POMS Reference

DI 14510: Procedures for Cases Involving Participation in a VR or Similar Program

TN 5 (01-16)

A. Procedure to identify cases

The DDS must determine that the beneficiary’s disability or blindness has medically ceased, or that the beneficiary’s disability ended during a Title XVI Age 18 Redetermination before continued payment of disability or blindness benefits to beneficiaries participating in VR or similar program may occur.

If a beneficiary is participating in a VR or similar program, eView will display a “Potential Section 301 Case” flag. A paper case will have an SSA-408 (Route Slip) attached to the folder annotated with “Potential 301 Case.” If DDS recognizes a potential Section 301 case that the field office (FO) has not identified, make the medical determination and follow procedures in DI 14510.010B.

If the case is a certified electronic folder (CEF), add a “Potential Section 301 Case” flag (see DI 81020.085).

B. Procedure to make a medical determination

1. Continuance of disability

If DDS determines a continuance of disability or blindness (or a beneficiary in an Age 18 Redetermination is found disabled under the adult standard for initial claims), make all systems inputs and release the case according to existing procedures.

For CEF cases, process per DI 81010.200 through DI 81010.255.

For routing CEF cases, process per DI 81020.250.

2. Cessation of medical determination

Process cessation cases per DI 81010.200 through DI 81010.255.

CEF cases with a “Potential Section 301 Case” flag generate an alert to the FO via the EDCS Actions Page “CDR Cessation Added-Potential 301 Benefit Continuation.” For paper cases, the DDS alerts the FO of the cessation with the remark on the SSA-408, “Potential 301 benefits – handle per DI 14510.003C.

NOTE: Continuation of benefits under Section 301 does not apply when medical cessation is due to failure to cooperate (FTC) or whereabouts unknown (WU).

a. Cessation notice

Prepare and release the cessation notice according to existing procedures. Include the following paragraph in the cessation notice:

  

“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 about 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.”

Place a copy of the notice in the paper or electronic folder.

b. Title II cases

Complete the SSA-833 (Cessation or Continuance of Disability or Blindness Determination and Transmittal) and enter the cessation date in item 9B. Do not enter the disability termination date. Check “301” case in item 9I. Enter “301 Case” in Remarks.

c. Title XVI cases

Complete the SSA-832 (Cessation or Continuation of Disability or Blindness Determination and Transmittal) and enter the cessation date in item 9B. Do not enter the disability termination date. Check “301” case in item 9I. Enter “301 Case” in Remarks.

NOTE: For paper cases, fax a copy of the SSA-832 to the servicing FO with a cover sheet annotated “301 Case – Input VP diary per DI 14510.003D.2." (Refer to Detailed Office/Organization Resource System (DOORS) to obtain the FO fax number.)

C. Procedure for systems input in cessation cases

1. Title II cases

Input a “Y” in the 301 field on the D833 screen of the NDDSS (see SM 06001.505B.11.). Enter remarks in field 50 as follows: “Potential 301 case – handle per DI 14510.003C.” Route paper folders to the servicing FO. For closing and routing instructions, see DI 81020.250.

2. Title XVI cases

Input a “Y” in the 301 field on the D832 screen of the National Disability Determination Service System (NDDSS) (SM 06001.505B.11.). Enter remarks in field 50 as follows: “Potential 301 case – handle per DI 14510.003C.” Input an N7 diary (disability cessation pending) or N8 diary (blindness cessation pending) with a diary date of no less than 60 days. Route paper folders to the servicing FO. For closing and routing instructions, see DI 81020.250.