Effective Dates: 09/05/2023 - Present Previous | Next

TN 35 (09-23)

RS 00205.400 Processing Claims and Conversion Cases for Student Benefits

A. Background

To reduce the number of inappropriate interruptions of benefit payments and to improve payment accuracy to student beneficiaries, we changed from a back-end to a front-end enforcement process for students whose date of birth is 06/02/83 or later. We revised Form SSA-1372 (RS 00205.400C).

The student obtains the school official's certification of the student's school attendance before returning the form to the field office (FO). The student also leaves page 4 of the SSA-1372 with the school official for reporting changes in full-time attendance (FTA).

We eliminated Forms SSA-1386, SSA-1388, and SSA-1390.

B. Policy

The student must have an official of their school certify the student's attendance before we adjudicate the claim. The official must answer the questions on page 3 in addition to completing the signature area of the form. Obtain FTA verification of all periods of attendance, whether current or retroactive, in which the child has attained age 18 prior to adjudication in every case. This policy applies to all educational institutions.

C. Student's statement regarding school attendance (Form SSA-1372)

For an exhibit of Form SSA-1372, see OS 15010.580.

D. Procedure for an initial or re-entitlement claim

1. General

If you are taking a claim for a child who is at least age 17 years and 6 months, or will be that age or older as of the date the claim is processed, determine if the child will be a student in the month of attainment of age 18. In addition, question the child about childhood disability benefits (CDB).

If the child alleges disability, follow the instructions in RS 00203.080 – RS 00203.090 to develop a CDB claim.

For instructions about determining fugitive status, follow the instructions in GN 02613.050 (Initial Claims – Determining Fugitive Status) and EM-09025.

NOTE: A child who qualifies for student benefits as the child of a living NH in an initial claim must be in FTA “throughout the month” for the first MOET. A student is deemed to meet this requirement if they meet the definition of FTA in What is Full-Time Attendance in RS 00205.300.

2. Forms

The FO completes the child’s application in MCS (or on Form SSA-4-BK, Application for Child's Insurance Benefits, for MCS exclusions) and Form SSA-1372, Student's Statement Regarding School Attendance, and provides the student with the following forms:

  • •

    Form SSA-1383, Student Reporting Form see OS 15010.583; and

  • •

    Form SSA-453-F4, How Your Earnings Affect Your Benefits see OS 15010.145.

3. School certification

The student must take the SSA-1372 to the school for a school official to certify on page 3 the school attendance information the student provided on page 2. The student must leave page 4, Notice of Cessation of Full-Time Attendance, of the SSA-1372 with the school official so the school will be able to report the date and reason the student's full-time attendance ended.

The student, either in person or by mail, must return pages 2 and 3 of the SSA-1372 to the FO after the school official certifies the student's information.

4. Processing the claim

Process the claim as follows:

STEP

ACTION

1

Review Form SSA-1372

  • •

    to resolve any discrepancies; and

  • •

    to determine whether there are factors that preclude student entitlement (e.g., incarceration (RS 00205.130), being paid by an employer to attend school (RS 00205.125A.1.)).

Does it appear the child may qualify for student benefits?

If yes, go to step 2.

If no, go to step 5.

2

Determine if the school the child is attending is an educational institution (EI) as discussed in RS 00205.250.

Does the development indicate the school is an EI?

If yes, go to step 3.

If no, go to step 5.

3

Determine if the child is in full-time attendance (FTA) as discussed in the following sections:

Does the development indicate the child is in FTA?

If yes, go to step 4.

If no, go to step 5.

4

Take action to award benefits (MSOM COMMON 005.029).

Enter the school’s operating basis as certified by the school official in question 3 on page 3 (Certification by School Official) of the SSA-1372.

Absent evidence to the contrary, consider the student to be a capable adult and pay benefits directly to them. Appoint a representative payee (payee) only if the student is incapable of managing benefits. Continue entitlement while developing a payee.

NOTE: Be aware that the beneficiary may be receiving another benefit, such as SSI, through a payee. The same payee must be appointed for all benefits to which the beneficiary is entitled (GN 00502.183B.3). If the beneficiary is already receiving benefits through a payee, you must complete a new capability determination prior to paying the beneficiary directly (GN 00502.055C).

Fax the SSA-1372 into the Non-Disability Repository for Evidentiary Documents (NDRed) or electronic disability (eDIB) folder.

