Effective Dates: 02/12/2026 - Present Previous | Next

TN 12 (02-26)

DI 12027.001 Statutory Benefit Continuation

CITATIONS:

Social Security Act -- Sections 223(g) and 1631(a)(7);
Regulations -- 20 CFR 404.1597, 404.1597a, 416.995, and 416.996

A. Benefit continuation during an appeal

When we determine that an individual’s physical or mental impairment(s) ceased, never existed, or is no longer disabling (i.e., medically improved), we notify the individual of the right to an appeal and to statutory benefit continuation (SBC) (if the individual is eligible for SBC). We will ask individuals who are eligible for SBC to complete the SSA-792 (Statutory Benefit Continuation Election Statement) and indicate on the form whether they elect or decline SBC.

For an overview of benefit continuation during the administrative appeal process, see DI 28001.070.

B. Situations when benefit continuation applies

1. Reconsideration and hearing levels

An individual may elect or decline SBC during a reconsideration or an Administrative Law Judge (ALJ) hearing appeal of:

a. Medical cessation

A medical cessation determination is an adverse determination where disability ceases for medical reasons. This includes adverse determinations in medical continuing disability reviews (CDR) and age 18 medical redeterminations.

b. Adverse medical reopening/revision

SBC election options apply to an adverse medical reopening/revision determination in the following types of cases:

  • •

    allowance to denial,

  • •

    allowance to closed period,

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    continuance to medical cessation, and

  • •

    revision to a different cessation date.

2. Remands

SBC also applies in cases remanded to the ALJ by the Appeals Council (AC), including when a case is sent back to the ALJ after a court remand. In these situations:

  • •

    The ALJ’s decision or dismissal order on the medical cessation appeal is vacated and is no longer in effect.

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    Pending a new decision by the ALJ or final action by the AC on the AC’s recommended decision, SBC is available to the individual and others receiving benefits on the individual’s record.

C. Situations excluded from benefit continuation

The continued benefit provisions do not apply to:

  • •

    a closed period of disability (i.e., an initial determination that an individual was disabled only for a specified period of time),

  • •

    an adverse medical reopening/revision to a later onset,

  • •

    a case pending at the AC or federal court level, or

  • •

    other SBC exclusion scenarios listed in DI 12027.015.

To Link to this section - Use this URL:
http://policy.ssa.gov/poms.nsf/lnx/0412027001
DI 12027.001 - Statutory Benefit Continuation - 02/12/2026
Batch run: 02/12/2026
Rev:02/12/2026