DI 11055: Supplemental Security Income (SSI) Disability Cases
TN 64 (09-09)
A personalized disability notice (PDN) is required in closed-period allowances when the date of onset is later or cessation is earlier than alleged by the claimant. The Disability Determination Services (DDS) prepares an interim initial Title XVI personalized closed-period allowance notice. When the field office (FO) effectuates the claim, the Modernized Supplemental Security Income Claims System (MSSICS) generates the official award notice.
If the claim is an Electronic Disability Claim System (EDCS) exclusion, the DDS designates the notice and related paragraphs in Item 29 of the SSA-831. The FO then prepares a manual notice (including payment information), releasing it to the claimant.
To facilitate FO preparation of the notice, the DDS designates the following information, if applicable, in Item 29 of the SSA-831 (Disability Determination and Transmittal):
“FO/DL-8025” (SSI PAYMENT DECISION)
004 Lead-in Paragraph Referring to Interim Notice
1029 Lead-in Paragraph
1396 Closed Period--Blindness or 1397 Closed Period--Disability
1382 Reminder To Report If Condition Worsens
Appropriate Medicaid Paragraph
841 Disclaimer Paragraph-Use only in concurrent Title II and Title XVI
Upon completion of the SSA-831, the DDS routes the folder to the FO under cover of an SSA-408 (Route Slip). DDS advises the FO to prepare the manual notice, releasing a copy of the award notice to the attorney or authorized representative or authorized party (if one is involved in the claim).
NOTE: California, Iowa, Nevada, and Massachusetts are the four states that pay a State blindness supplement when the DDS finds a claimant statutorily blind. If the DDS establishes a closed period on the blind impairment, the DDS prepares a personalized disability explanation addressing the blindness issue and releases it with an SSA-L1157-U2-SI (Supplemental Security Income Notice).