Effective Dates: 01/21/2011 - Present Previous | Next

TN 88 (02-26)

GN 00203.002 Discussing Title II and Title XVI Filing Options

A. Background

If someone contacts SSA to apply for a specific benefit, they may not be aware of other benefits they could get based on their age or relationships. Technicians must inform them about all benefits they may qualify for, and explain program policies so the individual can make an informed decision about applying.

NOTE: For information on interviewing Medicare claimants, see GN 00203.025.

B. Policy for discussing filing options

Technicians must evaluate the individual’s record to determine the benefits they may qualify for, explain the eligibility requirements, and inform them of their option to file an application to get a formal determination with appeal rights.

Technicians should always begin the discussion with Title II benefits. This discussion should inform the technician if there is a need to discuss SSI eligibility (e.g., entitlement to the Title II benefit would preclude SSI eligibility).

Note: 

NoteSSI claimants and recipients must file for Title II benefits for which they are eligible to maintain their elegibility for SSI. Follow the policy and procedures in SI 00510.001.

Important: When discussing benefit eligibility be aware of recent filings that were denied. If the individual is requesting to file a new application based on a recent denial, determine if the appeal process or reopening is applicable. See GN 03101.060, GN 04001.040, and GN 04001.050 for more information.

C. Identifying potential eligibility to Title II benefits

Depending on an individual’s age and eligibility for benefits, there may be multiple benefit types to consider. Always identify if the individual is currently receiving a Title II benefit(s) or SSI payment before identifying other benefits or payments. Entitlement or eligibility to a Title II benefit or Title XVI payment can affect the filing options or requirements to other benefits. The chart below can help you identify which Title II benefits to discuss with the individual.

Title II Benefit

Age

Eligibility Requirements

Retirement Benefits

(RS 00202.001)

62 or older
  • •

    Fully Insured

Spouse's Benefits

(RS 00202.001B.5)

62 or older

 

 

 

 

 

 

Under 62
  • •

    Currently married for at least one year, and

  • •

    NH entitled to DIB or RIB,

    OR

  • •

    Divorced,

  • •

    Married at least 10 years, and

  • •

    NH entitled to RIB or DIB, or

  • •

    NH attained age 62, and fully insured,

    OR

  • •

    Has a child under age 16 or disabled and entitled to benefits on spouse's earning's record, and

  • •

    Has been married to the spouse for at least one year.

 

NOTE: For alternatives to marriage requirement, see RS 00202.001B.5.

Parent's Benefits

(RS 00209.001)

62 and older
  • •

    NH died fully insured,

  • •

    CL received ½ support from NH (see RS 00209.010) and filed proof of support within time limits described in RS 00209.010, and

  • •

    CL did not marry after NH's death.

Widow(er)'s Benefits

(RS 00207.001)

60 or older
  • •

    NH died fully insured,

  • •

    Married 9 months, or 10 years if marriage ended in divorce, and

  • •

    Not currently married, or remarriage occurred after attainment of age 50 and disabled at time of remarriage.

Disabled Widow(er)'s Benefits

(RS 00207.001.A.3)

50-59
  • •

    Meets the requirements for widow(er)'s benefits,

  • •

    Has medical impairment or blindness (see disability requirements, and

  • •

    Disabled within the prescribed period (e.g. within 7 years of NH's death).

Mother's/Father's Benefits

(RS 00208.001, (RS 00208.010)

60 and older
  • •

    Widow(er) of a NH who died fully or currently insured,

  • •

    Not entitled to widow(er)'s benefits, and

  • •

    Has in care the deceased's child who is entitled to child benefits.

Disability Benefits

(DI 10105.060)

18-FRA

Childhood Disability Benefits (CDB)

(RS 00203.001)

18 - FRA
  • •

    Child of NH either entitled to RIB or DIB, or died fully or currently insured,

  • •

    Unmarried, and

  • •

    Disabled prior to age 22, or

  • •

    Disabled after age 22, and

  • •

    Previously entitled to CDB, and

  • •

    Disability began before the close of the 84-month period following the month in which CDB was terminated.

Child's Benefits

(RS 00203.001)

Under 18

 

 

18
  • •

    Child of NH either entitled to RIB or DIB, or died fully or currently insured,

  • •

    Dependent on NH, and

  • •

    Unmarried.

