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What administrative actions are NOT initial determinations?

June 8, 2008 by admin

2190. What administrative actions are NOT initial determinations?

The following are examples of administrative actions, but they are not initial determinations:

  1. Determination of misuse of payments by a representative payee;

  2. Method of recovering an overpayment (e.g., by withholding part of a regular monthly payment, netting against an underpayment, etc.);

    Note: The amount to be withheld is an initial determination. (See §2189 (Y).)

  3. Compromise settlement for an overpayment;

  4. Representative's fees (i.e., a finding as to the amount an attorney or other representative may charge for representing a claimant before SSA);

  5. Eligibility for and the amount of an emergency advance payment;

  6. Eligibility for presumptive disability or presumptive blindness payments;

  7. Timing and frequency of payment;

  8. Termination of eligibility after 12 months in a row of suspension;

  9. Finding that a prior determination may not be re-opened or revised under the rules of administrative finality;

  10. Finding that the expedited appeals process does not apply;

  11. Finding that good cause for extending the appeals period does not exist;

  12. Findings based on income estimates for a future period (Any changes of income estimates are handled as redeterminations.);

  13. Reduction, suspension, or termination of the federally administered State supplementary payment;

  14. Denial of a request to be made a representative payee;

  15. Disqualifying or suspending a person from acting as a representative in connection with a proceeding before SSA;

  16. Determining whether (and the amount of) travel expenses incurred are reimbursable in connection with a proceeding before SSA;

  17. Denying a request to re-adjudicate a claim and apply an Acquiescence Ruling; and

  18. Actions to pay, adjust or terminate provisional benefits related to an Expedited Reinstatement (EXR) request.

See §2003.

Last Revised: Jul. 25, 2006

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