TN 12 (08-22)
DI 23510.030 Decision Paragraph for a Disability Insurance Benefit (DIB) Claim Filed after Death
(Table)
To determine the correct decision paragraph in the personalized disability explanation
(PDE) by the regulation basis code, use this table:
Personalized Disability Explanation (PDE) Paragraphs
|
Regulation Basis Code
(Item 22 of the SSA-831)[1]
|
Basis for Determination
|
Decision Paragraph[2]
|
|
F1
|
Impairment not severe at time of death – Medical consideration alone
|
329 (NH's Name)
|
|
F2
|
Impairment not severe at time of death – Medical consideration alone
|
324 (NH's Name) (Date ER Last Met)
|
|
H1
|
Impairment severe at time of death – medical and vocational considerations: Capacity
for Substantial Gainful Activity (SGA)—any relevant past work
|
330.2 (NH's Name)
|
|
H2
|
Impairment severe at time of death – medical and vocational considerations: Capacity
for Substantial Gainful Activity (SGA)—any relevant past work
|
324(B) (NH's Name) (Date ER Last Met)
|
|
J1
|
Impairment severe at time of death – Medical and vocational considerations: Capacity
for SGA—Other Than Relevant Past Work
|
330.2 (NH's Name)
|
|
J2
|
Impairment severe at time of death – Medical and vocational considerations: Capacity
for SGA—Other Than Relevant Past Work
|
324(B) (NH's Name) (Date ER Last Met)
|
|
E1
|
Impairment no longer severe at time of death and did not prevent SGA for a period
of at least 12 months
|
331.1(A) (NH's Name)
|
|
E2
|
Impairment no longer severe at time of death and did not prevent SGA for a period
of at least 12 months
|
324(B) (NH's Name) (Date ER Last Met)
|
|
E3
|
Impairment is severe at time of adjudication/death but would not have been expected
to last 12 months
|
331(E) (NH's Name)
|
|
E4
|
Impairment is severe at time of adjudication/death but would not have been expected
to last 12 months
|
324(B) (NH's Name) (Date ER Last Met)
|
|
M5
|
Insufficient evidence provided
|
341(A) (NH's Name)
|
|
M6
|
Insufficient evidence provided
|
341(A) (NH's Name)
|
|
M3
|
Applicant does not want to continue development of claim: Wants determination made
on evidence in file or does not indicate determination based on evidence in file
|
343(C) (NH's Name)
|
|
M4
|
Applicant does not want to continue development of claim: Wants determination made
on evidence in file or does not indicate determination based on evidence in file
|
343(C) (NH's Name)
|
|
M7
|
Applicant does not want to continue development of claim: Does not want determination
to be made on evidence in file
|
343(C) (NH's Name)
|
|
M8
|
Applicant does not want to continue development of claim: Does not want determination
to be made on evidence in file
|
343(C) (NH's Name)
|
|
K1
|
Number Holder (NH) willfully failed to follow prescribed treatment
|
381A (NH's Name)
|
|
K2
|
Number Holder (NH) willfully failed to follow prescribed treatment
|
381A (NH's Name)
|
For a list of the PDE paragraphs in the table, see NL 00708.100. The list is in numerical order and contains text for each paragraph listed.
For additional information on PDE paragraphs in initial DIB after death denials, see
DI 26530.030.
NOTE: The PDE paragraphs should be written in the third person.