TN 16 (11-24)

DI 14510.007 Field Office (FO) Procedures for Section 301 Cases after Office of Disability Operations (ODO) Determination

A. Identifying a Section 301 determination

You can identify Section 301 cases in several ways:

  • Remarks on the Master Beneficiary Record (MBR) and Supplemental Security Income Record (SSR);

  • A “Y” in the 301 Indicator of the Disability Determination Section Query (DDSQ);

  • A Disability Control File (DCF) event indicating “301 case” on the query CDR screen (QCDR) or the CDR Entitlement (ECDR) screen (Title II cases) and Development Worksheet (Title XVI cases);

  • A copy of the Section 301 decision in eView or the Evidence Portal (EP).

B. Procedure when ODO approves Section 301 payments

1. Title II cases

The Section 301 provision allows continued benefits (including Medicare and Medicaid) to the beneficiary and any auxiliaries on the record following medical cessation until the beneficiary stops participating in the vocational program, or ODO determines that continued participation will not increase the likelihood of permanent removal from the disability rolls. ODO annotates the decision in the special message field of the MBR. The FO checks eView and EP for the Section 301 decision and updates the 301DEC tickle accordingly when the 301DEC tickle on the DCF Continuing Disability Review Worksheet (CDRW) matures.

2. Title XVI cases

The FO receives Title XVI and concurrent Section 301 payment continuation cases with the Section 301 flag from ODO by email (accessing the Detailed Office/Organization Resource System (DOORS) to identify the appropriate email address) with the subject line “Action: Section 301 VP Diary Update Needed.” The FO takes the following actions:

  • Input or update the Vocational Rehabilitation Plan (VP) diary using the diaries (UDIA) function in Direct SSR Update. The VP diary prevents the case from updating to an N07/N08 payment status;

  • Update the 301DEC issue on the DCF and Development Worksheet; and

  • Annotate the SSR remarks with “Section 301 payment continuation. Program participation expected to end MM/YY.”

ODO reviews the SSR for the updated VP diary. ODO will follow up by email if the FO has not updated the VP diary within 15 days.

NOTE: If N07/N08 termination occurred, reinstate benefits effective with the N07/N08 month. If N07/N08 termination has not occurred, the FO removes the N07/N08 future action.

C. Procedure when ODO approves Section 301 payments for a closed period

1. Title II cases

ODO processes the termination action, sends the closed period notice, and annotates the decision in the special message field of the MBR. The FO checks eView and EP for the Section 301 decision, and receipts in the 301DEC tickle when the 301DEC tickle on the DCF CDRW matures.

2. Title XVI cases

ODO sends the closed period notice and emails the FO advising them to:

  • Delete the VP diary;

  • Receipt in the 301 Issue on the DCF and Development Worksheet;

  • Input N07/N08, effective with the month after the month shown in item 9C of the SSA-832 (Cessation Or Continuance of Disability or Blindness Determination and Transmittal - Title XVI); and

  • Annotate the SSR remarks with “Section 301 closed period MM/YY-MM/YY.”

ODO reviews the SSR for the N07/N08 input. ODO will follow up by email if the FO has not updated the diary within 15 days.

D. Procedure when ODO denies Section 301 payments

1. Title II cases

ODO processes the termination action, sends the denial notice, and annotates the decision in the special message field of the MBR. The FO checks eView and EP for the Section 301 decision and receipts in the 301DEC tickle when the 301DEC tickle on the DCF CDRW matures.

2. Title XVI cases

ODO sends the denial notice and emails the FO advising them to:

  • Delete the VP diary;

  • Receipt-in the 301 Issue on the DCF and Development Worksheet;

  • Input N07/N08, effective with the month after the month shown in item 9C of the SSA-832; and

  • Annotate the SSR remarks with “Section 301 denial.”

ODO reviews the SSR for the N07/N08 input. ODO follow up by email if the FO has not updated the diary within 15 days.

E. Procedure for work reported while receiving Section 301 payments

When you receive a work report for a beneficiary receiving Section 301 payments, issue a receipt per DI 13010.020 and ask if they are still participating in a program of VR, employment, training, educational, or other support services.

Document the information, including the name and address(es) of the service provider(s) (if any), on an SSA-5002 (Report of Contact) and send it to ODO by uploading the Potential Section 301 Case Flag along with the SSA-5002 and any other related documents to the Paperless Processing Center (PPC) using the EP's 4290 Barcode. Select the "Yes" on the Document Information screen, to make the transmission actionable when PC involvement is required.

NOTE: Using the 4290 Barcode ensures the documents are routed to the correct component.

1. Title II cases

Do not create a work review in eWork.

