POMS Reference

DI 27030: Reconsideration Notice Instructions

TN 1 (05-10)

A. Fully favorable allowances

The Field Office (FO) generates most disability insurance benefit (DIB), childhood disability beneficiary (CDB) and disabled widow(er) benefit (DWB) allowance notices based on input of the regulation basis code by the Disability Determination Services (DDS). For further instructions, see DI 26535.036 - Special Situations, and DI 81020.130 - Electronic Case Closure.

B. Partially favorable allowances

Title II allowance notices are computer generated based upon systems input. The Disability Determination Services (DDS) makes no entry in item 29 of the SSA-831 (Disability Determination and Transmittal).

1. Initial denial to partially favorable reconsideration allowance

When the DDS prepares a Title II reconsideration partially favorable allowance after an initial denial, an SSA-L1157-U2DI (Social Security Notice of Disability) with a personalized explanation is prepared and released according to the instructions in DI 27025.010 – Personalized Explanation Requirements – General.

2. Affirmation of closed period or unfavorable onset date allowance

When a closed period or unfavorable onset date allowance is affirmed, the DDS prepares and releases a modified notice on preprinted form SSA-L928 with a personalized explanation. The DDS must delete the phrase “denying your claim” from the third sentence of the first paragraph. Include paragraph 842 (Title XVI disclaimer) on concurrent Title II/Title XVI claims when the SSA-L928 is not preprinted.

References:

DI 31515.240 – Form SSA –L928 - Reconsideration – Affirmation of DIB, DWB, or CDB Denial,

NL 00708.100 - Numbered Paragraphs

DI 27025.015 Closed Period and Unfavorable Onset Date Allowances Explanation.

3. Date last insured (DLI) development

If a later onset date is established and the file indicates that the FO is developing earnings which could affect the DLI, contact the FO to verify DLI before releasing the notice. This eliminates erroneous partially favorable determinations when FO development establishes DLI prior to the onset established by the DDS.