The purpose of identifying the claimant is to establish that they are the person alleged. The SSN card by itself is not sufficient evidence to establish the applicant’s identity, see GN 00203.020.

Always make reasonable efforts to resolve material discrepancies. You must consider the proof of age tolerance policy before disallowing the claim. For additional information, see GN 00302.030. See also GN 00203.030 to resolve date of birth discrepancies in Title II claims.

Marital and child relationship requirements often involve complex issues. Always consider State and Federal law prior to disallowing the claim. For more instructions, see GN 00305.005 and GN 00306.001.

Unique issues arise with independently entitled divorced spouse claims since the number holder (NH) is eligible but has not filed for benefits. For development when attempting to obtain proofs from the non-filing NH, see RS 00202.100.

You must distinguish between the uncooperative claimant who fails to submit available evidence and the cooperative claimant who submitted all available evidence but such evidence has very low probative value.

• •

  For in-office or teleclaim interviews, an initial request constitutes the initial “written” request (e.g., attestation cover notice with proof request) provided to the claimant after their initial claim interview. Tell the applicant that we may have to deny the claim if we do not receive the requested evidence within 30 days from the date of the interview.

• •

  Internet applications (iClaim)--For Internet applications (first-party applicants using iClaim), the iClaim utility determines what proofs are necessary during the claims taking process and checks to see if the proof already exists in our records. If we need proofs, iClaim generates a list of only the documents required and displays them on the Evidence and Receipt screen and propagates the issue(s) to the DW01 screen. The evidence issue(s) propagated to the DW01 mirror the issue(s) seen by the applicant on the Evidence and Receipt screen. The Disability Report (SSA-3368) and Authorization to Disclose Information to the Social Security Administration (SSA-827) are not displayed on the Evidence and Receipt screen. Only certain first-party iClaim users are permitted to access the electronic authorization (eAuth) utility to submit an SSA-827 in iClaim. For users who are permitted access to eAuth, the on-screen request in iClaim for the SSA-827 constitutes the initial request for the SSA-827. See the note below for what to do with Disability iClaims missing the SSA-3368 or the SSA-827.

• •

  If a third-party files the Internet claim, we include the list of documents required with the paper Internet Application Summary mailed to the claimant for review and signature.

• •

  If we do not receive the information or evidence after 15 days, send a final request notice explaining that we will deny the claim 30 days from the date of the original request, as discussed in GN 01010.410C.2. in this section.

  IMPORTANT: The 30-day period shown on the final request notice starts with the date of the initial written request

NOTE: If you later determine that you need an additional piece of evidence that was not included in the original request (e.g., the SSA-3368 or SSA-827), mail a separate “initial request” (e.g., SSA-L1043, Social Security Request for Information) for the specific item and provide additional time for the claimant to respond.

If the claimant does not respond to the initial request, or indicates a lack of interest or unwillingness to cooperate, send an SSA-L1045-U2 (Letter Requesting Proof from Claimant) explaining that we will deny the claim 30 days from the date of the original request.

Be sure to include the following information in the notice:

• •

  The specific items we need as evidence.

• •

  A statement advising the claimant to contact the field office (FO) if they have not received the evidence and need more time.

• •

  A statement informing the claimant that we will disallow or deny the application if we do not receive a response by the date indicated on the letter (i.e. 30 days from the original written request).

You must document all contacts with the claimant via a Report of Contact (RPOC) in the MCS to include follow-up dates and the outcome of the contact. Document the development worksheets (DW03) in MCS to describe your efforts to obtain the required evidence and indicate if the claimant requested assistance. For information on identifying claimants who may need assistance, see GN 00301.180.

Prepare a special determination via an RPOC describing what the claimant said or did that led to the conclusion to disallow the claim. You must also document if the claimant did not make a reasonable effort to furnish the necessary evidence.

You must deny the claim if the claimant does not present the evidence needed for entitlement, and:

• •

  the claimant received assistance to the fullest extent possible in accordance with GN 00301.180; and

• •

  the claimant has not responded to the final request letter discussed in GN 01010.410C.2. in this section; or

• •

  the claimant clearly indicated a lack of interest or failure to cooperate; or

• •

  we cannot locate the claimant.

Use the factor of entitlement not established as the reason for the disallowance or denial even when the claimant fails to pursue the claim. To include information in a disallowance or denial notice due to failure to submit essential evidence, see NL 00601.020E.2.

If you cannot locate the claimant, send the notice to the claimant's last known address.

REMINDER: The lawful presence and citizenship requirements are factors affecting payment of benefits, but they are NOT factors of entitlement, see RS 00204.010B.1.

If the claimant presents new evidence to establish eligibility or entitlement and it is within the reconsideration period, treat the new evidence as a reconsideration request, and fax it to the paperless unit of the processing center (PC) of jurisdiction for non-disability claims.

For component responsibility, see GN 03102.175.

For disability claims, please refer to DI 81010.145.

If the claimant provides the new evidence to establish eligibility or entitlement but is not within the reconsideration period, consider reopening the claim if appropriate.

To determine when not to reopen correct determinations, see GN 04001.070. To consider reopening under new and material evidence, see GN 04010.030.

In some situations, if the PC discovers issues that were clearly overlooked or erroneously applied, the PC can request further development of the issues. The FO must document all the development done to avoid additional PC requests. The PC should not question the FO's judgment on the amount of help a claimant needs. A claimant’s ability to pursue a claim and the degree of help they need is largely a matter of judgment. The FO adjudicator is usually in the best position to make this judgment.

NOTE: For claims involving identity requirements, refer to GN 00203.020. If we denied the application for lack of identity evidence, refer to Claim Denials in GN 01010.400.