A dependent adult child, who files for ESRD Medicare benefits based on the insured
status of a parent, must provide proof of dependency by meeting dependency requirements
for entitlement to child's social security benefits on the basis of a parent's earnings
(see GN 00306.002C), and meet one of the three additional conditions:
-
-
2.
is under a disability that began before age 22; or
-
3.
is under age 26, is receiving at least one-half support from that parent, and has
continuously received at least one-half support from that parent since the day before
attaining age 22.
If the field office (FO) cannot establish one of the conditions under (1) or (3) and
there is no determination of a disability that began before age 22, the FO must send
the case to the Disability Determination Services (DDS) to decide whether the dependent
adult child met the requirements for disability prior to age 22.
When a DDS determination is needed to prove dependency, the FO takes the following
actions:
-
•
Send the case to the DDS for a prior to age 22 disability determination.
-
•
Include in the folder, a completed SSA-3367, SSA-3368, SSA-827, and any available
medical evidence provided by the claimant.
-
•
Add the remark to the SSA-3367, "ESRD Medicare only, disability determination prior
to age 22 needed."
NOTE: These cases are EDCS exclusions
For further information about FO dependency documentation and decisions, see DI 11052.005E.