results in no change in the onset established on the subsequent allowance, then a partially favorable Dixon determination must be prepared and a notice sent.

The claimant and his/her current representative(s) must be notified of any decision which is partially unfavorable.

B. Procedure -- title II only

Prepare a Form SSA-L951-U2/C2. Add the third line heading “IMPORTANT INFORMATION;” and

1. Onset established as later than alleged

For title II onset established later than alleged:

  1. Include an introductory statement which reads:

    “The Dixon court order requires the Social Security Administration to look at your earlier claim again.

    We have completed this review and we find that you meet the medical requirements for disability benefits on (established onset date) but you do not meet these requirements prior to that date. You must meet certain medical and non-medical requirements to be entitled to disability benefits. Attached to this notice is an explanation of the decision that we made on your claim and how we arrived at it.” (Delete last sentence if merged text format is used.)

    NOTE: For cases involving a consolidated decision (i.e., a Dixon claim and a pending claim) add: “This notice includes our decision on both the Dixon case review and the new application filed on (date of new application) .”

  2. Include an optional paragraph to be used if the claimant is in current pay status that reads:

    “This determination does not affect the checks that you are getting now based on your later application.”

  3. Include a discussion of the evidence containing the elements in DI 26530.015.

  4. Include the last three paragraphs from the SSA-L1157-U2 DI (Social Security Notice-Disability) . Add “as of the date we have now found that you meet the medical requirements for disability benefits” after the word “requirements” in the first sentence of the third paragraph from the SSA-L1157-U2 DI.

2. Closed period established

For title II closed period established cases:

  1. Include an introductory statement that reads:

    “The Dixon court order requires the Social Security Administration to look at your earlier claim again.

    We have completed this review and we find that you meet the medical requirements for disability benefits from (established onset date) to (cessation date) . You must meet certain medical and non-medical requirements to be entitled to disability benefits. Attached to this notice is an explanation of the decision we made in your claim and how we arrived at it.” (Delete last sentence if merged text format is used.)

  2. Follow B.1.b. and c. above.

  3. Include the last three paragraphs from the SSA-L1157-U2 DI. (If the onset is established as later than alleged add “as of the date we have now found that you meet the medical requirements for disability benefits” after the word “requirements” in the first sentence of the third paragraph from the SSA-L1157-U2 DI).

C. Procedure -- title XVI only

Prepare a Form SSA-L8052-U2/C2. Add the third line heading “IMPORTANT INFORMATION;” and

1. Onset established later than alleged

For title XVI onset established later than alleged:

  1. Follow B.1.a.-c. above

  2. Include the last three paragraphs from the SSA-L1157-U2-SI. Add “as of the date we have now found that you meet the medical requirements for disability benefits” after the word “requirements” in the first sentence of the third paragraph from the SSA-L1157-U2-SI.

2. Closed period established

For title XVI closed period established cases:

  1. Follow B.2.a. and b. above.

  2. Follow C.1.b. above.

D. Procedure -- concurrent cases

1. Title II

For title II concurrent cases, follow B. above, but add disclaimer paragraph 842.

2. Title