POMS Reference

DI 40515: Due Process/Statutory Benefit Continuation

TN 14 (02-10)

CITATIONS: Social Security Act - Sections 223(g) and 1631(a)(7) ; Regulations - 20 CFR 404.1597 - 404.1597a and 416.995 - 416.996

A. Introduction to statutory benefit continuation during medical cessation appeal

Congress enacted a benefit continuation statute to help prevent financial hardship to beneficiaries who appeal a medical cessation determination.

Operationally, the field office (FO) is the focal point and is responsible for processing statutory benefit continuation cases after the adverse medical determination has been made.

B. Option for continuation of benefits during appeal

Option for continuation of benefits during appeal applies to:

1. Title II cases

Medical improvement determinations for Title II made after January 11, 1983.

NOTE:  Section 5102 of P.L. 101-508, the Omnibus Budget Reconciliation Act of 1990, made benefit continuation a permanent provision.

2. Title XVI cases

Medical improvement determinations for Title XVI made after October 1984. See SI 02301.300.

C. References

  • DI 12027.000, Statutory Benefit Continuation (SBC).

  • DI 28080.110, Disability Determination Services (DDS) Processing of Medical Cessation Cases – P.L. 98-460.

  • DI 28080.115, Disability Determination Services (DDS) Special Situations.