POMS Reference

DI 28080: Due Process

TN 3 (04-12)

This section provides instructions for the Disability Determination Services (DDS) processing of medical cessations under P.L. 98-460.

A. Screening and processing

When the DDS receives a continuing disability review (CDR) case, take the following actions:

  • Screen the case to determine whether the CDR is title II only, title XVI only, or concurrent title II/title XVI, and obtain queries.

  • Adjudicate the case according to the CDR evaluation process, including consideration of medical improvement described in DI 28010.000.

B. Initial cessations for title II, title XVI or concurrent title II/title XVI

When processing an initial cessation, complete the following steps:

  1. Complete development and adjudication in accordance with existing CDR instructions in DI 28084.000, including preparation of the SSA-833-U3 (title II) and SSA-832-C3/U3 (title XVI), Cessation or Continuance of Disability or Blindness Determination and Transmittal.

  2. Do not make a cessation input.

  3. Retain a copy of the SSA-833-U3 and the SSA-832-C3/U3 in the official claims folder.

  4. Prepare and release a personalized cessation notice, including both statutory benefit continuation (SBC) and appeal rights. For notice instructions, see DI 28095.040.

  5. Route the folder to the FO and include the remark “Title II (or Title XVI or Concurrent) Medical Cessation - SBC” since the cessation input has not been done.

  6. Input folder movement data before releasing the official claims folder. For an explanation about processing CDR decisional data (continuance or cessation) and claims movement information for title II and title XVI disability claims, forwarded to the DDS for CDR, see SM 05901.001.

C. State Agency Operating Report (SAOR)

The DDS must adhere to established SAOR workload reporting and sampling procedures. It is essential that the beneficiary receive the correct notice.

D. References

  • DI 28005.000, The CDR Evaluation Process – Table of Contents

  • SM 05901.000, Continuing Disability Review (CDR) Processing – Table of Contents