I-3-9-35.Notice of Proposed Revision in Title XVI Cases When Claimant Is in Payment Status

Last Update: 9/08/05 (Transmittal I-3-36)

Notice of a proposed revision of a Title XVI decision after it has been effectuated is not required when the revision would be fully favorable to the claimant because such notice would serve no useful purpose. However, when the revision would not be fully favorable, notice of a proposed revision is required, in accordance with the decision in Goldberg v. Kelly, whether the revision would be based on the same or additional evidence (20 CFR 416.1336). In addition, the individual must be afforded a right to request a hearing.

The content of the notice will parallel the contents described in I-3-9-34. However, the notice must further advise the individual that if a hearing is requested within 10 days, payments will be continued until a hearing decision is rendered. If no hearing is requested, payments will be continued until the Appeals Council issues a decision. Any payments made for a period of time that the individual is found to be ineligible constitute an overpayment. Therefore, to avoid an overpayment, the individual may waive continuation of payment, or ask that the payments be continued at a reduced rate, after having received a full explanation of his or her rights.