I-3-6-55.Interim Disability Benefits in Cases of Delayed Final Decisions (“8001” Cases)

Last Update: 10/13/11 (Transmittal I-3-42)

A. General

Pursuant to §8001 of Public Law 100-647 (The Technical and Miscellaneous Revenue Act of 1988) which amended §§223 and 1631(a) of the Social Security Act to add §§223(h) and 1631(a)(8), if a hearing decision is favorable to a claimant the Social Security Administration (SSA) will pay the claimant interim benefits under the circumstances described in B. below.

NOTE:

The provisions of §8001 are also applicable to favorable attorney advisor decisions.

B. Payment of Interim Benefits

If a hearing decision is favorable to a claimant, SSA will pay the claimant interim benefits if:

  1. The hearing decision finds that the claimant is disabled under title II or is disabled or blind under title XVI (or continues to be disabled under title II or disabled or blind under title XVI); and

  2. The Appeals Council (AC) has initiated review of the hearing decision on its own motion pursuant to 20 CFR 404.969 or 416.1469; or

  3. The AC reopens the favorable hearing decision pursuant to 20 CFR 404.987 or 416.1487; and

  4. 110 days have elapsed after the date of the hearing decision; and

  5. The Commissioner has not issued a final decision.

C. When Interim Benefits Begin and End

1. When interim benefits begin

SSA will pay the claimant interim benefits under title II for months beginning with the month before the month in which the 110th day after the date of the hearing decision expires, and under title XVI for months beginning with the month in which the 110th day after the date of the hearing decision expires.

2. When interim benefits end

If SSA begins paying a claimant interim benefits, SSA will stop paying the interim benefits under title II in the month before the month in which the Commissioner issues a final decision, and under title XVI in the month in which the Commissioner issues a final decision.

D. Notice

We must include notice of this provision in AC reopening notices, remand orders, and own motion review notices whenever the AC reviews a hearing decision covered by the provisions of §8001 on its own motion or reopens such a decision. The analyst will ensure that the following §8001 language is included as the closing paragraph of reopening notices, remand orders, and own motion review notices:

Section 8001 of Public Law 100-647 requires the payment of interim benefits in cases where we make a favorable hearing decision about your disability and no final decision is issued within 110 days after the date of the hearing decision. Because the Appeals Council has exercised its [(own motion review)(reopening)] authority in this case, interim benefits may be payable if a final decision is not issued within 110 days after the date of the hearing decision. You will receive interim benefits until we issue a final decision. Another Social Security Administration office will notify [(the claimant)(you)] at the appropriate time as to the amount and the effective date of any interim payments.

E. Routing

Analysts will annotate in red ink the remarks section of the route slip forwarding an own motion or reopening recommendation to the AC, “POTENTIAL 8001 CASE.” In addition, staff will route the paper claim file and appeals file to the RSI Branch, immediately after the AC releases its own motion or reopening notice. The RSI Branch will set up controls and return the files to the Quality Review Branch. When appropriate, the RSI Branch will request the effectuating components to initiate or terminate interim benefit payments.