Identification Number:
DI 14510 TN 7
Intended Audience:See Transmittal Sheet
Originating Office:ORDP OISP
Title:Procedures for Cases Involving Participation in a VR or Similar Program
Type:POMS Transmittals
Program:Disability
Link To Reference:
 

PROGRAM OPERATIONS MANUAL SYSTEM
Part DI – Disability Insurance
Chapter 145 – Continued Payments to Individuals Participating in a Vocational Rehabilitation or Similar Program
Subchapter 10 – Procedures for Cases Involving Participation in a VR or Similar Program
Transmittal No. 7, 09/08/2020

Audience

PSC: BA, CA, CS, DE, DEC, DPS, DS, DT, DTE, FLC, ICDS, IES, ILPDS, ISRA, PETE, RECONR, SCPS, TSA, TST;
OCO-OEIO: BET, BIES, CAQCR, CC, CR, CTE, ERE, FCR, FDE, PETL, RECONE, RECONR, RECOVR;
OCO-ODO: BET, BTE, CCE, CR, CST, CT, CTE, CTTA, DE, DEC, DS, DSE, PCS, PETE, PETL, RCOVTA, RECONE, RECOVR;
ODD-DDS: ADJ, DHU;
FO/TSC: CS, CS TII, CS TXVI, CSR, CTE, DRT, FR, OA, OS, RR, TA, TSC-CSR;

Originating Component

OISP

Effective Date

Upon Receipt

Background

Removing SSA links from public website.

Summary of Changes

DI 14510.025 Office of Disability Operations (ODO) Procedures for Processing Allowances, Closed Periods, and Denials of Section 301 Payments

 

DI 14510.025 Office of Disability Operations (ODO) Procedures for Processing Allowances, Closed Periods, and Denials of Section 301 Payments

Document the allowance, closed period, or denial determination on an SSA-553 (Special Determination). The documentation should identify the facts of the case, including:

  • The type of program the beneficiary is participating in;

  • The name and address of the service provider;

  • The basis for the decision; and

  • The diary date for review of the case if benefits are continued.

The diary date is generally set for one year. If the beneficiary expects to complete the program of services in less than one year, or if there are indications that the beneficiary may not complete the program, it may be earlier. A diary date of less than one year may also be appropriate if there is an indication that the beneficiary will acquire the education, work skills, or work experience that was the basis for the initial likelihood determination, in less than one year and prior to the beneficiary completing the program.

A. Procedure for Section 301 payment allowances

1. Both Title II and Title XVI cases

  • Print the SSA-833 (Cessation or Continuance of Disability or Blindness Determination and Transmittal) or SSA-832 (Cessation or Continuation of Disability or Blindness Determination and Transmittal) from CFUI or eView and annotate in the remarks section of the document, “DO NOT PROCESS — SECTION 301 PAYMENT CONTINUATION.”

  • Scan the SSA-553 and SSA-833 or SSA-832 into eView or NDRED.

  • Prepare and send a notice of allowance of the Section 301 payment continuation due to participation in a VR or similar program.

  • Complete the Web-Based Section 301 Data Sheet.

IMPORTANT: If the Title II beneficiary is participating in a State VR agency program, the State VR agency may be eligible for VR reimbursement under certain circumstances. E-mail a copy of the SSA-4290-F5 (Development of Participation in a Vocational Rehabilitation or Similar Program), the SSA-553, and the SSA-833 or SSA-832 to the ORDES OES VR Team at VR.301.Claims@ssa.gov.

2. Title II cases

  • Do not process the disability cessation;

  • Annotate the Master Beneficiary Record (MBR) with a special message: “Section 301 payment case - do not process any reported work;”

  • Post the Section 301 payment continuation event (see MS CDR 001.005 CDR PC Input Screen (IPCA)); and

  • Diary the case for one year from the current month or earlier for review on the Disability Control File (DCF) (see DI 14510.025A).

The latest event on the DCF should be the medical cessation posted by the Disability Determination Services (DDS) to the Disability Determination Services Query (DDSQ). If DDS does not post the cessation to the DCF, review the Disability Determination Service Query (DDSQ/HA04) to determine if DDS reversed the cessation to a continuance. (If DDS reversed the cessation, Section 301 payment continuation is no longer applicable.)

If DDS did not reverse the cessation, manually annotate the cessation determination to DCF (MS CDR 001.005 (CDR PC Input Screen (IPCA)). Once you post the cessation, enter the Section 301 event on the DCF.

