TN 34 (11-21)

DI 23570.030 Disability Determination Services (DDS) Procedures for Documenting an Age-18 Redetermination and Disabled Child (DC) Disability Determination

A. Fully favorable age-18 determinations

The DDS must complete all actions below (for example, completion of the Form SSA-538 (Childhood Disability Evaluation Form) for child cases, release of notices, etc.) using the existing procedures for processing continuances in a continuing disability review (CDR).

1. Notices for favorable disability determinations

Use the special notices and language format designated for this workload (for example, “Notice of Continuation”).

2. Completing the Form SSA-832 for a continuance

Complete the form SSA-832 (Cessation or Continuance of Disability or Blindness Determination and Transmittal- Title XVI) as normal in DI 28084.020 for each item with the following exceptions.

  1. a. 

    Item 12

    Use the following continuance codes as appropriate.

    1. 1. 

      For a disability redetermination when the child is under age 18, use the existing “Reason for Continuance” codes:

      • Code 71 (Impairment Meets the Listing (DC, BC)),

      • Code 73 (Impairment Medically Equals Listing (DC, BC)), or

      • Code 78 (Impairment Functionally Equals Listing (DC, BC)).

        NOTE: Do not use Code 79 (Individualized Functional Assessment (IFA)-Comparable Severity) as the IFA is no longer an appropriate basis for fully favorable determination. Do not use codes based on lack of medical improvement (for example, Code 76 for “No Medical Improvement”) because medical improvement is not the issue for disability redetermination cases.

    2. 2. 

      For an age-18 redetermination, use the existing “Reason for Continuance” codes:

      • Code 70 (Impairment Meets Listing),

      • Code 72 (Impairment Equals Listing), or

      • Code 74 (Impairment Plus Vocational Factors).

        NOTE: Do not use codes based on lack of medical improvement (for example, Code 76 for “No Medical Improvement”) because medical improvement is not the issue for disability redetermination cases.

  2. b. 

    Item 20

    Use the following Why Review Was Made (WRM) codes as appropriate.

    1. 1. 

      For a disability redetermination when the child is under age 18, enter Code 27 (IFA Disability Redetermination, P.L. 104-193). Always use this code for a childhood medical redetermination if the original determination involved an IFA, or enter Code 28 (Maladaptive Behavior Disability Redetermination, P.L. 104-193).

    2. 2. 

      For an age-18 redetermination, enter Code 29 (Age 18 Disability Redetermination P.L. 104-193).

  3. c. 

    Item 24

    For a child and an age-18 redetermination, enter in the Remark section, “P.L. 104-193.”

B. Unfavorable age-18 determinations

Follow the existing procedures except as indicated in DI 23570.030B.2. and DI 23570.030B.3. in this section. For additional information on unfavorable an age-18 redetermination, see DI 23570.025C.

1. Notices for unfavorable disability determinations

The DDS must prepare and release the notice for an unfavorable age-18 redetermination decision. Use the special cessation notice designated for this workload, see DI 23570.120 Age 18 Disability Redetermination – Cessation Notice Language.

NOTE: When a legally competent adult disabled individual has a representative payee, the DDS should send the cessation notice to competent adult disabled individuals. Also, send a modified copy of the cessation notice to his or her representative payee. The representative payee's notice should not contain personal information. Include the decision paragraph and the sentence “(Beneficiary Name) has been given a more detailed explanation of our decision” on the personalized attachment.

2. Completing the Form SSA-832 for a cessation

Complete Form SSA-832 as normal in DI 28084.015 with the following exceptions.

  1. a. 

    Item 9

    Use the following cessation codes as appropriate.

    1. 1. 

      For a disability redetermination when the child is under age 18, complete as normal.

    2. 2. 

      For an age-18 redetermination, complete as normal.

  2. b. 

    Item 11

    Use the following cessation codes as appropriate.

    1. 1. 

      For a disability redetermination when the child is under age 18, enter Code 95 IFA medical redetermination does not meet new definition of disability. Always use this code on a child disability redetermination if the initial determination was based on an IFA; or enter Code 96 for Maladaptive Behavior Disability Redetermination, does not meet new definition of disability.

    2. 2. 

      For an age-18 redetermination, enter Code 97 (Age-18 Disability Redetermination, Impairment(s) Does Not Meet Definition of Disability for Adults).

      NOTE: If the benefits will cease due to failure to cooperate (FTC), use Code 62 (Failure to Cooperate).

  3. c. 

    Item 20

    Use the following cessation codes as appropriate.

    1. 1. 

      For a disability redetermination when the child is under age 18, enter Code 27 (IFA Disability Redetermination, P.L. 104-193) Always use this code for a childhood disability redetermination if the original determination involved an IFA; or enter Code 28 (Maladaptive Behavior Disability Redetermination, P.L. 104-193).

    2. 2. 

      For an age-18 redetermination, enter Code 29 (Age 18 Disability Redetermination P.L. 104-193).

  4. d. 

    Item 24

    For a disability redetermination when the child is under age 18 and an age-18 redetermination, enter in the Remark section, “P.L. 104-193.” If the case is a potential “Section 301” case, see DI 14510.010B.2.c.

3. National Disability Determination Services System (NDDSS) input

Complete all inputs in the NDDSS and complete other actions as normal in the same manner as a cessation or continuance for normal a CDR. If the case is a potential “Section 301” case, see DI 14510.010C.2.


To Link to this section - Use this URL:
http://policy.ssa.gov/poms.nsf/lnx/0423570030
DI 23570.030 - Disability Determination Services (DDS) Procedures for Documenting an Age-18 Redetermination and Disabled Child (DC) Disability Determination - 11/30/2021
Batch run: 11/30/2021
Rev:11/30/2021