Once the form is stored and viewed for content in either the Evidence Portal (EP) or eView, destroy the paper copy.

If Payment Center (PC) action is necessary, in addition to faxing the form into NDRed or eDIB, fax the form into the Paperless (PPL) repository.

NOTE: 

If the initial Post Entitlement Online System (POS) action excepts, Title II Redesign (T2R) will automate a Paperless Action Control Record (ACR) to the jurisdictional PC. In these situations, there is no requirement to fax the document directly into Paperless.

 

5

Deny the claim (disallowance code 38, student not attending an EI, or disallowance code 41, student not in FTA, SM 00380.100).

Fax the SSA-1372 following the instructions in step 4. If the child is also applying for disability benefits, annotate Form SSA-1372 “Not full-time student” and fax it with the disability material.

E. Process when a child beneficiary is currently on the rolls

1. SSA-1387 to payee

Central Office (CO) mails Form SSA-1387, Advance Notice of Termination of Child's Benefits, to the payee when a child beneficiary attains age 17 years and 9 months. This notice informs the payee that the child's benefits will terminate at age 18 unless the child is a full-time elementary or secondary-school student or qualifies for childhood disability benefits. The notice further explains what action the payee should take if the child is disabled and the child should take if they are a full-time student. If the child is disabled, the payee should call or visit any Social Security office or call SSA's toll-free number.

If the payee visits an FO, they should take:

  • •

    The SSA-1387;

  • •

    A history of the child's disabling condition;

  • •

    Names and addresses of the child's medical record sources;

  • •

    Names and addresses of the schools the child attended;

  • •

    The child's employment history;

  • •

    The child's Social Security number; and

  • •

    A copy of a check or bank statement, if the child's name is on the account, for direct deposit.

The notice tells the payee that, if the child will be a student after age 18, the child must complete the SSA-1372 and return it to a local Social Security office before age 18.

2. SSA-1372 to child

At the same time CO mails the SSA-1387 to the payee, it mails the SSA-1372 to the child. The cover sheet tells the child that, to receive student benefits after age 18, they must:

  • •

    Complete the SSA-1372, Student's Statement Regarding School Attendance;

  • •

    Take the form to an official of their school to certify the student's attendance;

  • •

    Leave the form, “Notice of Cessation of Full-Time Attendance,” with a school official; and

  • •

    Take or mail the completed form to a Social Security office.

NOTE: For direct deposit, the student must enroll through their financial institution, call Social Security's National 800 Number (1-800-772-1213), or contact a Social Security office (see GN 02402.025).

 

The cover sheet tells the child that, to receive childhood disability benefits, they must contact a Social Security office and provide:

  • •

    A history of the disabling condition;

  • •

    Names and addresses of medical record sources;

  • •

    Names of schools attended;

  • •

    Their work history; and

  • •

    Their Social Security number.

F. Procedure for age 18 conversion cases

1. The student returns the SSA-1372 to the FO

If the child returns the completed and certified SSA-1372 (pages 2 and 3) to the FO, the FO reviews the student's statement and the school's certification to determine whether student benefits are payable. Be sure the child has answered the disability question.

If the child alleges disability, follow the instructions in RS 00203.080 – RS 00203.090 to develop a CDB claim.

For instructions about determining fugitive status, follow the instructions in GN 02613.050 (Initial Claims – Determining Fugitive Status) and “Fugitive Felon: Stop Suspension or Denial of Individuals with Felony Warrants Affected by the Martinez Settlement” EM-09025.

If the child does not qualify for student benefits, process the denial (RS 00205.400F.5.).

If the child qualifies for student benefits, process the SSA-1372 and give or mail the student the following forms:

  • •

    SSA-1383, Student Reporting Form see OS 15010.583; and

  • •

    SSA-453-F4, How Your Earnings Affect Your Benefits see OS 15010.145.

2. If a PC receives a misrouted SSA-1372

Review the student's statement and the school's certification (pages 2 and 3) to determine whether student benefits are payable. Be sure the child has answered the disability question.

If the child alleges disability, develop a CDB claim.

If the child does not qualify for student benefits, process the termination (RS 00205.400F.6.).

If the child does qualify for student benefits, the PC will:

  1. 1. 

    Send the student the following forms:

    • •

      SSA-1383, Student Reporting Form, see OS ; and

    • •

      SSA-453-F4, How Your Earnings Affect Your Benefits.

