SSA - POMS: GN 00204.005 - Claimant Dies Before Filing/Effectuation

A. Policy - claimant dies before filing an application

1. Protective filing established

If a claimant dies before filing an application but after we receive a protective filing, someone eligible to receive the deceased claimant’s underpayment may file the application. The period in which an application can be filed is determined by the protective filing closeout period in GN 00204.012.

NOTE: A protective filing may be a written statement of intent to file (including a written statement prepared by a Social Security Administration employee such as a completed SSA-2514 (Record of Claimant's Intent to File) (or its electronic equivalent), or enhanced Leads and Appointment System (eLAS) Worksheet or an oral inquiry about Supplemental Security Income (SSI). See GN 00204.010 for protective filing policy and SI 00601.015 through SI 00601.025 for SSI protective filings.

2. Protective filing not established

A valid application for Disability Insurance Benefits (DIB) may be filed within 3 months after the month in which the disabled individual died by someone eligible to receive the deceased claimant’s underpayment. This time period also applies to applications for disability freeze. See DI 26001.005 for the policy on disability freeze. This provision of the law does not extend to Disabled Widow’s Benefits (DWB) or Childhood Disability Benefits (CDB) or provide for a “good cause” provision for late filing.

See GN 02301.030 for who may receive a title II underpayment and SI 02101.003 for who may receive a SSI underpayment. If there is a title II underpayment and the lump sum death payment (LSDP) has not been paid, see RS 00210.001 and RS 00210.010 for instructions on issuing the LSDP.

B. Policy - claimant dies after filing but before effectuation

If the claimant dies after filing but before effectuation of the application, follow the procedures in GN 00204.005F.

C. Procedure - closing out the title II/title XVI protective filing

1. Someone is eligible to receive the underpayment

If someone is eligible to receive the underpayment, follow the procedures in GN 00204.012 for closing out the title II protective filing and SI 00601.037 for closing out the title XVI protective filing. Also seeSI 00601.040C for the SSI notice requirements.

2. Cannot locate the individual eligible to receive the underpayment

If you cannot locate the individual eligible to receive the underpayment, document the file with the attempts made to locate the individual, and send the closeout notice, addressed to the individual eligible to receive the underpayment, to the deceased claimant’s last known address.

3. No underpayment exists or no one is eligible to receive the underpayment

If no underpayment exists, e.g., the claimant dies in the first month of entitlement/eligibility, take no further action to close out the protective filing.

D. Procedure - NH appears qualified for DIB

If it appears the claimant would have qualified for DIB during the 12 months before death, or the protective filing date or that a freeze could be established and the time limitation in GN 00204.005A has not expired:

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Obtain an application for DIB from the individual eligible to receive the underpayment. Also request medical evidence, if available, and proof of death (DI 11010.330).
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Send the application to the Disability Determinations Service (DDS) for a disability determination.
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If the DDS determines that the claimant was disabled, prepare a manual award and forward it to the program service center to process the underpayment. See GN 01010.220 for processing manual awards.

NOTE: If it appears the deceased claimant would have been entitled to both title II Retirement Insurance Benefits (RIB) and DIB, see RS 00615.110.

E. Procedure - claimant not qualified for DIB

If the time limitation in GN 00204.005A. has elapsed and the applicant insists on filing or disability insured status is not met, disallow the application using the appropriate disallowance code.

F. Procedure - death after filing an application but before effectuation

If the claimant filed an application but died before we could effectuate it, process the application as follows:

1. Title II

a. No entitlement

Send an abatement notice to the applicant if other than the claimant. If the claimant filed on their own behalf, then no notice is necessary. See GN 01010.475 for abatement instructions.

b. Entitlement - benefits payable

Determine the person(s) entitled to receive the underpayment, and process the award. If no one is eligible to receive the underpayment, document the file to that effect. See GN 01061.020 for instructions on how to dispose of underpayments.

c. Entitlement - no benefits payable

Effectuate the application and send a “no payment” award notice to the executor of the estate at the deceased’s last known address.

2. Title XVI

a. Interim Assistance Reimbursement (IAR) Involved

When an IAR is involved and an underpayment is possible:

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Pay any underpayment to the State only if the appropriate signed IAR authorization is received and the information/evidence needed to determine eligibility can be obtained (including the disability determination for disability applications) and establishes eligibility. For an explanation of IAR authorizations, see SI 02003.005 and SI 02003.010. If there is excess money payable to a survivor, see SI 02101.004B. Input the death termination once payment is made.
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Input the death termination promptly if either the nondisability or disability development cannot be completed or the claim is denied.

b. IAR Not Involved

When an IAR is not involved and an underpayment is possible:

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Continue to develop the information/evidence to adjudicate the claim if there is a survivor eligible to receive the underpayment. If eligibility can be established, pay the underpayment to the survivor and input the death termination per SI 02101.003 - SI 02101.008.
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Input the death termination if either the nondisability or disability development cannot be completed, or the claim is denied.
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Input the death termination and discontinue the nondisability development if there is no survivor eligible to receive the underpayment.

c. State Request Medical Determination

If the State requests a medical determination, ask the DDS to make the medical determination only if:

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The underpayment cannot be paid per GN 00204.005F.2.(a-b), and
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the conditions in SI 01730.015 for requiring a medical evaluation are met.

d. Death in the Filing Date Month

If the FO receives notification that the claimant died in the filing date month, curtail developing the title XVI factors of eligibility. Input the death termination and refer any inquiries about medical expenses to the State Medicaid agency. See GN 00204.007 for determining the application filing date. If title II retroactivity is involved, follow the procedures in GN 00204.005F.1.b for adjudicating title II. If retroactivity is not involved, follow the procedures in GN 01010.475 for abating the application.

G. References

Title II protective filing, GN 00204.010

Title XVI protective filing, SI 00601.015 through SI 00601.020

Title XVI oral inquiries, SI 00601.025

State requests for title XVI disability determination, SI 01730.015

Notice requirements, NL 00601.010

Underpaid person is deceased, GN 02301.030

Social Security

Program Operations Manual System (POMS)

GN 00204.005 Claimant Dies Before Filing/Effectuation