C.F.R. » Title 20 » CHAPTER III—SOCIAL SECURITY ADMINISTRATION › PART 416—SUPPLEMENTAL SECURITY INCOME FOR THE AGED, BLIND, AND DISABLED › Subpart N—Determinations, Administrative Review Process, and Reopening of Determinations and Decisions

20 C.F.R. § 416.1402

Administrative actions that are initial determinations

Read at: eCFRecfr.gov CornellLII GovInfogovinfo.gov CasesGoogle Scholar

Initial determinations are the determinations we make that are subject to administrative and judicial review. We will base our initial determination on the preponderance of the evidence. We will state the important facts and give the reasons for our conclusions in the initial determination. Initial determinations regarding supplemental security income benefits include, but are not limited to, determinations about—

(a) Your eligibility for, or the amount of, your supplemental security income benefits or your special SSI cash benefits under § 416.262, except actions solely involving transitions to eligibility between these types of benefits (see §§ 416.1403 (a)(13) and (a)(14)).

(b) Suspension, reduction, or termination of your SSI benefits or special SSI cash benefits (see §§ 416.261 and 416.262) or suspension or termination of your special SSI eligibility status (see §§ 416.264 through 416.269);

(c) Whether an overpayment of benefits must be repaid to us;

(d) Whether the payment of your benefits will be made, on your behalf, to a representative payee;

(e) Who will act as your payee if we determine that representative payment will be made;

(f) Imposing penalties for failing to report important information;

(g) Your drug addiction or alcoholism;

(h) Whether you are eligible for special SSI eligibility status under § 416.265;

(i) Your disability;

(j) Whether your completion of, or continuation for a specified period of time in, an appropriate program of vocational rehabilitation services, employment services, or other support services will increase the likelihood that you will not have to return to the disability or blindness benefit rolls, and thus, whether your benefits may be continued even though you are not disabled or blind;

(k) Whether or not you have a disabling impairment as defined in § 416.911;

(l) How much and to whom benefits due a deceased individual will be paid;

(m) A claim for benefits under § 416.351 based on alleged misinformation;

(n) Our calculation of the amount of change in your federally administered State supplementary payment amount (i.e., a reduction, suspension, or termination) which results from a mass change, as defined in § 416.1401; and

(o) Whether we were negligent in investigating or monitoring or failing to investigate or monitor your representative payee, which resulted in the misuse of benefits by your representative payee.

[45 FR 52096, Aug. 5, 1980, as amended at 47 FR 15325, Apr. 9, 1982; 49 FR 22275, May 29, 1984; 58 FR 52913, Oct. 13, 1993; 59 FR 41405, Aug. 12, 1994; 59 FR 43039, Aug. 22, 1994; 59 FR 44928, Aug. 31, 1994; 60 FR 8153, Feb. 10, 1995; 60 FR 14215, Mar. 15, 1995; 69 FR 60240, Oct. 7, 2004; 70 FR 36509, June 24, 2005; 73 FR 76944, Dec. 18, 2008]
Notes of Decisions
Cited in 32 cases (23 in the last 5 years), 1987–2025 · leading case: Mary Ruth Smith v. Shirley S. Chater, Commissioner of Social Security
Sort: Relevance Newest Treatment
Mary Ruth Smith v. Shirley S. Chater, Commissioner of Social Security (1996) ca4 · cites it 2× “See 20 C.F.R. § 416.1402 (d) (Determinations regarding the assignment of a representative payee are reviewable unless that assignment is made because the claimant is a medically determined alcoholic or drug addict.”
Willis v. Sullivan (1991) ca6 “20 C.F.R. § 416.1402 . . This decision was separate and distinct from the post-remand decision that Willis was eligible for disability benefits under Title II.”
Ford v. Shalala (1999) nyed “See 20 C.F.R. § 416.1402 . A claimant who disagrees with the initial determination is entitled to seek reconsideration from the agency.”
Eichie v. Kuakazi (2023) nysd · cites it 3× “Administrative actions that are categorized as initial determinations are subject to administrative and judicial review, 20 C.F.R. § 416.1402 , while administrative actions that are not categorized as initial determinations are not reviewable administratively or by a court, id.”
Foster v. Social Security Administration (2022) ared · cites it 2× “See 20 C.F.R. § 416.1402 (b); Social Security Program Operations Manual System (POMS): SI 02301.”
Richter v. Social Security Administration (2019) ned · cites it 2× “20 C.F.R. § 416.1402 . In contrast, administrative actions that are not “initial determinations” may be reviewed by the SSA, but are not subject to administrative or judicial review.”
Seid v. Commissioner of Social Security (2024) ohsd · cites it 2× “25-1 at 2–3; 25-2 at 37); see 20 C.F.R. § 416.1402 (c). Both notices explained how the Agency calculated the overpayment and provided Plaintiff with information about appealing the decision (a reconsideration) and/or requesting a waiver of the repayment.”
Wood v. SSA (TV2) (2023) tned · cites it 2× “Defendant further cites to 20 C.F.R. § 416.1402 (j) to demonstrate that a Section 301 benefits determination is an initial determination that the agency makes before a claimant can seek administrative and judicial review [Id.”
Allen v. Berryhill (2018) alnd “After the Commissioner denied reconsideration (tr. at 101), Allen requested a hearing before an ALJ, asserting that the "account was a restrictive account.”
Aychillhum v. SSI (2023) casd “See 20 C.F.R. § 416.1402 (noting initial 17 agency determinations include a suspension or reduction of SSI benefits and a 18 determination of whether “an overpayment of benefits must be repaid”); id.”
Simmons v. Commissioner of Social Security (2023) flmd “3 The administrative review process includes receipt of an initial determination, 20 C.F.R. § 416.1402 , reconsideration, 20 C.”
Busz v. Commissioner of Social Security (2024) innd “Under 20 C.F.R. § 416.1402 (a), a determination regarding the amount of supplemental security income is an “initial determination” subject to further review.”
Show all 32 citing cases →
— 20 C.F.R. § 416.1402(a) — 1 case
Eichie v. Kuakazi (2023) nysd “Administrative actions that are categorized as initial determinations are subject to administrative and judicial review, 20 C.F.R. § 416.1402 , while administrative actions that are not categorized as initial determinations are not reviewable administratively or by a court, id.”
Annotations are extracted automatically from the opinions in the Syfert caselaw corpus and ranked by authority, recency, and treatment. Dots show Syfertize treatment of the citing case itself.