TN 14 (02-10)
DI 40515.010 Due Process Requirements - Title XVI
CITATIONS: Social Security Act, Section 1631 (a) (7) ; Regulations 20 CFR 416.995 , 416.996 , and 416.1336
A. Policy on Title XVI due process requirements
1. Due process and notice of planned action
Due process requires that you send the beneficiary a notice of planned action before benefits are adversely affected.
Benefits are continued if:
An appeal is requested within 10 days of receipt of the notice of planned action; and
The beneficiary does not waive, in writing his or her right to continuation of benefits. See SI 02301.300 for additional guidance in Title XVI due process cases.
EXCEPTION: Due process notification is not required when the beneficiary's death has been confirmed.
2. Statutory benefit continuation option applies
The decision notice provides due process when the statutory benefit continuation option applies. The policy for Title XVI cases is the same as that for Title II cases. See DI 40515.005B.2.
3. Title II/Title XVI concurrent cases
Process the Title II case under Title II procedures, and the Title XVI case under Title XVI procedures. The decision notice provides due process for Title II and Title XVI when the statutory benefit continuation option applies.
Work and earnings
The Title II case receives Title II due process per DI 13010.185F, and the Title XVI case receives Goldberg/Kelly (G/K) due process per SI 02301.300. This applies whether you process the adverse actions at different times or at the same time.
SI 02301.300, Due Process Protections - General
SI 02301.301, Overview of Goldberg/Kelly (GK) Processing.
SI 02301.305, Online Goldberg Kelly (GK) Notices
SI 02301.307, Manual Goldberg Kelly (GK) Notice Procedures
SI 02301.310, Appeal and the Right to Goldberg Kelly (GK) Payment Continuation
SI 02301.315, Erroneous Payments and GK Payment Continuation
DI 40515.100, Title II and Title XVI Statutory Benefit Continuation During Medical Cessation Appeal.