  • On the MCDR screen, select 3=PC Update (MS CDR 001.005).

  • On the ECDR screen, select 5=T2 Medical.

  • On the IPCA screen, select 15=301 Case–VOC REHAB.

  • Use the worksheet (CDRW screen) to diary the case for review (MS CDR 001.013 (CDR Development Worksheet (CDRW)).

3. Title XVI cases

  • Add a remark to the DCF: “301 Allowance mm/dd/yy;”

  • Email (FO e-mail addresses are listed in the Detailed Office/Organization Resource System (DOORS)) the Section 301 flag to the servicing Field Office (FO) with instructions to annotate the Section 301 approval to the Supplemental Security Record (SSR) remarks and to establish or update the VP diary; and

  • Place the case in Development Hold File (DHF) for 15 days.

  • After 15 days, review the SSR to verify that the FO updated the VP diary and that the payment status is C01 and/or N07/N08 has been removed.

If the FO has not taken action, follow up by emailing the appropriate FO with the subject line “Follow-Up Request Action Needed: Section 301 VP Diary Update Needed.”.

B. Example of allowance documentation for SSA-553

This is an example of a properly completed SSA-553 for an allowance:

Issue:

Is Richard Martin eligible for continued payments under Section 225(b) of the Social Security Act?

(NOTE: Substitute “section 1631(a)(6)” for Title XVI-only cases and “sections 225(b) and 1631(a)(6)” for concurrent Title II/Title XVI cases.)

Facts:

The DDS established a period of disability beginning 06/26/2002 for Mr. Martin based on hypertensive cardiovascular disease.

The DDS determined his disability ceased effective 05/2019.

Mr. Martin is currently participating in a program of training and services with a vocational goal of engraver apprentice under an individual work plan with the ABC Agency, 123 Street, City, ST 45678. ABC Agency is an Employment Network under the Ticket to Work Program.

He has been participating in the program since at least 04/2019.

He has not yet completed the required training to be an engraver apprentice. He continues to participate in work skills training under his program and receives counseling and guidance.

Upon completion of his training, he will have the skills to perform the job of engraver apprentice.

He can perform this occupation at the substantial gainful activity level, and he will be able to meet the demands of this occupation despite a possible future reduction in a residual functional capacity.

Determination:

We have determined that Mr. Martin is participating in an appropriate program, the completion of which will increase the likelihood that we will permanently remove him from the disability rolls.

Expected Completion Date of Training Program: 03/31/2021

Diary for review: 05/01/2020

C. Procedure for Section 301 payments closed period

1. Both Title II and Title XVI cases

  • Print the SSA-833 or SSA-832 and update the termination date;

  • Annotate “301 Closed Period Payment” to the notes field of the SSA-833 or SSA-832;

  • Scan the SSA-553 and the SSA-833 or SSA-832 into eView or NDRED;

  • Prepare and send a notice of the closed period of the Section 301 participation;

  • Complete the Web-Based Section 301 Data Sheet.

2. Title II cases

  • Forward the folder to the benefit authorizer for termination action; and

  • Annotate the “301 Closed Period Payment” to the special message field of the MBR.

3. Title XVI cases

  • Add a remark to the DCF “301 Closed Period mm/dd/yy-mm/dd/yy;”

  • Email the flag to the servicing FO to instruct them to delete the VP diary; and

  • Place the case in DHF for 15 days.

  • After 15 days, review the SSR to verify that the FO deleted the VP diary and that the C01/N07 months are correct.

If the FO has not taken action, follow up by emailing the appropriate FO with the subject line “Follow-Up Request Action Needed: Section 301 VP Diary Update Needed.”.

D. Example of closed period documentation for SSA-553

This is an example of a properly completed SSA-553 for an allowance.

Issue:

Is Richard Johnson eligible for payments under section 225(b) of the Social Security Act?

(NOTE: Substitute “section 1631(a)(6)” for Title XVI-only cases and “sections 225(b) and 1631(a)(6)” for concurrent Title II/Title XVI cases.)

Facts:

The DDS established a period of disability beginning 06/26/2002 for Mr. Johnson based on hypertensive cardiovascular disease.

The DDS determined his disability ceased effective 05/2018.

Mr. Johnson has completed the program of training and services with a vocational goal of engraver apprentice under an individual work plan with the ABC Agency, 123 Street, City, ST 45678. ABC Agency is an Employment Network under the Ticket to Work Program.

He was participating in the program from 04/2018 through 04/2019.

