DI 23501: Prisoner Cases
BASIC (01-09)
Citations:
20 C.F.R. § 404.1506;
SSR 83-21
The SSA-831 should be completed as usual for any Title II claim with the following exceptions.
A. Item 7
The Disability Determination Service (DDS) changes item 7 on a “freeze only disability insurance benefit (DIB) case”. To determine if input is required, see DI 23501.010D.2.b.
B. Item 26
All denied cases where a felony-related or confinement-related impairment is excluded from consideration must be listed in item 26 (List No.) of the SSA-831 (Disability Determination and Transmittal) as indicated in the chart below. The identification permits the retrieval of these cases for any future study.
| Situation | Listing Code |
|---|---|
|
Denial in which a felony-related impairment is excluded from consideration in the disability determination (For exclusion criteria see DI 23501.010C.2.). |
608 |
|
A disability “freeze only” allowance in which disability is not established for cash benefit purposes because a confinement-related impairment is excluded from consideration in the disability determination (For freeze only criteria see DI 23501.010D.2.b.). |
623 |
C. Item 27 (Rationale)
1. Technical rationale
A rationale is required in all “prisoner” cases where the individual has been convicted (or convicted and confined) for a felony committed after October 19, 1980. The rationale must:
clearly show if an impairment(s) arose or was aggravated (and if aggravated, the extent of the aggravation) in connection with the commission of the felony, or in connection with confinement pursuant to conviction of the felony;
identify any such impairment(s) and describe the weight attributed to the felony-related impairment(s), the confinement-related impairment(s), and any remaining impairment(s) which is not excluded from consideration; and.
reflect how consideration of any felony-related or confinement-related impairment affected the disability determination or decision.
Concluding rationale statements are needed on prisoner cases.
a. Not disabled when all impairments considered
“Impairment(s) not disabling; no effort has been made to isolate any felony-related impairment(s).”
b. Disabled when all impairments considered – impairment(s) not felony-related
“Disabling impairment(s) not felony-related.”
c. Disabled when all impairments considered – impairment(s) felony-related
“Disabling impairment(s) felony-related.”
d. Not disabled when all impairments considered – confinement involved
“Impairment(s) not disabling; no effort has been made to isolate any felony-related or confinement-related impairment(s).”
e. Disabled when all impairments considered – impairment(s) not felony-related or confinement-related
“Disabling impairment(s) not felony-related or confinement-related.”
f. Disabled when all impairments considered – impairment(s) confinement-related – freeze case – DIB ONLY
“Determination of allowance justified only when consideration is given to impairment(s) associated with confinement. FREEZE ONLY – not under a disability for cash benefit purposes during any month confined.”
g. Disabled when all impairments considered – impairment confinement-related – DWB or CDB
“Disabling impairment(s) is confinement-related.”
2. Personalized paragraph
A personalized disability explanation is required for prisoner cases in addition to the elements listed in DI 26530.020 – Personalized Disability Explanation in Initial Denials. Attach the personalized notice to the appropriate notice (and rider) indicated in DI 23501.025.
If only one impairment is alleged, and that impairment cannot be considered in determining disability because the impairment is felony-related, include the following elements:
A list of medical evidence used to determine if the impairment is felony-related;
When all medical reports were not obtained, a statement that the Social Security Administration (SSA) evaluated only the reports necessary to make a decision; and
A statement that the impairment cannot be considered in determining disability because it is connected with a felony committed after October 19, 1980 for which the claimant is convicted.
If felony-related and non-felony-related impairments are alleged:
List the medical evidence used to determine that an impairment is felony-related; and
Provide a statement that the impairment cannot be considered in determining disability because it is connected with a felony committed after October 19, 1980 for which the claimant is convicted.
D. Item 29
The DDS prepares and releases all denial notices. If a system-generated notice cannot be used, the DDS examiner designates “DDS D/L” and the appropriate notice or rider in item 29 of the SSA-831. (For a list of prisoner case notices and riders see DI 23501.025.)
E. Item 34
Enter the appropriate following remark:
PRISONER CASE – Felony committed on or before October 19, 1980 – claimant convicted and currently confined.
PRISONER CASE – Felony committed after October 19, 1980 – claimant convicted and currently confined.
PRISONER CASE – Felony committed after October 19, 1980 – claimant convicted but not currently confined.
PRISONER CASE – Possible felony committed after October 19, 1980 – (trial pending).
PRISONER CASE – Possible felony committed on or before October 19, 1980 – (trial pending).
In a “Freeze Only” allowance on a DIB claim enter: “FREEZE ONLY - Not under a disability for cash benefit purposes during any month confined”.
Enter “Disabling impairment is felony-related” or “Disabling impairment is confinement-related” for childhood disability benefit (CDB) or disabled widow(er) benefit (DWB) felony-related or confinement-related impairment denials.