Due process requires the DDS to inform the beneficiary (and their representative payee,
if any) of the right to appeal and offer rebuttal evidence before taking any action
that will unfavorably affect their benefits.
Provide due process notification by sending either a due process predetermination
notice or a due process notice. Send the predetermination notice when benefit continuation
language is not required. Provide due process in the determination notice in medical
cessation cases when benefit continuation language is required.
When reopening a cessation to make a more favorable determination, do not send a predetermination
due process notice.
When reopening a prior cessation determination due to an earlier or later cessation
date, send a due process determination notice if the revised determination requires
benefit continuation language.
For information on due process notifications for adverse reopenings, see DI 27525.001.
1. Predetermination notice
The predetermination notice applies to reopenings that do not require benefit continuation
language. In adverse reopening determinations of concurrent Title II or Title XVI
claims, the Title XVI due process requirements also apply to the Title II claim.
Send a predetermination notice if the prior determination involves one of the following:
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Change from blind to disabled;
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Failure to follow prescribed treatment (FTFPT);
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Fraud or similar fault (FSF);
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Failure to cooperate (FTC) when FTC arose at the field office (FO). In FTC cases identified
by the DDS, statutory benefit continuation will be offered because these FTC cessations
are considered medical determinations; or
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2. Due process determination notice
The due process determination notice applies to adverse medical CDR reopenings.
When reopening a prior cessation determination due to an earlier or later cessation
date, send a due process determination notice if the revised determination requires
benefit continuation language.