PROGRAM OPERATIONS MANUAL SYSTEMPart DI – Disability InsuranceChapter 252 – Title XVI Child Claims Based on DisabilitySubchapter 35 – Case Processing Instructions for Title XVI Child ClaimsTransmittal No. 3, 03/11/2020
States provide social, developmental, educational, medical, and rehabilitative services to children with special health care needs under Title V of the Social Security Act. We refer children who are eligible for title XVI benefits to the designated State agency that provides these services.
Summary of Changes
DI 25235.040 Referrals of Title XVI Disabled Children to Designated Title V or Other Agency
This new section consolidates existing policy and procedures for referring title XVI disabled children to designated State agencies. The policy and procedures were previously in several sections of the DI 26520 subchapter (Vocational Rehabilitation (VR) and Other Referrals). The current transmittal does not change existing policy on referring children to the designated State agencies. It does not change existing disability determination services (DDS) practices.
The disability determination service (DDS) will refer all allowed blind and disabled children under age 16 to the agency administering the State program under Title V of the Social Security Act or other agency designated by the State for social, developmental, educational, medical, and rehabilitative services.
The DDS will use the SSA-3661-U2 (Transmittal of Title XVI Referral to Designated State Agency) to transmit the referral to the designated title V or other State Agency.
The DDS will complete items 1 - 13 of the SSA-3661-U2:
Enter the name and address of the appropriate designated State Agency.
Enter the child's SSN.
Enter the child's name.
Enter the child's date of birth.
Check "M" or "F."
Enter the three-digit DDS Code.
Enter the child's full address.
Enter the full name and relationship of the adult responsible for the child.
Enter the responsible adult's address.
Enter any special information you feel the designated State Agency might find useful.
Enter the date of the referral.
15 - 18
To be completed by the designated State Agency. [The designated State Agency uses these blocks to notify SSA when it determines that the child's impairment(s) has diminished to the extent that it may no longer be disabling.]
Attach legible copies of the following material:
SSA-1994 (Cover Sheet Confidential Medical Information)
SSA-831 (Disability Determination and Transmittal) or SSA-832 (Cessation or Continuance of Disability or Blindness Determination and Transmittal - Title XVI)
SSA-3820-BK (Disability Report - Child)
Current medical reports on the child's primary impairment(s) (generally, reports within the last 12 months)
Other useful information
Send the original and copy of form SSA-3661-U2 and any attachments to the designated Title V or other State Agency designated to provide social, developmental, educational, medical, and rehabilitative services.
Enter the code "C" in the VOC field of the D831 or D833 closure screen in the National Disability Determination Services System (NDDSS).
No entry is made in item 21 of the SSA-831 (Disability Determination and Transmittal) or item 19 or the SSA-832 (Cessation of Disability or Blindness Determination and Transmittal - Title XVI) when a disabled or blind child under age 16 is referred to a designated State Agency.
If the file indicates that the child was previously referred to the designated State Agency and the DDS determines that a child under age 16 is no longer disabled or blind for Title XVI purposes, forward a copy of the SSA-832 (Cessation of Disability or Blindness Determination and Transmittal - Title XVI) to the State agency designated to receive referrals of allowed Title XVI children.