Record in file all efforts you made to resolve the issues, including dates, results
of the efforts, and justification for a cessation. The DDS makes the FTC determination.
Send the WU file to the FO to make the determination. For all situations, the cessation
date cannot be earlier than the date the continuing disability issue arose.
FTC cessations are medical determinations. In FTC cases (Title II or Title XVI, or
both), disability ceases in the first month in which the individual failed, without
good cause, to do what SSA or the DDS requested after:
-
•
SSA or the DDS made the individual aware that he or she must do what SSA or the DDS
requests, and
-
•
SSA or the DDS advised the individual of the repercussions of failing to cooperate
without good cause.
NOTE: The date of cessation should be based on the due date of the form/notice, not
the date it was mailed. The 5-days of mail time should be factored into that due date,
meaning we give the individual 10 days to respond, plus 5 days mail time to receive
or follow-up the form/notice.
Examples of FTC determinations:
Example
1:
Disabled adult individual does not keep CE
On 07/13/2016, the DDS sends a letter to the individual explaining that a CE is necessary
and we have scheduled it for 08/21/2016. The letter also explains that if the individual
does not keep the appointment, we may make the determination based on the evidence
in file. If we do so, it is very likely we will determine that the individual is no
longer disabled. The individual confirms that they will keep the CE. However, the
individual does not attend the CE. The individual does not have good cause for not
keeping the appointment. In the case of a CE, the individual cannot comply with the
request until the date of the CE. Therefore, DDS prepares a cessation determination
using 08/2016 as the cessation month.
Example
2:
Disabled adult individual requests CE be rescheduled; however, the individual does
not keep the
rescheduled CE.
On 04/10/2016, the DDS sends a letter to the individual explaining that a CE is necessary
and we have scheduled it for 05/02/2016. The letter also explains if the individual
does not keep the appointment, we may make the determination based on the evidence
in file. If we do so, it is very likely we will determine that the individual is no
longer disabled.
The individual does not attend the 05/02/2016 CE because of illness. The individual
contacts DDS and requests another CE appointment. The DDS reschedules the CE for 06/19/2016.
The individual again does not attend the rescheduled CE. The individual does not contact
the DDS to explain good cause for not attending the rescheduled CE. In this case,
the DDS prepares a cessation determination using 06/2016 as the cessation month. This
is the first month that the individual willingly does not comply with the request.
Example
3:
Disabled adult individual will not attend CE.
The DDS schedules a CE for 05/2016. The individual calls the DDS 04/2016 and informs
the DDS that they will not attend a CE. The individual does not provide a “good cause”
for not wanting to go to a CE. The DDS explains that we will make a determination
on the evidence in file. If we do so, it is very likely that we will determine that
the individual is no longer disabled. In this case, the DDS cancels the CE and prepares
a cessation determination using 04/2016 as the cessation month. This is the first
month that the individual willingly does not comply with the request and the individual
does not have good cause for unwillingness to attend the CE.