TN 4 (09-21)

DI 28080.001 Due Process for Continuing Disability Review (CDR) Cases

Citation: 20 CFR §§ 404.1595, 416.1331

A. What is due process?

The Fifth Amendment to the Constitution provides that no person shall be deprived of property interest without due process of law. Due process is giving the individual (and his or her representative payee, if any) an opportunity to offer rebuttal evidence and respond to the proposed adverse action before the adjudicator renders a final decision.

Specifically, due process requires that the adjudicator inform the individual that his or her benefits will stop or reduce (or an overpayment may result) if:

  • He or she is no longer disabled (cessation); or

  • He or she is no longer entitled or eligible to disability benefits or payments on the current application (adverse reopening); or

  • He or she receives erroneous payments after a determination of denial; or

  • The adjudicator changes the onset date to a later date; or

  • The adjudicator changes the cessation date to an earlier date.

B. Provide due process

Merely advising the individual that his or her benefits will stop because of the continuing disability review (CDR) does not satisfy due process requirements. The adjudicator must also inform the individual of his or her right to respond and provide rebuttal evidence and allow the individual an opportunity to provide that response before the adjudicator makes a cessation determination.

 

Extend due process to the individual in writing, and store a copy of the notice in the official case folder. Resolve any doubts regarding the need to provide due process in favor of providing it.

C. References

  • DI 27525.001 Due Process Notification for Adverse Reopenings

  • DI 27525.005 Providing a Due Process Pre-Determination Notice in Cases Involving Onset Change

  • DI 27525.010 Providing Due Process in Adverse Reopenings Involving Title XVI and Concurrent Title II/Title XVI Cases

  • DI 27540.025 Title II-Only Pre-determination Notice Previously Mailed – Final Decision Notice Instructions

  • DI 27540.030 Title XVI-Only – Goldberg/Kelly Payment Continuation Applies

  • DI 27540.035 Concurrent Title II/Title XVI – Statutory Benefit Continuation Does Not Apply

  • DI 28055.035 Due Process and Notice Requirements for DDS Impairment Severity Cases


To Link to this section - Use this URL:
http://policy.ssa.gov/poms.nsf/lnx/0428080001
DI 28080.001 - Due Process for Continuing Disability Review (CDR) Cases - 09/15/2021
Batch run: 09/15/2021
Rev:09/15/2021