Process an auxiliary or survivor claim as a delayed claim if:

1. a. 

   A proper applicant files an application for an auxiliary or survivor claimant and we are developing evidence for at least one factor of entitlement;

   OR

   A potential auxiliary or survivor claimant with no valid application has a protective filing, per GN 00204.010; AND

2. b. 

   The family maximum is involved and we would overpay other entitled auxiliary or survivor claimants if we do not include the delayed claimant in the initial benefit calculation; AND

3. c. 

   Other entitled claimants are due immediate payment.

Do not process an auxiliary or survivor claim as a delayed claim if it meets any of the following conditions:

• •

  The only outstanding issue is representative payee development. Use a suspension event according to GN 00504.110, or a diary code listed in GN 01040.010, as appropriate.

• •

  We establish a lead for the potential claimant rather than a protective filing. Document development and dispose of the lead per GN 00202.020H.

1. a. 

   Establish an application in the Modernized Claims System (MCS) with data provided by the proper applicant.

2. b. 

   Enter a decision status (DEC STAT) code of “08 DELAY” on the Decision Input screen (DECI) in MCS.

3. c. 

   Enter the applicable diary code on the DECI screen in MCS to diary for the outstanding evidence, per GN 01040.010, and explain the development that is pending in the diary reason field on the Diary Screen (DIAR) in MCS.

4. d. 

   Establish a diary date of 60 days, or later, if you expect development to last more than 60 days. For additional information on the DIAR Screen, see MS MCS 009.015.

5. e. 

   Add paragraph “ENTR26” on the Notice 3 Screen (NOT3) in MCS, see NL 00725.225 and MS MCS 03509.010.

6. f. 

   Process the claim through MCS Earnings Computation (EC).

7. g. 

   If the claim will not process through EC, see GN 01010.140C.3. in this section.

1. a. 

   Establish an application in MCS with available information provided by the NH or other applicants, when possible. Use actual or alleged data. If the claimant’s SSN is unknown, key in “?” or “NONE” in the claimant SSN (CL SSN) field on the MCS Systems Menu Screen (MENU).

2. b. 

   Entering a “?” in the CL SSN field on the MCS MENU Screen will generate the Claimant SSN Unknown (CLUNK) issue on the DW01 or DW02 Screen. Resolve the issue by following the Management Override (MOVR) instructions found in MS MCS 011.010.

3. c. 

   Input placeholder information to advance through the MCS screens. Do not use a fictitious Social Security Number. Use the Alpha-Index Query (ALPH) to locate an auxiliary or survivor’s SSN; for additional information see MS QUERIES 003.003.

4. d. 

   Enter a “?” or “NONE” in the claimant SSN field on the RSDHI Claims Application Screen (APPL) in MCS, if the claimant’s SSN is unknown. For additional information on the APPL Screen, see MS MCS 005.009.

5. e. 

   Receipt in the application issue in the receipt field (REC) on the MCS Development Worksheet Screen (DW01). Do not enter “X’s” in the application issue receipt field.

6. f. 

   Enter “X’s” in the attestation issue (ATTEST) receipt field (REC) on the DW01. Do not enter the date in the attestation issue (ATTEST) receipt field (REC).

7. g. 

   Add the following remark to the Remarks Screen (RMKS) in the MCS application screen path, “THIS IS NOT A VALID APPLICATION. A PROTECTIVE FILING DATE OF MM/DD/YYYY HAS BEEN ESTABLISHED FOR (NAME OF CLAIMANT). NO CLAIM HAS BEEN FILED AND NO INFORMATION HAS BEEN ATTESTED TO. 6 MONTH CLOSEOUT NOTICE SENT ON MM/DD/YYYY.” Store a copy of the claim in the Online Retrieval System (ORS) via the Print and Store Screen (PRST), see MS MCS 008.001.

8. h. 

   Enter a decision status (DEC STAT) code of “08 DELAY” on the Decision Input (DECI) screen in MCS.

9. i. 

   Enter diary code “023”on the DECI screen in MCS to indicate we are developing for an auxiliary or survivor claim, and explain that development is pending for a delayed claimant’s application in the diary reason field on the Diary (DIAR) screen in MCS.

10. j. 

    Establish a diary date of 6 months to correspond with the date on the protective filing closeout notice stored in ORS, see GN 01010.140C.4.b. in this section.

11. k. 

    Consider the need for a payee, per GN 00502.070, and enter payee information on the Notice 1 Screen (NOT1). If the payee is unknown, key “UNKNOWN” in the applicant name field on the APPL Screen in MCS.

12. l. 

    Complete the representative payee fields on the NOT1 Screen in MCS. If the payee is unknown, key “?” for the payee name and applicant SSN on the NOT1 Screen.

13. m. 

    Suppress the notice by entering “Y” (YES) in the SUPPRESS (Y/N) field on the MCS Notice 3 Screen (NOT3).

14. n. 

    Process the claim through MCS Earnings Computation (EC).

15. o. 

    If the claim will not clear through EC, see GN 01010.140C.3. in this section.

16. p. 

    Add a Special Message to the MBR via Miscellaneous Online Edited Transactions (MONET), once the MBR is established, stating, “BIC XX PROTECTIVE FILING ONLY (MM/DD/YYYY). OBTAIN VALID APPLICATION. CLOSEOUT SENT MM/DD/YYYY”

1. a. 

