Nonpayment of disability benefits due to noncompliance with rules regarding treatment for drug addiction or alcoholism.
(a) Suspension of monthly benefits.(1) For an individual entitled to benefits based on a disability ( § 404.1505) and for whom drug addiction or alcoholism is a contributing factor material to the determination of disability (as described in § 404.1535 ), monthly benefits will be suspended beginning with the first month after we notify the individual in writing that he or she has been determined not to be in compliance with the treatment requirements for such individuals ( § 404.1536 ).
(2) This rule applies to all individuals entitled to disability benefits ( § 404.315 ), widow(er)'s benefits ( § 404.335 ), and child's benefits based on a disability ( § 404.350) effective with benefits paid in months beginning on or after March 1, 1995.
(3) Benefit payments to any other person who is entitled on the basis of a disabled wage earner's entitlement to disability benefits are payable as though the disabled wage earner were receiving benefits.
(b) Resumption of monthly benefits. The payment of benefits may be resumed only after an individual demonstrates and maintains compliance with appropriate treatment requirements for:
(1) 2 consecutive months for the first determination of noncompliance;
(2) 3 consecutive months for the second determination of noncompliance; and
(3) 6 consecutive months for the third and all subsequent determinations of noncompliance.
(c) Termination of benefits.(1) A suspension of benefit payments due to noncompliance with the treatment requirements for 12 consecutive months will result in termination of benefits effective with the first month following the 12th month of suspension of benefits.
(2) Benefit payments to any other person who is entitled on the basis of a disabled wage earner's entitlement to disability benefits are payable as though the disabled wage earner were receiving benefits.
[60 FR 8146, Feb. 10, 1995]
Title 20 published on 2012-04-01
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