BASIC (01-09)

A. General

The program center returns an allowed case to the disability determination service (DDS) for reopening if an individual is subsequently convicted of a felony. The DDS must reopen the determination to exclude from consideration:

1. Any impairment which arose in connection with the commission of the felony.

2. The aggravation of a pre-existing impairment if the aggravation occurred in connection with the commission of the felony.

When a case is returned to the DDS, the DDS evaluates the case for consideration of any felony-related impairment and determine whether revision to a denial is appropriate if the felony-related impairment is excluded from consideration. If the determination must be revised to a denial or other unfavorable determination, follow DI 27525.000 Reopenings - Due Process to ensure that the appropriate due process notification is given. The guide language in DI 23501.075B. is used for written due process notification to the beneficiary. It should be modified as necessary if the unfavorable determination is for a later onset date or closed period.

When an individual is denied due to exclusion of a felony-related impairment, and the felony conviction is subsequently overturned, the field office (FO) returns the case to the DDS. The DDS should reopen the previous determination and prepare a revised determination which considers the excluded impairment. Follow Reopening and Revising a Determination or Decision - DI 27501.005, when the previous determination must be revised to either exclude a felony-related impairment, or to consider such an impairment when a felony conviction is overturned.

B. Model language for Title II Due Process Notice

On behalf of the Social Security Administration, we are notifying you that it appears a determination will be made that you do not meet the disability requirements of the law. Therefore, the previous determination awarding benefits based on disability may have to be revised and your claim denied. You may not be entitled to benefits based on your present application. You were initially found disabled because of         . Our records now show that this condition is based on an impairment connected with the commission of a felony after October 19, 1980, for which you have subsequently been convicted. This includes an impairment that arose during the felony. This also includes the aggravation of an impairment if the aggravation occurred during the felony. The law does not allow us to consider these impairments in determining if you are disabled. Where the jurisdiction does not classify any crime as a felony, we apply these provisions to a crime which can be punished by death or by imprisonment for more than one year.  

(When the disability is based on a combination of impairments, an explanation is given as to why the remaining impairment(s) does not meet the definition of disability. When the disability is based solely on the felony-related impairment, this paragraph is not needed.)  

We are giving you the opportunity to present additional statements or evidence that you want to be considered before a determination is made if you feel that the previous allowance of your claim is correct and should not be changed to a denial. If you want to submit statements or evidence, please send it to us within 10 days from receipt of this notice using the enclosed envelope which requires no postage.

If you do not contact us within 10 days from receipt of this notice, a formal determination concerning your entitlement to benefits based on disability will be made. It is important that you let us know within the next 10 days if you want to submit a statement or evidence even though you need more time to submit it.

When the formal determination is made, you will be notified in writing by the Social Security Administration. If the allowance of your claim is reversed to a denial, your benefit payments will stop.