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Navigating SSI’s Medical CDR or Age 18 Redetermination – What the Beneficiary, Parent, or Representative Payee Needs to Know

Read all mail from Social Security Administration (SSA) program. 

  • * Or get help reading the mail. 

  • * If mail includes form to fill out, make sure to fill it out and send to SSA. 

  • * If mail confirms appointment for youth to see a doctor or other healthcare provider, the youth must keep the appointment or request a new date. 

  • * SSI can be terminated if beneficiary does not return forms or show up for appointments, unless good cause is shown. 

 

Make sure SSA knows about all medical conditions and treatment. 

  • * This information should go on forms completed or should be shared during in-person meetings. 

  • * Tell SSA about new medical conditions being treated, such as new mental health treatment. 

  • * Tell SSA about all medications and any side effects from the medication. 

  • * Tell SSA if youth is seeing a new doctor or therapist. 

 

Tell SSA about special education services and other special services the youth receives or has received through the public school. 

  • * This includes extra services in the classroom and any extra time on tests. 

  • * This includes services outside of the classroom, including class work assistance, speech services, physical therapy, or occupational therapy. 

  • * This includes any special vocational services. 

  • * This includes any summer special education program. 

  • * Sharing the most recent Individualized Education Plan (IEP) or Section 504 Plan will help make sure SSA knows about these services. 

 

Make sure SSA knows about vocational programs, trial work experiences, and paid employment. 

  • * This includes sharing any documents that say the youth needs extra services to make him or her ready for regular employment. 

  • * This includes information about any job coach services that are provided or have been provided. 

  • * This includes any challenges faced by the youth during the trial work or paid employment. 

  • * Sharing the State VR Agency’s Individualized Plan of Employment (IPE) will make sure SSA knows of about the agency’s services. 

 

Carefully read SSI notice, if SSI to be terminated; steps for appealing. 

  • * Notice will explain when last SSI payment will be received. 

  • * Notice will explain how to appeal and time limit for appealing (60 days from receipt of notice). 

  • * Notice will explain how to request that SSI continue during the appeal and time limit for this request (10 days from receipt of notice). 

  • * If appealing by mail, always best to go to Post Office and pay extra money to send by Certified Mail, signed receipt requested (keeping receipts to show when mailed or received by SSA). 

  • * Always assume it will take mail 5 days to reach SSA. 

  • * If in doubt, take notice to a local SSA office and explain you are there to file an appeal. 

 

Look for free legal or advocacy services to help with appeal.  

  • * Contact the Legal Services or Legal Aid office where you live and see if they will help with an SSI appeal. 

  • * Contact the Protection and Advocacy/Disability Rights organization where you live and see if they will handle an SSI appeal. 

  • * Contact your State or local bar association to see if any private attorneys will handle an SSI appeal, with a fee to be paid out of any back benefits only if they win. 

Section 301 Allows SSI to Continue After a Termination Notice - What the Beneficiary, Parent, or Representative Payee Needs to Know

Understand how section 301 works for youth, ages 14 to 25 

  • The beneficiary had to be in a vocational rehabilitation (VR) program or other special program before getting the SSI termination notice. 

  • The VR program or special program, in most cases, is one expected to lead to future employment. 

  • In most cases, this means the person is unlikely to need SSI in the future after they complete the VR program or special program. 

  • When section 301 criteria are met, SSI will continue after the termination notice even if the beneficiary does not appeal. 

  • SSI payments can continue until the VR program or special program is completed. 

 

Special 301 rules for 18 to 21 year old special education students 

  • The young person got an SSI termination notice following a Medical Continuing Disability Review (CDR) or Age 18 Redetermination. 

  • This person continues getting special education services with an Individualized Education Plan (IEP). 

  • The special education program does not need to involve any vocational services. 

  • SSI benefits will continue until the special education program ends or until the student turns age 22. 

 

Section 301 allows SSI to continue while beneficiary is being served by a State VR agency. 

  • Must get services through an Individualized Plan of Employment (IPE). 

  • SSA must decide that these services make it likely that person will not need SSI in the future after program ends. 

  • SSI will continue until the VR-funded plan is completed. 

 

Always plan to ask SSA or the person hearing an appeal (Hearing Office or ALJ) to consider Section 301. 

  • Section 301 is often overlooked. 

  • Many staff at SSA offices will not be familiar with Section 301. 

  • Many Hearing Officers or ALJs will not be familiar with Section 301. 

  • Let them know that Section 301 is covered in SSA’s policy manual.