TN 12 (02-92)

DI 40510.055 Title II Medical or SGA Cessations - New Title XVI Application

A. Introduction

A currently entitled title II beneficiary may file a title XVI claim. The FO is instructed to adopt the title II allowance. Therefore, there must be coordination between the reviewer and the FO so that the title II allowance is not adopted to the title XVI application when the reviewer is preparing to cease title II benefits.

B. Policy

When a reviewer is processing a title II only SGA cessation and the folder reveals that a title XVI application has been filed, the reviewer will obtain an SSI Online Query printout to determine the status of the title XVI claim.

C. Procedure

To determine title XVI involvement get a current SSI-2 query which contains the PSY field in accordance with DI 40505.210 if an SSI-2 query 30 days old or less is not in file.

Handle as follows when title XVI status is determined:

If title XVI is ...Then ...
Not Yet AllowedTelephone the FO that the title II benefits are being ceased, the effective date of cessation, and the basis for cessation. Document the conversation in the title II folder, make sure due process has been afforded, and process the determination.
Allowed/Title II SGA CessationAdvise the FO that title II claim is being sent to them for preparation of the SGA cessation and to take whatever action is warranted on the title XVI claim.
Allowed/Title II Medical CessationFollow the instructions provided above for the “title XVI “Not Yet Allowed” situation.
 NOTE: Work activity performed July 1, 1987, or later does not raise an issue of continuing eligibility for title XVI payments. The TWP/EPE provisions do not apply and SGA is no longer a basis for title XVI cessation. FO's will process title XVI work activity in accordance with SI 02302.001.

To Link to this section - Use this URL:
http://policy.ssa.gov/poms.nsf/lnx/0440510055
DI 40510.055 - Title II Medical or SGA Cessations - New Title XVI Application - 03/29/2013
Batch run: 03/29/2013
Rev:03/29/2013