Do not process a work CDR or a substantial gainful activity (SGA) determination for beneficiaries receiving Section 301 payments. Such beneficiaries are not entitled to a Trial Work Period (TWP), or Extended Period of Eligibility (EPE).

If the beneficiary files an appeal of the medical cessation with payment continuation, the FO suspends Section 301 development.

If the suspension of Section 301 development is due to statutory benefit continuation (SBC), the FO refers to DI 12027.050. The FO determines if the TWP has been completed and if the claimant would be placed in S9 if there is SGA in the EPE.

2. Title XVI cases

Non-disability provisions, such as income counting and resource limits, continue to apply to beneficiaries receiving Section 301 payments. Apply the earned and unearned income exclusions to the work and earnings of these beneficiaries as appropriate. This includes Impairment-Related Work Expenses (IRWE), Blind Work Expenses (BWE), Student Earned Income Exclusions (SEIE), and the Plan to Achieve Self-Support (PASS). We can modify a PASS while a beneficiary is receiving Section 301 payments; however, we cannot approve a new PASS after we determine that the beneficiary is no longer disabled.

F. Procedure when ODO requests assistance from the FO

ODO may request assistance from the FO by email to:

  • Obtain information about the service provider, or

  • Determine the status of a beneficiary’s participation in a VR or similar program, or

  • Determine whether such program ended,

If ODO requests FO assistance, obtain an updated SSA-4290-F5 (Development of Participation in Vocational Rehabilitation (VR) or Similar Program) and complete parts I and II. Return the SSA-4290-F5 to ODO using the EP's 4290 Barcode. Select the "Yes" on the Document Information screen, to make the transmission actionable when PC involvement is required.

G. Procedure when Section 301 payments terminate

When a beneficiary completes or stops participating in the program, benefits terminate effective the month after the month of completion, or the month after the month participation stopped.

EXAMPLE: If the beneficiary completes the VR or similar program during October 2023, payments terminate effective November 2023.

1. Title II cases

ODO sends the required notices, updates the remarks on the MBR and terminates benefits. If ODO does not receipt the DCF tickle, the FO will complete this action.

2. Title XVI cases

ODO releases the termination notice, annotates the DCF, and sends an email to the FO requesting immediate action to terminate benefits with the effective date.

The FO processes the termination with a two-day action:

Day 1 - Use MSSICS Direct SSR Update:

  • Delete the VP diary;

  • Transmit the MG code of T with the disability cessation date (if not already on the record) using the Continuing Disability Review (UDCR) Screen;

  • Input a Remark indicating the period of Section 301 eligibility and termination date; and

  • Suppress all notices per SM 01301.675.

Input ensures the correct cessation date shows on the record.

Day 2 - Use SSI Data Inputs – SPE1 (PE Single Input):

  • Input N07/N08 per SM 01305.001 or an SZ code of N per SM 01301.450 for the month benefits terminate per ODO's instructions (See also SM 01305.005 to determine the code, message, and action required for each payment status (PS) field reject and alert); and

  • Suppress all notices.

Input ensures the correct months of payment after cessation are shown on the record.

NOTE: Check all inputs for the proper C01 and N07 months to ensure the overpayment or the underpayment is correct.

ODO reviews the SSR for the N07/N08 input. ODO will follow up by email if the FO has not updated the diary within 15 days.

H. Procedure when FO learns that participation in VR or similar program ceased or the program ended

The FO may receive new or revised information about the beneficiary’s participation in a VR or similar program from the beneficiary or the service provider during a Redetermination (RZ) or other Post-Entitlement (PE) actions.

1. Title II cases

During any PE discussions, if the MBR has a 301 indicator or 301 payment remarks, ask the beneficiary or representative payee if thebeneficiary is participating in VR or a similar program. If the beneficiary stopped participating or the program ended, accept the allegation and:

  • Obtain a statement from the beneficiary on an SSA-5002 (Report of Contact) showing the date the program ended or the date participation ceased and fax it into eView or EP;

  • Send a manual due process notice. Follow the instructions in DI 14510.007H.3;

  • Wait 15 days for a response to the due process notice;

If there is no response or the information you receive does not change the decision to suspend benefits, input an S9 suspension the month after participation ended and:

  • Input a 60-day diary (301DEC) using the CDRW on the DCF for case control;

  • Transmit the Potential Section 301 Case Flag and SSA-5002 to ODO using the EP's 4290 Barcode. Select the "Yes" on the Document Information screen, to make the transmission actionable when PC involvement is required;

  • Check the block “Case S9.” Provide the effective S9 date and the date participation stopped or the program ended;

  • Update the remarks on the MBR, “Section 301 participation ended. Sent to ODO MM/DD/YY.”

