BASIC (04-00)

VB 02502.010 Processing Reconsideration Requests

A. Definition — Common Issue Concurrent Title II/Title VIII/Title XVI Claims

A common issue is a single factor of eligibility (e.g., age, military service) which causes a less than favorable determination on concurrent claims, any of which is being appealed. A common issue is not present if any of the claims may be denied without consideration of the factor(s) which caused the less than fully favorable determination on the other claim. In reconsideration determinations involving SVB, issues common to determinations under all three titles (II, VIII and XVI) should be rare. Since qualification for SVB is dependent on eligibility under title XVI, such eligibility may be a common issue in a number of cases.

B. Policy

1. Concurrent SVB/SSI Claims — Reconsideration of SSI Eligibility

Normally, reconsideration requests involving determinations on SVB claims are processed by case review only. However, a claim for SVB also constitutes an SSI claim. Therefore, a claimant requesting reconsideration of a determination on his/her SSI eligibility can elect reconsideration by case review or informal conference.

2. Reconsideration of PE Initial Determinations

As in SSI cases, individuals receiving SVB payments can request reconsideration of PE initial determinations to reduce, suspend or terminate benefits by means of case review, informal conference or formal conference.

As in SSI cases, a beneficiary appealing a PE initial determination to reduce, suspend or terminate SVB payments will continue to receive payments if the reconsideration request is made within 10 days of receipt of the notice of the initial determination (or later if good cause is established). Payment is not continued or resumed if the beneficiary has waived the right to payment continuation in writing.

C. Procedure — FO Jurisdiction

Either the servicing FO or the central processing site (CPS) is responsible for making the reconsideration determination in SVB cases.

See VB 00901.015 for jurisdiction and routing procedures for SVB cases involving a request for reconsideration.

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VB 02502.010 - Processing Reconsideration Requests - 08/30/2012
Batch run: 08/30/2012