   Complete the A101 following instructions in MS MCS 014.001;

2. b. 

   Enter “Y” in the DELAYED CLAIMAINT field on the Beneficiary Data Screen (BENE) of the A101;

3. c. 

   Include the delayed auxiliary or survivor claimant(s) on the Monthly Benefits Screen (MBEN) when you compute the benefit amounts, if the family maximum is involved;

4. d. 

   Enter “BIC [insert BIC – Delayed” in the REMARKS field of the Beneficiary Claim Remarks Notice Screen (BCRN). Specify in the remarks if the delayed claim is a valid application or no valid application with a protective filing only;

5. e. 

   Enter the diary code(s) in the REMARKS field on the BCRN screen; and

6. f. 

   Enter notice information in the NOTICE field of the BCRN screen for claims with a valid application. Suppress the notice for delayed claims with no valid application based on a protective filing only.

When the MBR shows a beneficiary in LAF PB or PT, it is an indication that an SSA technician adjudicated a delayed claim. Review the records (i.e. MCS application) and make an initial entitlement determination for the delayed claimant. Review ORS to determine if the delayed claim was established using “placeholder” information due to a protective filing.

If we already secured a valid application from a proper applicant and there are no changes in the primary insurance amount (PIA), entitlement data for the delayed claimant or any other currently entitled beneficiary, do not load a new claim in MCS or prepare an A101.

• •

  Annotate the Report of Contact (RPOC) screen in MCS to explain that there are no changes in the PIA or entitlement data for delayed claimant or currently entitled beneficiary.

• •

  If the RPOC screen in MCS is not available, input a Special Message on the MBR and explain that there are no changes in the PIA or entitlement data for delayed claimant or currently entitled beneficiary.

• •

  Document the specific details of the delayed claimant’s entitlement on form SSA-5002. Include any minor data change(s) and information regarding the representative payee for a minor child, if applicable.

• •

  The claims specialist (CS) or claims technical expert (CTE) signs form SSA-5002.

• •

  Fax a copy of form SSA-5002 to NDRed via EP.

• •

  Fax a request including the SSA-5002 to the PC Paperless repository via EP. Select “Claim Delayed-Delayed Claims” from the paperless barcode dropdown options. Annotate the paperless barcode coversheet remarks with, “BA ACTION REQ/BENEFIT PAYABLE-SEE RPOC IN FILE.”

• •

  Manually clear (MANCLR) any pending application in MCS or eRPS to your office.

If we already secured a valid application from a proper applicant and there are changes in the PIA, entitlement data for the delayed claimant or any other currently entitled beneficiary:

• •

  Load the claim in MCS and process the claim via an A101.

• •

  If an A101 exclusion exists, MANCLR the MCS claim and process via an EF101.

NOTE: If we initially established an application using placeholder information for the delayed claimant, secure an application from a proper applicant before you make an initial determination. Load the claim in MCS and process the claim via an A101. Update the electronic Representative Payee System (eRPS) with the correct payee information.

After proper development, if you determine that the delayed claimant is not entitled to benefits or we did not receive an application, then take all of the following actions.

• •

  Manually clear (MANCLR) any pending application in MCS or eRPS for the delayed claimant; and

• •

  Input a manual adjustment credit and award data entry (MACADE) denial with the applicable denial code. Use miscellaneous code “064” if no other code applies. The MACADE denial results in a MADCAP exception, which serves as an electronic transfer of the action to a Benefit Authorizer (BA) in the Processing Center (PC); and

• •

  Prepare and release a denial notice to delayed claimants who filed a valid application. Do not issue a denial notice to delayed claimants with no valid application who we established using “placeholder” information; and

• •

  Prepare and sign form SSA-5002 to document the basis for denying the delayed claim. Include instructions for the PC to adjust the monthly benefit amount (MBA) for currently entitled beneficiaries; and

• •

  Fax form SSA-5002 under cover of form SSA-3601 to the PC Paperless repository via EP; and

• •

  Fax a copy of form SSA-5002 to NDRed via EP for retention purposes.

When we process an allowance for a delayed claim and a representative is involved, consider whether the maximum fee has already been authorized to the representative. If the maximum fee has not already been authorized, and the auxiliary beneficiary’s effective filing date is the same as the primary claimant and the auxiliary was not individually represented, calculate past-due benefits for the auxiliary based on the effectuation date of the primary beneficiary, refer to GN 03920.035. Ensure that we send the proper notice to the claimant and representative containing the relevant paragraphs. Include the appropriate code on the MCS DW01 Screen per MS MCS 008.004. If denying the delayed claim, authorize the appropriate fee amount from the remaining beneficiaries and provide the applicable notices.

The addition or deletion of a beneficiary may cause the total family benefits (TFB) to become the applicable limit for offset or cease to be the applicable limit for offset. When the family composition changes, re-compute the offset. Use the interactive computation facility (ICF) as though the new number of beneficiaries were established and entitled for the first month we imposed or considered WC/PDB offset. For additional guidance on how changes in family composition affect WC/PDB offset, see DI 52150.070.

Consider a combined family maximum whenever a simultaneously entitled child or other beneficiary receives a higher benefit based on the combined maximum. If combined maximums apply and you deny a delayed claim, consider whether a rate increase is due to the remaining auxiliaries or survivors on the record.