Effective Dates: 03/26/2025 - Present Previous | Next

TN 9 (03-25)

DI 12095.172 Appeals Council Remand of Medical Cessation -- Exhibits

Exhibit 1 - Appeals Council Request for Payment Status         

Exhibit 2 - Hearing Office Termination of Payment Continuation Transmittal

Exhibit 3 - Appeals Council Termination of Payment Continuation Transmittal

 

EXHIBIT 1 - APPEALS COUNCIL REQUEST FOR PAYMENTS STATUS

 

SSI Payment Status Request -- Please Expedite

Part 1. (To be completed by AC)

  •  

    The case of the individual named below has been remanded to an Administrative Law Judge for further proceedings. A copy of the remand order is attached.

Case Information

Case Information
  ​
  1. a. 

                         

    Individual's Name
  1. b. 

                  

    SSN
  1. c. 

                            

    Date of Remand Order

     

  2. d. 

                            

    Date of Prior Request for Hearing

     

  3. e. 

                            

    Date of Prior Decision of Dismissal Order

     

  4. f. 

    This case was remanded to:

                            HO

                            Address

                            

                             Telephone

     

                              Name of Hearing Office Manager or Other Contact Person

 

Part 2. (To be completed by FO)

  •  

    Please perform SSI queries, check off the appropriate category, and take the actions indicated so that the individual may be promptly notified of his or her rights to continued payments.

    (Check one)

Choose One

 

Categories
    a. Individual received continued payments before at the ALJ hearing level, but is not receiving payments now. HO will send Notice #1. FO will reinstate payments prospectively, will complete a redetermination and will then issue a check retroactive to the first month of nonpayment following the date of the prior decision or dismissal order shown in i.e. If the individual wants to waive continued payments, the FO will have the individual complete a written waiver, which will be sent to the HO for association with the claims folder and the FO will stop the payments.
    b. Individual received continued payments before at the ALJ hearing level, and is receiving payments now. HO will send Notice #2. No FO action necessary; payments should continue uninterrupted. If the individual wants to waive continued payments, the FO will have the individual complete a written waiver, which will be sent to the HO for association with the claims folder and the FO will stop the payments.
    c. Individual did not receive continued payments before at the ALJ hearing level. HO will send Notice #3. If the individual contacts the FO to request continued payments, the FO will have the individual complete a written request, which will be sent to the HO for association with the claims folder. The FO will then complete a redetermination, and will reinstate payments, effective for the month of the remand order shown in i.e.

Please telephone the HO shown in l.f. above and send them a copy of this form as followup. For the telephone contact give the following information:

  • —

    Name of individual (l.a.)

  • —

    SSN (l.b.)

  • —

    Date of Remand Order (l.c.)

  • —

    Which category checked off in Part 2. above (a. or b. or c.)?

  • —

    Name and telephone number of FO staff person making the call.

 

EXHIBIT 2 HEARING OFFICE TRANSMITTAL OF DECISION OR DISMISSAL - TERMINATION OF PAYMENT CONTINUATION

Transmittal of Decision or Dismissal

NOTE: 

For closed period or unfavorable decisions or dismissals, the hearings office will add the following language to the decision or dismissal transmittal: “Further action necessary by claims processing component. The individual in this medical cessation case appears to have had disability payments or benefits continued through the hearings level. The ALJ’s decision of (date) is less than fully favorable; disability ceased on (date). Please terminate continued disability payments or benefits immediately.”

 

EXHIBIT 3 - APPEALS COUNCIL TERMINATION OF PAYMENT CONTINUATION TRANSMITTAL



Social Security Administration

Refer to

Memorandum

 

 
Date: ​
From: Appeals Council, CHA,
Subject: Termination of Continued Disability Payments/Benefits - ACTION
To: DO/BO                    
​ Attached is the DO copy of my decision on the appeal of

 

Claimant

Social Security Number
                     ​
(Name of Individual) SSN:
  ​

Title II       , XVI     , II/XVI       (check one)

 

The individual in this medical cessation case had disability payments/benefits continued through the hearing level.

 

Check One

Options
   The ALJ issued a favorable decision, which is now being reversed.
   The ALJ issued a recommended decision and payments/benefits continue until the Appeals Council issues the final decision. That final decision is my decision of     (date) which is unfavorable; disability ceased on     (date).
  ​

Please terminate disability payments/benefits immediately.

                  

Member, Appeals Council

Attachment

 

cc:

CF(s)

To Link to this section - Use this URL:
http://policy.ssa.gov/poms.nsf/lnx/0412095172
DI 12095.172 - Appeals Council Remand of Medical Cessation -- Exhibits - 03/26/2025
Batch run: 03/26/2025
Rev:03/26/2025