TN 111 (06-24)

NL 00703.596 Lump Sum Death Payment-Potential Eligibility

Document Identifier for Word Processor: E4029

A. Exhibit Letter

We are sorry to learn of your loss. Please accept our sincere sympathy. Our records show that you may be entitled to a Lump-Sum Death Payment (LSDP) of $255.00 on (1) record.

The Lump-Sum Death Payment is paid in the following order of priority to:

1. The surviving spouse who was living in the same household with the worker at the time of death.

2. A surviving spouse who is entitled to or eligible for monthly benefits in the month the worker died.

3. A child who is entitled to or eligible for benefits for the month the worker died. If more than one child qualifies, the children share equally in the lump-sum.

What To Do Next

You should get in touch with us right away because an application for the LSDP must be filed within two years of the insured person’s death. This time can be extended if “good cause” is established for failure to file within the initial two-year period.

What Will Happen

If you file an application, we will review the case and make a decision. If you do not agree with what we decide, you will be able to appeal the decision.

Suspect Social Security Fraud?

Please visit or call the Inspector General's Fraud Hotline at 1-800-269-0271 (TTY 1-866-501-2101).

If You Have Questions

We invite you to visit our website at on the Internet to find general information about Social Security. If you have any specific questions, you may call us toll-free at 1-800-772-1213, or call your local Social Security office at (2). We can answer most questions over the phone. If you are deaf or hard of hearing, you may call our TTY number, 1-800-325-0778. You can also write or visit any Social Security office. The office that serves your area is located at:


If you do call or visit an office, please have this letter with you. It will help us answer your questions. Also, if you plan to visit an office, you may call ahead to make an appointment. This will help us serve you more quickly when you arrive at the office.

B. Requesting Instructions

When a claimant dies and no eligible spouse is currently receiving benefits on the record, the lump sum death payment is not released automatically by the system. Therefore, the T2 Entitlement and Eligibility (EE) business process produces the A2I408 alert and may also generate a A2I412 alert.

Use this notice to communicate to the survivors of the deceased that they may be eligible for the lump sum death payment.


  1. (1) 

    Name of Deceased’s

  2. (2) 

    Field Office Address City, State ZIP

C. Typing Instructions

Information for this notice will be shown on the Form SSA-573. Address the notice to the Family of the Deceased or a Survivor named on the record.

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NL 00703.596 - Lump Sum Death Payment-Potential Eligibility - 06/28/2024
Batch run: 06/28/2024