TN 5 (01-16)

A. Procedure for identifying cases

The Disability Determination Services (DDS) must make a medical cessation determination before continued payment of payments to beneficiaries participating in an appropriate program of VR services, employment services, or other support services may occur. The field office (FO) will develop participation in VR or a similar program per DI 14510.003C.

To prevent erroneous termination of a potential Section 301 case, ODO will take the following action immediately upon receipt of a case.

• For a Title II case, check the Master Beneficiary Record (MBR) special message field for Section 301 remarks. If there are no remarks, annotate the MBR special message field for "Section 301 determination pending - do not take action on medical cessation -- mm/dd/yy."

• For a Title XVI case, check the Supplemental Security Record (SSR) for Section 301 remarks and the Vocational Rehabilitation Plan (VP) diary. If there are no remarks or the VP diary is not present, fax a request to the servicing FO to input the diary and update the remarks on the SSR.

B. Procedure for development of an appropriate program

Review the SSA-4290-F5 (Development of Participation in a Vocational or Similar Program) and development obtained by the FO to verify that the beneficiary is participating in VR or a similar program that meets the definition of an appropriate program of VR services, employment services, or other support services as described in DI 14505.010B.

Request further documentation from the provider of services, if necessary, to determine whether the program meets the requirements. Such documentation may include copies of licenses, registration or accreditation.

If a provider refuses to provide information on an SSA-4290-F5 because of privacy concerns, mail or fax them a signed SSA-827 (Authorization to Disclose Information to the Social Security Administration). Address unresolved issues regarding an appropriate program to:

If the program analyst is unable to resolve the issue, he or she may send an email to:

ORDES.Controls@SSA.gov

ATTN:Employment Policy Team

Include a description of the issue and a copy of the SSA-4290-F5. Also, include an ODO contact name, phone number, and fax number for reply.

C. Procedure to develop current participation

Review the SSA-4290-F5 to determine whether the beneficiary is currently participating in the program per DI 14505.010C.

• We determine a beneficiary to be participating in VR or a similar program if he or she is taking part in the activities and services outlined in his or her individual work plan (IWP), individualized plan for employment (IPE), or from an appropriate provider described in DI 14505.010B.

• For a beneficiary participating in a Plan to Achieve Self-Support (PASS), the PASS specialist who approved the PASS will complete Part II, Section C of the SSA-4290-F5. To contact the PASS specialist, visit www.socialsecurity.gov/disabilityresearch/wi/passcadre.htm.

• We determine a student age 18 through 21 receiving services under an individualized education program (IEP) to be participating in the program if he or she is taking part in the activities and services outlined in the IEP.

We determine current participation when the SSA-4290-F5 is dated within the preceding 90 days, and the beneficiary is taking part in the activities and services outlined in his or her plan or program. A “yes” response to question two of Part II, Section A, B, C, or D indicates current participation.

D. Procedure for additional evaluation factors

1. Current documentation

The SSA-4290-F5 and all supporting documentation used to make a likelihood determination must be dated within the preceding 90 days. If development is older than that, contact the provider by telephone to update the information and record the contact on an SSA-5002 (Report of Contact).

2. Continued participation

The beneficiary’s participation in the program must have started before the month disability or blindness ceased and must continue beyond the two-month grace period after the medical cessation.

For interruptions in participation, see DI 14505.010D.

3. Work goal

For beneficiaries other than students ages 18 through 21 in an IEP, there must be a specific occupational or employment goal. “Competitive employment” is not sufficient.

4. Education, skills, and work experience

A description of the education, work skills, or work experience that the beneficiary will acquire by completing the program or continuing in the program for a specified period.

5. Completion date

There must be a projected completion date for the program.