TN 1 (10-20)

RM 03812.012 Potential Claim Involved

1. A. 

   Review all related case material to determine if any of the following conditions exist:

   1. 1. 

      The NH expresses an intent or desire to apply for disability benefits.

   2. 2. 

      The NH is age 61 and 8 months or older, and expresses an intent or desire to apply for benefits.

   3. 3. 

      The inquirer advises that the NH is deceased.

2. B. 

   If the case meets one of the conditions in A above:

   1. 1. 

      Scout for the alleged earnings per RM 03803.028 and RM 03809.

   2. 2. 

      Request a certified earnings record (SSA-794 C1). This action should be taken whether or not there is an unresolved coverage issue or a discrepancy between alleged and reported wages.

   3. 3. 

      Do not prepare an earnings determination even if all necessary evidence is attached.

   4. 4. 

      Upon receipt of the certified earnings record, route all related material to the servicing FO per RM 03803.011.

3. C. 

   If the case does not meet one of the conditions in A above, but NH is age 61 and 8 months or older:

   1. 1. 

      Handle as a regular disagreement case and prepare a closeout letter or initiate an ED as appropriate per RM 03803.

   2. 2. 

      Include the following in each closeout letter sent in “completed” disagreement cases:

      1. a. 

         A statement as to the NH's insured status.

      2. b. 

         If the NH is insured, include a statement that he/she is eligible to apply for social security benefits and may wish to get in touch with his/her social security office.

      3. c. 

         If the NH is not insured, include a statement that even though he/she does not yet have enough quarters of coverage to be eligible for benefits, his /her social security office will be glad to discuss the requirements with him /her.

         NOTE: If the MEF printout reflect less than 40 quarters of coverage, it will be necessary to request an SSA-1826 before the information in C.2. above can be provided. Refer to RM 03812.013B for a detailed explanation of this requirement.