I-2-2-92.Sample Language Which May Be Appropriate in the Notice of Hearing - Eligibility Issues - Title XVI

Last Update: 8/15/05 (Transmittal I-2-61)

A. Cessation of benefits “non-rollback conversion case” — application of State plan issues — Title XVI

Because your disability was established based on a State plan, the issue to be determined is whether you continue to be disabled under the criteria of the State plan or whether you are disabled under the Federal criteria.

B. Child's disability issues — Title XVI

1. Initial Claims.

The general issue is whether you are eligible, as an individual under age 18, for supplemental security income within the meaning of section 1602 and 1614(a)(3)(C) of the Social Security Act.

To decide if you are disabled, I will follow a step-by-step process until I can make a decision. The issues in the process concern:

  • any work you may have done since you became disabled;

  • the severity of your impairment(s); and

  • the combined effect of your impairment(s) and whether they meet or medically equal the criteria for one of the impairments in the Listing of Impairments in Appendix 1 of Subpart P of the regulations, or are functionally equal to the Listings.

The child must be present at the hearing.

2. Cessation Cases.

I will decide if you continue to be disabled under section 1614(a)(4) of the Act as an individual under age 18. I will consider:

  • whether there has been any medical improvement in your impairment(s) since we last found you disabled or still disabled; and

  • whether one of the exceptions to medical improvement stated in the Act and our regulations applies.

If no medical improvement has occurred and no exception applies, I will find that your disability continues. If I do not rule for you on that basis, I will consider whether you are disabled. I will follow a step-by-step process until I can make a decision. The issues in the process concern:

  • whether your impairment(s) still meets or equals the severity of the listed impairment it met or equaled before; and

  • the combined effect of your impairment(s) and whether they meet or medically equal the criteria for one of the impairments in the Listing of Impairments in Appendix 1 of Subpart P of the regulations or functionally equal the listings.

Our regulations explain the rules for deciding if you continue to be disabled and, if so, when you became disabled. These rules appear in the Code of Federal Regulations, Title 20, Chapter III, Part 416, Subpart I.

The child must be present at this hearing.

C. Excess income and resources — Title XVI

The general issue is whether you are eligible for supplemental security income under sections 1602 and 1611 of the Social Security Act. The specific issue is whether you have income or resources in excess of the amount set by the regulations as the maximum allowable to be eligible for supplemental security income.

NOTE:

The source of income or the specific resource in question should be set out.