If the widow(er) is entitled to mother’s or father’s benefits and becomes disabled,
determine if it would be advantageous for the disabled widow(er) to elect DWB per
RS 00207.005B. Additionally, review the widow(er)’s own earnings record to determine if he or she
is insured for DIB, following instruction in DI 11015.001B.
NOTE: A mother or father beneficiary can be deemed to be entitled to DWB for health insurance
(HI) purposes only, so he or she may wish to establish eligibility to DWB solely for
HI purposes.
Follow processing instructions in DI 11015.005B (in this section), noting that it is not necessary to establish an MCS claim to create
an EDCS case for the disabled widow(er). Create the MCS-Exclusion case in EDCS per
DI 81010.020 and DI 81010.035B.
1. If disability is established
When the DDS makes a favorable determination, use the CLAIM INT DWB barcode or Medicare
DWB barcode to fax actionable material into the PC's paperless queue. Provide the
disability onset date and other coding if necessary. In EDCS, the claims material
is faxed to the EF.
2. If disability is not established
When the DDS makes an unfavorable determination, the FO processes the disallowance
via Manual Adjustment, Credit, and Award Direct Data Entry (MACADE). For complete
MACADE processing instructions, see Disallowances, Abatements, and Withdrawals SM
00380.000.
References:
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RS 00207.005 – Widow(er)’s Benefits – Conversion of Benefits – Policy
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RS 00207.020 – Health Insurance (HI) for Disabled Widow(er)s
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RS 00208.110 – Medicare – Requirements for Entitlement – Mothers/Fathers