Background

This transmittal amends the Hearings, Appeals and Litigation Law (HALLEX) manual Chapter I-2-8 to clarify the processes that hearing offices will follow to terminate benefits in medical cessation cases and clarify the processes that hearing offices will follow to help reinstate continued benefits when they receive medical cessation remands from the Appeals Council. We also added an exhibit with appropriate notice language.

Explanation of Content and Changes

We made the following changes:

I-2-8-6 A – This subsection explains when the claimant is and is not entitled to elect continued benefits on medical cessation cases. We moved information on automatic benefit termination to subsection B. We moved information on manual benefit termination to subsection C.

I-2-8-6 B – We changed this subsection to address when continued benefit payments cease automatically in a hearing level case. We moved the information previously in this subsection to HALLEX I-2-8-7.

I-2-8-6 C – We changed this subsection to address when continued benefit payments require manual termination in a hearing level case and the proper procedures to follow. We moved the information previously in this section to HALLEX I-2-8-7.

I-2-8-7 – We created a new section by moving information in I-2-8-6 B through F into this section.

I-2-8-7 A – We created a general subsection that explains when a claimant and his or her auxiliaries are entitled to receive continued benefit payments on medical cessation remand cases.

I-2-8-7 B – We moved information on title XVI-only and concurrent cases in HALLEX I-2-8-6 B and C to this subsection, and rearranged the section for clarity. We also added updated information regarding our electronic business processes.

I-2-8-7 C – We added a new subsection that addresses how we process title II-only cases. To the extent possible, this subsection tracks subsection B. We also added a reference to the new HALLEX I-2-8-105 for sample notice language.

I-2-8-7 D – We moved information previously in HALLEX I-2- 8-6 D and E into this subsection, and rearranged the information for clarity. We also added updated information regarding our electronic business processes.

I-2-8-7 E – We moved information currently in HALLEX I-2-8-6 F into this subsection, and simplified the information.

I-2-8-105 – We created a new exhibit so that hearing office staff will have the necessary language to issue the title II notices referenced in new HALLEX 1-2-8-7.

Date: October 24, 2014