Query the MBR to determine if the claimant was previously entitled to a disability
benefit under Title II (i.e., disabled number holder, disabled surviving spouse, or
disabled child). If entitlement has terminated, determine the reason for termination.
A combination of three of the following MBR entries, along with a Ledger Account File
(LAF) code of T6, T8, U, or X7, indicates entitlement terminated due to the performance
of SGA:
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BENEFIT Line - reason for suspension/termination (RFST) coding of DIBCES.
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DIB Line - Cessation Disability Reason-code of E (CDR-E).
NOTE: A medical cessation which occurs after an SGA cessation may overlay the CDR-E code
with CDR-M coding. CDR-M coding is not conclusive evidence that benefits did not terminate
due to SGA. Further, a medical cessation occurring after an SGA cessation does not
preclude potential eligibility for EXR.
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DIB Line - A difference between the extended period of eligibility begin date (EBD)
and the disability benefit cessation (DBC) dates of three or more years.
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DIB Line - An entry in the extended period of eligibility Medicare begin date (EMD)
field that is at least 78 months earlier than the Medicare Part A termination date
(or 24 months earlier if the Part A termination date is prior to 10/1/00).
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HI-DIB Line - A Medicare Part A termination date more than 78 months (or 24 months
if termination date is prior to 10/1/00) after the applicant's disability cessation
date (ADC).
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HISTORY Line - an RFST of EPESGA in the SUSP/TERM field, followed by DIBCES in subsequent
lines.
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SP MSG – A special message with information relating to SGA cessation and termination.