The individual (or their representative payee) must request SBC for cash benefits
and Medicare, if applicable, within 15 calendar days (10 days plus 5 days for mailing)
from the date of the medical cessation, adverse reopening medical determination notice,
or the unfavorable reconsideration determination notice.
Separate SBC elections are required at the reconsideration and administrative law
judge (ALJ) hearing levels. SBC cannot be elected at the Appeals Council (AC) level
of review. If the AC remands the case to the ALJ, the individual can receive SBC.
See DI 12027.060 for Title II only cases and DI 12027.065 for concurrent Title II/Title XVI cases.
Follow the procedures in DI 12027.010 for obtaining the individual's SBC election as well as the following specified time
limits:
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The individual may change election options only within the 15-day time frame but may
request to stop receiving SBC at any time.
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If, during the 15-day election period, the individual declines SBC, they will not
have the opportunity to elect SBC again until the individual receives the reconsideration
determination notice and files an appeal at the hearing level.
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An election remains effective until a new determination or decision on the current
appeal is issued, or until the individual asks to stop receiving SBC, whichever is
earlier.
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The 60-day appeal period for requesting reconsideration or an ALJ hearing is not affected
by an individual's SBC election.
A request for SBC establishes the claimant's intent to appeal. See DI 12026.020 for field office appeal procedures at the reconsideration level and DI 12010.001 for hearings before an ALJ. See GN 03101.020 about time limits for filing an appeal.