Effective Dates: 05/25/2023 - Present Previous | Next

TN 1 (05-23)

DI 28065.035 Additional Requirements for Completing Form SSA-833-U5 in Felony/Prisoner Cases

For the most part, completion of Form SSA-833-U5 Cessation or Continuance of Disability or Blindness Determination and Transmittal - Title II is the same for felony/prisoner cases (see DI 28065.001 CDR Considerations for Individuals Convicted of a Felony) as for any medical CDR determination. However, certain items require special entries as described below.

A. Item 1B - Case type

When the continuance determination is based on confinement-related impairment(s), check block FZ.

B. Item 12 - Continuance Code

When there is insufficient evidence to make a disability determination due to the Title II beneficiary being confined to a penal institution, use Title II continuance code "41".

C. Item 24 - Remarks

When there is insufficient evidence to make a determination about whether disability continues because of confinement to a penal institution, continue the period of disability and enter: "Prisoner Case - Resolution of CD issue required upon reinstatement of benefits."

D. Item 29 - Notice Instructions

  1. 1. 

    Continuances: Enter: SSA-L1013

  2. 2. 

    Cessations: Enter: ODO/DL

E. Item 34 - List Number

In addition to any other applicable list numbers, enter one of the following as applicable:

  1. 1. 

    608 - Cessation in which a felony-related impairment is excluded from consideration.

  2. 2. 

    610 - Benefits suspended due to confinement

  3. 3. 

    623 - Prisoner Case. Freeze Only established.

F. References

To Link to this section - Use this URL:
http://policy.ssa.gov/poms.nsf/lnx/0428065035
DI 28065.035 - Additional Requirements for Completing Form SSA-833-U5 in Felony/Prisoner Cases - 05/25/2023
Batch run: 05/25/2023
Rev:05/25/2023