  2. 2. 

    Process the SSA-1372 (RS 00205.400F.6.).

3. Form SSA-1372 is received after benefits terminated and the child was in FTA in the age 18 attainment month

If the child was in FTA in the age 18 attainment month and their entitlement was erroneously terminated, treat the SSA-1372 as new and material evidence. Do not require a new application unless the period of nonattendance exceeded four consecutive months (RS 00205.320D).

Input the information per RS 00205.400F.6.

4. Student changes schools or does not graduate on schedule

If the student changes schools or does not graduate on schedule, they must complete another SSA-1372, have their attendance certified by a school official, and return pages 2 and 3 to the FO for processing.

The FO inputs new entitlement data to the STUD screen (MSOM COMMON 005.029) based on the new SSA-1372. See RS 00205.400F.6., step 4, in this section.

5. Form SSA-1372 is received after benefits terminated and the child was not in FTA in the age 18 attainment month

If we receive a Form SSA-1372 after terminating benefits and the child was not in actual or deemed FTA in the age 18 attainment month (RS 00205.320D), send the child a notice informing them of our decision. Include paragraph number 209 (with appropriate fill-ins) from NL 00708.100.

6. Processing Form SSA-1372

Process the Form SSA-1372 as follows:

STEP

ACTION

1

Review Form SSA-1372

  • •

    To resolve any discrepancies; and

  • •

    To determine if there are factors that preclude student entitlement (e.g., incarceration (RS 00205.130), being paid by an employer to attend school (RS 00205.125A.1.)).

Does it appear the child may qualify for student benefits?

If yes, go to step 2.

If no, go to step 5.

2

 

 

Determine if the school the child is attending is an EI as discussed in RS 00205.250.

Does the development indicate the school is an EI?

If yes, go to step 3.

If no, go to step 5.

3

Determine if the child is in FTA as discussed in the following sections:

Does school certification establish the child is in FTA?

If yes, go to step 4.

If no, go to step 5.

4

Follow the instructions in MSOM COMMON 005.029 to process the conversion to student benefits.

Absent evidence to the contrary, consider the student to be a capable adult and pay benefits directly to them. Appoint a representative payee (payee) only if the student is incapable of managing benefits. Continue entitlement while developing a payee.

NOTE: 

Be aware that the beneficiary may be receiving another benefit, such as SSI, through a payee. The same payee must be appointed for all benefits to which the beneficiary is entitled (GN 00502.183B.3). If the beneficiary is already receiving benefits through a payee, you must complete a new capability determination prior to paying the beneficiary directly (GN 00502.055C).

Code the STUD screen (MSOM COMMON 005.029) based on the student's expected graduation date from a secondary school and considering age 19 attainment (RS 00205.325). Enter the school’s operating basis as certified by the school official in question 3 on page 3 (Certification by School Official) of the SSA-1372.

Fax the SSA-1372 into NDRed or eDIB.

Destroy the paper copy after viewing for content in either the EP or eView.

If PC action is necessary, in addition to faxing the form into NDRed or eDIB, fax the form into the PPL repository.

NOTE: 

If the initial POS action excepts, T2R will automate a Paperless ACR to the jurisdictional PC. In these situations, there is no requirement to fax the document directly into Paperless.

5

The system automatically terminates benefits at age 18 if student data or disability data is not posted to the Master Beneficiary Record (MBR).

Fax the SSA-1372 following the instructions in step 4. If the child is also applying for disability benefits, annotate Form SSA-1372 “Not full-time student” and fax it with the disability material.

G. Procedure for VA non-insured cases

In Veterans’ Administration (VA) non-insured cases (RS 01702.540), forward completed student development and supporting evidence to the PC for processing.

If the child qualifies as a student, the PC prepares the award and lists the case under code 166, Development of Non-Insured VA Payment, (RS 01702.558 and RS 01702.562).

If the child does not qualify as a student, the PC prepares an amended award to terminate the child's benefits and adjusts rates to the remaining beneficiaries (RS 01702.572).

To Link to this section - Use this URL:
http://policy.ssa.gov/poms.nsf/lnx/0300205400
RS 00205.400 - Processing Claims and Conversion Cases for Student Benefits - 09/05/2023
Batch run: 12/06/2024
Rev:09/05/2023