TN 12 (07-08)

DI 27520.025 Erroneous Notice/Payment Cases

A. Introduction

If the Disability Determination Services (DDS) issues a medical denial/cessation/closed period determination but a claimant receives an erroneous notice of allowance or continuance due to a clerical error, use the following procedures to resolve this issue:

B. Initial Claims

Consider the time limit rules for initial claims per “Conditions for Reopening a Final Determination or Decision” DI 27505.001.

1. Reopening Permitted

If the claim is a Title II only claim, explain that due to a clerical error the claimant received incorrect payments despite an unfavorable DDS determination. Apply due process as indicated in “Providing Due Process in Erroneous Payment Cases” DI 27525.015.

For Title XVI cases, send a revised notice to the claimant including due process information on the back of the form SSA-L8156-U2 (SSI Notice of Planned Action – Medical).

2. Reopening Not Permitted

If the DDS cannot correct the situation under the rules for reopening because the time has expired, process the case in accordance with the Continuing Disability Review (CDR) procedures. For additional information, see “Conditions for Reopening a Final Determination or Decision” DI 27505.001A.5.

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DI 27520.025 - Erroneous Notice/Payment Cases - 05/31/2017
Batch run: 01/15/2019