BASIC (10-06)

A. Policy – SBC for EPE Cases

A medically ceased individual in his/her EPE who appeals the cessation determination may elect or decline SBC of his/her EPE pending the appeal.

SBC of the EPE will continue until the earlier of the appeal decision; or when the EPE would normally end because of the performance of substantial gainful activity (SGA) after the 36th month following the trial work period (TWP).

During the appeal period and continued EPE, regular EPE rules apply i.e., SBC paid only for non-SGA months.

B. Procedure – SBC for EPE Cases

When processing SBC for Title II EPE cases the field office (FO) will:

• Secure a signed election form from the proper individual electing or declining SBC for the EPE (continuation of his/her EPE). See DI 12095.171, Exhibit 4 for the appropriate SSA-795 election form. See DI 12027.010A. about who may sign the SBC election form.

• Provide a copy of the signed election form to the beneficiary.

• Fax the signed election statement (SSA-795) into section E of the electronic folder (EF), if the official folder is electronic. Verify the document is in the EF and shred the original.

• Place the signed election statement (SSA-795) in the blue section of the modular disability folder (MDF), if the official folder is paper.

• See DI 12027.010C. for Title II systems input when processing SBC when it was elected or terminating payments if SBC was declined.