2. Title XVI cases

During an RZ or any other PE event, if the case has a VP diary, ask the beneficiary or representative payee if they are participating in VR or a similar program. If the beneficiary states that the program ended for any reason, accept the beneficiary’s allegation, and:

  • Obtain a statement from the claimant on an SSA-5002 or on the Person Statement page in the Consolidated Claims Experience (CCE) Supplemental Security Income pages, showing the date the program ended or the date participation ceased and fax it into eView or EP;

  • Send a manual due process notice. Follow instructions in DI 14510.007H3; and

  • Wait 15 days for a response to the due process notice.

If you receive no response, or the information you receive does not change the decision to suspend benefits:

  • Input payment status N05 with the next Current Operating Month (COM) to avoid multiple overpayments;

  • Establish a tickle on the DCF or the Development Worksheet page for case control;

  • Suppress the systems-generated notice;

  • Add the Remark, "N05 due to pending 301 determination, participation ended MM/YY” to the SSR;

  • Transmit the Potential 301 Flag and SSA-5002 to ODO using the EP's 4290 Barcode. Select the "Yes" on the Document Information screen, to make the transmission actionable when PC involvement is required;

  • Check the block “Case N05.” Provide the effective N05 date and the date participation stopped or the program ended.

3. Due process notice

For Title II cases, send the SSA-L951-U2 (Social Security Notice Letterhead). For Title XVI cases, send an SSA-8165-U2 (Important Information) notice to the beneficiary and the representative payee using the following language:

“We plan to suspend your benefits, effective MM/YYYY, because you told us that you are no longer participating in your approved program of vocational rehabilitation, employment training, educational, or other support services.

On <fill in date of previous notice>, we notified you that your disability had ended, but we would continue to pay you because you were participating in an appropriate program of vocational rehabilitation, employment training, or educational or other services.

You told us that you stopped participating in your program in MM/YYYY.

Another office will make the special decision about whether you are eligible for payments for the month your disability ended through the month your participation in the program ended. We will notify you of their decision in another letter.

If you have any questions, you may contact your local Social Security office. The address and telephone number are printed at the top of this notice. If you call or visit a Social Security office, please have this notice with you. It will help us answer your questions.”

I. Beneficiary responds to due process notice regarding the suspension

If the beneficiary disagrees with the suspension:

  • Ask if the information we have is correct.

  • If the beneficiary has information that proves they are in VR or a similar program, document the response on an SSA-5002.

  • If the beneficiary does not have proof, but claims they are participating in VR or a similar program, use form SSA-4290-F5 and SSA-827 (Authorization to Disclose Information to the Social Security Administration) to obtain evidence from the service provider.

  • If the beneficiary states our information is correct, explain the suspension of benefits and explain that it is a terminating event, since the DDS determined that the beneficiary is no longer disabled and no longer eligible for Section 301 benefits.

  • If the claimant agrees with the suspension, but indicates they are disabled and wants to file a new claim, record the protective filing date in the appointment system for the new claim to be taken after the record has been terminated.

J. Past due VP diaries

ODO follows up on matured VP diaries and no FO action is required. However, if you discover a past due diary during an RZ or PE event, check eView or EP for recent development requests and denial or allowance notices. If there is no recent case activity, send an email to OCO.ODO.OSB.SECTION.301@ssa.gov alerting ODO of the past due VP diary.

K. Policy for overpayments resulting from continuing payments

A beneficiary who is overpaid because they received continued payments while awaiting a Section 301 determination can be found without fault for the overpayment if the person acted in good faith in believing they were participating in a qualified program and cooperated with our development of participation. However, this does not mean that an automatic waiver applies. You must develop for a full waiver (defeats the purpose or against equity and good conscience per GN 02250.100 and GN 02250.150).

The following are examples of when a person may not have acted in good faith:

  • The beneficiary knew they did not begin participating in a program before the medical cessation or that participation did not continue for at least two months after cessation.

  • The beneficiary did not cooperate with Section 301 development requests from the Social Security Administration (SSA) or DDS.

  • The beneficiary withheld information about income or resources causing an overpayment for another reason.

IMPORTANT: If you must make a 'fault' determination, consider any physical, mental, educational, or linguistic limitations the beneficiary has that affect their ability to act in good faith. For instructions on making ‘fault’ or ‘without fault’ findings, see SI 02260.010 and GN 02250.005C.


To Link to this section - Use this URL:
http://policy.ssa.gov/poms.nsf/lnx/0414510007
DI 14510.007 - Field Office (FO) Procedures for Section 301 Cases after Office of Disability Operations (ODO) Determination - 11/01/2024
Batch run: 11/26/2024
Rev:11/01/2024