Process any favorable or partially favorable final decision using an A101 or EF101. The benefit authorizer should adjust for payments previously released against payments currently due. See DI 42010.000 for instructions on processing administrative law judge (ALJ) and Appeals Council (AC) decisions. Develop any outstanding issues, e.g., workers' compensation, following instructions in DI 52150.001 - DI 52150.090. Handle any overpayment in accordance with GN 02201.000.

Interim benefits (IB) are payable up to the month before the month in which the Commissioner issues a final disability decision. The Office of Appellate Operations (OAO) does not issue a stop order until an appeal is filed, the appeal period ends, or the AC initiates its own motion review. For this reason, consider the appeal period months IB payments and do not create an overpayment, unless fraud is involved.

Code the MADCAP action to ignore the erroneous payments. See SM 00865.045. Manually archive CPS data on the master beneficiary record. See MSOM INTRANET CPS 001.001.

NOTE: The ALJ decision date becomes the final decision date if the claimant appeals, the appeal period ends, or the AC initiates its own motion review. The OAO will send a stop order. Do not stop IB payments until a stop order is issued.

When an ALJ changes his or her decision from fully favorable to partially favorable after AC own motion review, SSA will not consider any IB paid during an unfavorable period as an overpayment, unless the IB were fraudulently obtained. SSA will adjust for payments previously released against payments currently due, only for entitlement concurrent with payments due during the IB period.

Example: A fully favorable decision grants a claimant entitlement beginning October 2011. SSA began paying IB August 2015. After the AC’s own motion review, the ALJ issues a partially favorable decision. The claimant is granted a closed period of disability beginning October 2011 and ending January 2013. Because SSA paid IB beginning August 2015 outside of the new favorable period, SSA will not create an overpayment for any IB unless the IB were fraudulently obtained. SSA will release any underpayment due during the favorable closed period, since no payments due were payable during entitlement to IB.

SSA does not consider IB in the past-due benefits calculation to determine applicable attorney or representative fees. When calculating past due benefits for purpose of determining applicable attorney fees, exclude any IB payments from the past due benefit calculation.