SSA - POMS: DI 14510.030 - Office of Disability Operations (ODO) Procedures for Section 301 Post-adjudicative Actions

A. Procedure for report of work affecting continued eligibility for Section 301 payments

ODO may receive reports of work directly from the beneficiary, the provider of services, or from the field office (FO) (see DI 14510.007E). When you receive a work report, determine if the work experience is part of the beneficiary's Individual Work Plan (IWP), Individualized Plan for Employment (IPE), similar individualized written employment plan, or Individualized Education Program (IEP). If so, you do not need to take further action.

If the work experience is not part of the beneficiary's plan, determine if the beneficiary stopped participating in his or her plan or if he or she completed the program. If he or she stopped participating or completed the program, terminate benefits per DI 14510.030C.

If the beneficiary is still participating in his or her program but the work experience is not part of the plan, consider:

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Is the work at the substantial gainful activity level?
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Has the beneficiary acquired the education, work skills, or experience that was the basis for the initial likelihood determination?

These are indicators that continued participation in the program will no longer increase the likelihood of his or her permanent removal from the disability or blindness benefit rolls. If participation in the program will not increase the likelihood of his or her permanent removal from the disability or blindness benefit rolls, terminate benefits per DI 14510.030C.

B. Procedure when the diary matures

1. Title II

When the Disability Control File (DCF) diary date for the vocational rehabilitation (VR) or similar program matures for a Title II case, an issue will appear on the DCF tickle list and ODO will receive an alert in the Paperless Processing Center. If the diary is for program completion, follow the instructions in DI 14510.030E. If the diary is for follow-up, contact the provider of services to determine the status of the beneficiary's participation in the program or to determine if the program ended.

2. Title XVI

When the Vocational Rehabilitation Plan (VP) diary matures for a Title XVI case, ODO receives a diary alert. If the diary is for program completion, follow the instructions in DI 14510.030E.

If the diary is for follow-up and enough information is available on the system, contact the service provider to determine the status of the beneficiary's participation in the program or to determine if the program ended. Otherwise, send a request for assistance via a Modernized Development Worksheet (MDW) to the servicing FO. Be as specific as possible in your request. Explain what information you need from the service provider and if you will need an updated SSA-4290-F4 (Development of Participation in Vocational Rehabilitation or Similar Program). Provide your fax number for the FO to submit any documentation via fax.

C. Procedure when program is completed or individual stopped participating

Terminate benefits effective the month after the month of completion or the month after the month participation stopped. For example, if the VR or similar program is completed in October 2015, then payments will terminate effective November 2015 (for information on the termination process, see DI 14510.030E in this section).

For Title II cases, process the medical cessation.

For Title XVI cases, send an MDW and fax the flag to the servicing FO to process the medical cessation.

For both Title II and Title XVI cases, print a copy of the existing SSA-832 (Cessation Or Continuance of Disability or Blindness Determination and Transmittal - Title XVI) or SSA-833 (Cessation or Continuance of Disability or Blindness Determination and Transmittal - Title II) medical cessation determination, insert a handwritten date in item 9C showing the month and year of the termination. Identify the entry with “VR Benefit Termination Month." Initial the changes and fax a copy of the form into Paperless Processing Center system using the paperless fax number 1-877-385-0643 and NDRED or eView.

D. Procedure when the program is not completed

If the beneficiary did not complete the VR or similar program, contact the service provider to determine the status of the program.

If the development indicates that the beneficiary is continuing participation in the program, determine if the beneficiary acquired the education, work skills, or experience that was the basis for the initial likelihood determination.

1.

If yes, determine that continued participation in the program will no longer increase the likelihood that the beneficiary will not return to the disability or blindness benefit rolls and terminate payments on this basis (see DI 14510.030E in this section).
2.
If no, review the status of the program to determine whether continued participation in the program will provide the beneficiary with the education, work skills or work experience that was the basis for the initial likelihood determination.
1. a.
  
  If yes, determine that continued participation in the program will increase the likelihood that the beneficiary will not return to the disability or blindness benefit rolls and continue payment on that basis.
2. b.
  
  If no, determine that continued participation in the program will no longer increase such likelihood and terminate payments on that basis (see DI 14510.030E in this section).

1. Continued participation increases likelihood

If the beneficiary's continuing participation in the program will increase the likelihood that he or she will not return to the disability or blindness benefit rolls, re-diary the case for review.

For a Title II case, use the Disability Control File (DCF).

For a Title XVI case, fax a request the FO to extend the VP diary, if necessary.

2. Continued participation will no longer increase likelihood

If the beneficiary's continued participation in the program no longer increases the likelihood that he or she will not return to the disability or blindness benefit rolls, terminate benefits effective the month after the month in which you make the determination.

For termination process, see DI 14510.030E in this section.

E. Procedure for termination of Section 301 payments

1. Title II case

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Send an advance notice to the beneficiary advising of the planned termination of payments and affording due process (see GN 03001.015 (Notices Required Before And After Taking A Title II Adverse Action)).
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After the beneficiary has an opportunity to respond, if termination is still appropriate, forward the case to the benefit authorizer for termination action.
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Send a notice to the beneficiary advising of the termination of payments (see DI 14515.015 for notices).
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Update the special message field on the Master Beneficiary Record (MBR), “Section 301 benefit termination MM/YY.”
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Close the DCF annotating the Section 301 decision.

2. Title XVI case

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Send an advance notice to the beneficiary advising of the planned termination of payments and affording due process (see GN 03001.015 Notices Required Before and After Taking a Title II Adverse Action).
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After the beneficiary has an opportunity to respond and termination is still appropriate, fax the termination flag and send a high priority MDW assistance request to the servicing FO to terminate.
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Close the DCF annotating the Section 301 decision.
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Send a notice to the beneficiary advising of the termination of payment (see DI 14515.015 for notices).
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Place the case in Development Hold File (DHF) for 15 days.
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After 15 days, check the Supplemental Security Record (SSR) to verify that the FO deleted the VP diary.
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If the FO has not taken action, follow up by calling the FO’s administrative line.

Social Security

Program Operations Manual System (POMS)

DI 14510.030 Office of Disability Operations (ODO) Procedures for Section 301 Post-adjudicative Actions