TN 6 (10-15)

DI 42010.225 Followups and Controls on Continuing Title II Interim Benefits

The Social Security Administration (SSA) must pay monthly Federal benefits prospectively if the Commissioner does not make a final decision within 110 calendar days after the date of the administrative law judge (ALJ) decision. These interim benefits start the month before the month in which the 110th day falls and end the month before the month the Commissioner issues a final decision.

A. There is no interim benefits start order

The notice to a claimant about the Appeals Council’s (AC) review of a favorable ALJ decision tells the claimant that we will pay interim benefits effective with the month before the month in which the 110th day falls. The claimant may contact SSA as the 110th day approaches to inquire about interim benefits. If the processing center (PC) has not received the start order for Title II interim benefits, request a start order to initiate interim benefits by sending a fax to:

Office of Appellate Operations (OAO)
(703) 605-7201

B. Final ALJ or AC decision not issued within nine months

Interim benefit payments require close management to prevent payment beyond the month of final decision. Because of the sensitivity of this workload, please follow the OAO development guidelines in this section.

The procedures in this section apply if the case is pending an AC decision or was remanded back to the ALJ for a decision. Therefore, PC staff and management should carefully evaluate which office to contact.

If

then

The claimant is still in interim benefit payment status for nine months

The PC will query the Case Processing & Management System (CPMS) to see if the case is pending with the AC or is pending in the Hearing Office (HO).

If the case is pending with the AC:

The PC will email OAO at |||ODAR OAO 8001 and inquire about the status of the claim pending. OAO will provide status via fax or email if the case is pending with the AC. Establish diary to recontact OAO in three months and return the case to the holding file for the next followup.

If the case is pending in an HO:

The PC will email the hearing office director (HOD) and inquire about the status of the claim pending. Use the HO staff listing at: http://odar.ba.ssa.gov/hq-components/ocalj/field-staff-listings/ to obtain the name of the HOD. The HOD will provide status via telephone or email if the case is pending with the HO. Establish diary to recontact the HO in three months and return the case to the holding file for the next followup.

The claimant is still in interim benefit payment status for 12 months

The PC will query CPMS to verify whether the case is pending with the AC or HO.

If the case is pending with the AC

The PC will write a memorandum to the executive director of OAO requesting OAO to expedite the case and inform him or her that interim benefit payments continued for 12 months without a final decision. Include any special characteristics of the case. The module manager will forward the memorandum via email to |||ODAR OAO and return the case to the holding file for the next followup.

If the case is pending in an HO

The PC will write a memorandum to the director of the Division of Field Procedures (DFP) requesting DFP expedite the case and inform him or her that interim benefit payments continued for 12 months without a final decision. Include any special characteristics of the case. The module manager will forward the memorandum via email to |||ODAR OCALJ DFP and return the case to the holding file for the next followup.

The claimant is still in interim benefit payment status for 15 months

The PC will query CPMS to verify whether the case is pending with the AC or HO.

If the case is pending with the AC

The PC will send an email with subject line “URGENT-SECOND NOTIFICATION” to |||ODAR OAO and inquire about the status of the claim pending decision. OAO will provide status via telephone or email.