DI 40115.010 Processing Center (PC) Action when Disability Determination Services (DDS) Sets Onset in Grace Period of Prior Medical Termination
A. When does a period of disability and disability benefits end
The Social Security Act (Act) provides that a period of disability and disability benefits terminate at the end of the second month after the month in which the beneficiary is no longer disabled. The Act also precludes a re-entitled claimant from receiving benefits for overlapping periods of disability.
EXAMPLE: Disability ceased on 4/30/89 for medical improvement, and benefits terminated on 6/30/89. The claimant filed a new application on 6/19/89 alleging a new impairment. The Disability Determination Services (DDS) determined that the claimant was disabled as of 5/30/89; however, based on the claimant’s prior period of entitlement, the onset was established effective 07/01/89, which is the first day after the day benefits terminated.
B. Re-entitlement and completion of the SSA-833 and SSA-831
To re-entitle the claimant (using the example in “DI 40115.010A” above), the processing center (PC) examiner must complete forms:
1. Complete the SSA-833 and SSA-831
Prepare an SSA-833 to terminate the earlier period of disability on 6/30/89
Prepare an SSA-831 to establish a subsequent period of disability beginning 7/1/89 (the first day after the prior period of disability)
Enter the following items of the SSA-831:
05/30/89 in item 15A
07/1/89 in item 28C
Show in item 34 of the SSA-831:
“No Waiting Period” (except when the beneficiary is deemed to have served a waiting period for trial work period purposes per DI 13010.035), and
“Dates in 15A and 28C differ - new period of disability established after cessation.”
Notify the DDS of the correction per GN 04440.220.
2. Simultaneous processing
Follow “DI 40115.010C” below if both determinations are processed simultaneously in the PC, Disability Processing Branch. Generally, processing of the SSA-833 takes place before the SSA-831.
C. Notice and routing Instructions
Enter the letter and paragraph number block of the SSA-833 “NLN”;
Enter “S” in item 29 of the SSA-831; and
Prepare paragraph for the claims authorizer/claims technical examiner (CA/CTE) on an SSA-573 (Special Typing Instructions) to show dates of old and new periods of disability. Also, show months for which checks are due.
Route the folder to a CA/CTE.
Explain the effects of both determinations, and
Ask the CA/CTE to prepare a new award and forward it to a benefit authorizer/benefit technical examiner for processing.