He completed the required training to be an engraver apprentice.

He can perform this occupation at the substantial gainful activity level, and he will be able to meet the demands of this occupation despite a possible future reduction in residual functional capacity.

Determination:

We determined that Mr. Johnson is eligible for a closed period of Section 301 benefits since he was participating in an appropriate program before his disability ceased and through the grace period.

Graduation date: 04/2019

Termination date: 05/2019

E. Procedure for Section 301 payment denials

1. Both Title II and Title XVI cases

  • Print the SSA-833 or SSA-832 and annotate with the termination date;

  • Scan the SSA-553, and the SSA-833 or SSA-832 into eView or NDRED.

  • Prepare and send a notice of the denial of the Section 301 participation.

  • Complete the Web-Based Section 301 Data Sheet.

2. Title II cases

  • Forward the folder to the benefit authorizer for termination action; and

  • Add a special message to the MBR stating “Section 301 denial mm/dd/yy.”

3. Title XVI cases

  • Add a remark to the DCF: “Section 301 denial mm/dd/yy;”

  • Email the flag to the servicing FO to instruct them to delete the VP diary; and

  • Place the case in DHF for 15 days.

  • After 15 days, review the SSR to verify that the FO deleted the VP diary and input the N07/N08 for the appropriate months.

If diary is still pending, follow up by emailing the appropriate FO with the subject line "Follow-Up Request Action: Section 301 VP Diary Update Needed".

F. Example of denial documentation for SSA-553

This is an example of a properly completed SSA-553 for a denial:

Issue:

Is Richard Smith eligible for continued payments under section 1631(a)(6) of the Social Security Act? (NOTE: Substitute “section 225(b)” for Title II-only cases and “sections 225(b) and 1631(a)(6)” for concurrent Title II/Title XVI cases.)

Facts:

Mr. Smith was determined to be disabled beginning 02/01/00 based on chronic pulmonary insufficiency and was considered eligible for Supplemental Security Income (SSI) payments.

The DDS determined his disability ceased effective 07/2019.

On 01/10/19, we found Mr. Smith eligible for services with the Illinois State VR agency at 245 Street, City, ST 67890, who developed a rehabilitation plan for him. He stopped participating in the rehabilitation plan on 07/25/19.

Determination:

It is determined that Mr. Smith is not eligible for Section 301 payments because he was not in an appropriate program after 07/2019, the month his disability ceased.

G. Exhibit of flag for transmitting title XVI case to the FO

  

SECTION 301 CASE APPROVAL

Immediate Action Required

    

To FO____________________________

FO Email __________________________

ATTN: Title XVI Claims Representative

    

    

SSN: ______________________________

Section 301 payments approved.

  • Annotate '301 approval' to SSR Remarks.

  • Establish/update VP diary per DI 14510.007B.2.

  • Diary date:________________________

  • Retain folder until Section 301 payments terminate.

    

    

From ODO Unit ___________________

Name ___________________________

Phone ___________________________

H. Exhibit of cover sheet for transmitting title XVI case to FO

  

SECTION 301 CASE for CLOSED PERIOD

Immediate Action Required

  

To FO ____________________________

FO Email __________________________

ATTN: Title XVI Claims Representative

  

  

SSN : ______________________________

Section 301 payments allowed for a CLOSED PERIOD.

  • Annotate '301 closed period' to SSR Remarks.

  • Delete the VP diary per DI 14510.007C.2.

  • Input N07 or N08 effective with the month after the month shown in item 9C of the SSA-832; unless the individual or someone on his or her behalf files an appeal of the medical cessation and elects Statutory Benefit Continuation (SBC).

  

  

From ODO Unit ___________________

Name ___________________________

Phone ___________________________

I. Exhibit - Cover Sheet for Transmitting SSA-832 to the FO via email

  

SECTION 301 CASE DENIAL

Immediate Action Required

    

To FO___________________________

FO Email __________________________

ATTN: Title XVI Claims Representative

    

    

SSN: _____________________________

Section 301 payments denied.

  • Annotate '301 denial' to SSR Remarks.

  • Delete VP diary per DI 14510.007D.2.

  • Input N07 or N08 effective with the month after the month shown in item 9C of SSA-832 unless appeal of medical cessation filed and statutory benefit continuation elected.

    

    

From ODO Unit __________________

Name ___________________________

Phone ___________________________


DI 14510 TN 7 - Procedures for Cases Involving Participation in a VR or Similar Program - 9/08/2020