TN 2 (06-09)

A. Procedure personalized form notice (SSA-L444)

The Disability Determination Services (DDS) must prepare and release a personalized disability notice (PDN) to Title XVI claimants denied because disability or blindness criteria are not met. DDS notices are computer generated based upon systems input and no entry is made in item 29 of the SSA-831 (Disability Determination and Transmittal). The PDN consists of:

• preprinted form notice SSA-L444 (Supplemental Security Income Notice of Disapproved Claim); and

• a personalized explanation containing the required information.

For further instructions on the preparation of personalized explanations, see NL 00800.000, Notices for Title XVI.

B. Procedure for Medicaid or State supplementation riders

The DDS may be required to add Medicaid or State supplementation paragraphs for Title XVI notices. These paragraphs are provided on preprinted riders and selected, when appropriate, according to individual State procedures. Only one rider is appropriate for each State. See NL 00804.110, Medicaid — SSI Paragraphs.

If the DDS receives information that a claimant has changed his or her address during adjudication, the DDS should contact the field office (FO) to verify his or her State of residence for Medicaid and State supplementation purposes. If a rider is not available for the new State of residence, the appropriate paragraphs are typed on a blank rider “O” (Para. 800).

C. Multi-category cases

The DDS process these cases according to the instructions in DI 26005.005, Title XVI.

D. Procedure for approved language on closeout of the Title II aspects of Title XVI initial denials for DDS

Title II and title XVI denial notices include a blanket closeout paragraph that closes out all other classes of benefits covered by the scope of the application unless the FO advises DDS on the SSA-831 there is a title II claim pending.  If the SSA-831 indicates a title II claim is pending, contact the FO to verify if the title II claim is still pending.  Do not include closeout language on the denial notice if the title II claim is still pending.