POMS Reference

DI 33025: Procedures for Special Cases and Handling

TN 10 (12-17)

A. Background - Continued payment of benefits under Section 301

Refer to DI 28060.001 General - VR or Similar Program Participation, for additional information.

B. Policy - Identifying Section 301 Cases in the Disability Hearing Unit (DHU)

There are two instances when a DHU may see a Section 301 case:

  • The individual is seeking reconsideration of the initial medical cessation determination when he or she was eligible for Section 301 benefits and the subsequent determination finds that the individual is not eligible for the Section 301 benefits he or she is seeking.

  • During the development phase of the reconsideration request for medical cessation, the disability determinations services (DDS) discovers the case is a potential Section 301 case.

When the case has a certified electronic folder (CEF), i.e., the case is processed as an electronic continuing disability review (CDR) (eCDR); see DI 14510.035A.1.a. Appeals Process for Cases Involving Section 301 Determination.

NOTE: In the above circumstances, the DHU’s responsibility is the same as in all other cases.

C. Procedure for processing section 301 cases in the DHU

1. If disability continues

Process the case in the usual manner. The case is no longer a Section 301 case.

2. If disability ceases

In the disability hearing officer’s (DHO) decision notice, advise the individual that he or she will be considered for continued benefits under section 301, and that he or she will receive a subsequent notice regarding that determination.

   

Suggested wording:

Before the appeals language,

“You may be eligible for continued payments even though your disability has ended if you are currently participating in an appropriate program of vocational rehabilitation, employment, training, educational, or other support services. We are sending your case to another office for a special decision regarding continued payments based on the information we have about your participation in such a program. You will be notified of that decision in another letter.”

After the appeals language,

“If you disagree with this decision, you should appeal now. We will review this decision if you appeal. Do not wait to see if your vocational rehabilitation program is approved.”

Forward the case, per DI 33020.005A.3.a Routing Cases after the Disability Hearing.

For additional information on DDS processing of Section 301 claims, see DI 14510.010 Disability Determination Services (DDS) Procedures for Cases Involving Participation in Vocational Rehabilitation (VR) or Similar Program.