  • •

    Meets all requirements above, and

  • •

    Is a full-time elementary or secondary school student under age 19.

D. Discussing Title XVI eligibility

When individuals apply for a Title II benefit, technicians must explore their eligibility for SSI and obtain a filing decision only when they are:

  • •

    within 2 months of age 65 or older, or

  • •

    alleging disability or blindness.

Technicians do not need to discuss SSI under the following situations:

  • •

    An SSA-L991 notice was issued stating the individual did not want to apply for SSI.

  • •

    The individual applies for disability online (i.e., iClaim) and answers "no" to the intent to file for SSI question.

  • •

    The individuals is entitled to a Title II benefit that precludes SSI eligibility and any federally administered State supplement.

E. Explaining Title II program policies

Technicians must explain how certain program policies may affect current and future entitlement or eligibility to benefits so individuals can make an informed decision as to the type of benefit(s) for which they want to apply. Do not attempt to persuade the claimant about benefit decisions. Instead, provide the individual with Title II program information.

1. How work affects benefits

Explain how work may affect their eligibility or payments:

  • •

    Under FRA: Explain how their work will affect their benefits (see RS 02501.001 through RS 02501.075)

  • •

    Disability benefits: Explain how work may affect their eligibility for Title II benefits and Title XVI payments (See DI 10501.005B.)

  • •

    When to start benefits: Follow the policy and procedures in GN 00204.039.

2. What to consider when eligible for multiple benefits

Individuals may be eligible for more than one benefit; therefore, it is important for them to understand their filing options:

a. RIB and DIB

  • •

    Explain they can apply for both benefits and receive RIB while waiting for a DIB determination. In this situation, a conditional withdrawal statement is needed as part of the application which can be process if DIB is approved. (GN 00206.005)

  • •

    Explain how entitlement to a reduced RIB may reduce their DIB benefit amount if the DIB entitlement date is later than the RIB MOE. (RS 00615.401)

  • •

    Explain months of DIB entitlement will be excluded from the RIB reduction factor at FRA.

b. RIB and WIB

Explain the option to file for a reduced WIB and wait to file for RIB to obtain a higher benefits. (See RS 00615.301 for reduced WIB and RS 00615.690 for Delayed Retirement Credits (DRC).

c. RIB and Spouse

Explain how the deemed filing policy affects the month of entitlement for spouse’s benefits. (See GN 00204.035)

d. WIB and DIB

Explain how entitlement to DIB may result in a permanent reduction to their reduced widow(er)'s benefit. See (RS 00615.420)

3. Terminal Illness (TERI) and Presumptive disability or blindness (PD/PB)

Consider whether the case meets the requirements for a or terminal illness (TERI) (DI 11005.601 ) or presumptive disability/presumptive blindness (PD/PB) determination (DI 23535.001 ). DI 11005.006 provides special processing instructions for disability claims resulting from Operation Iraqi Freedom.

4. What to consider when other program payments are involved

Title II benefits may reduce payments from other programs, such as Railroad Retirement (RR) annuities, Veterans Affairs (VA) payments, or private pensions that could result in a decrease in their total monthly income.

a. Railroad Retirement Benefits

When individuals or their current or former spouse are eligible for or are receiving Railroad Retirement Board (RRB) benefits, they should contact their local RRB office to determine if they should apply for Title II benefits. For more information, see RS 01602.005.

b. Veterans Affairs (VA) Pension

Individuals receiving a VA survivor benefit should contact the VA to obtain a full explanation of pension income limitations before filing for Title II benefits. For more information, see RS 01702.410C.

c. Black Lung (BL) Benefits

Explain that Title II disability benefits based on a miner’s earnings may be reduced if the claimant receives Part C Black Lung benefits.

F. Explaining Title XVI program policies

Explain that eligibility for SSI payments is based on need, and the income and resource limits are specified by law. To determine initial and continuing eligibility, we collect information about the claimant’s income and resources. If the claimant is living with his or her spouse or parent (if claimant is a child) we collect their income and resources too.

Explain even if they meet the basic SSI eligibility requirements, their claim will be denied if they:

  • •

    Do not give us permission to contact any financial institution to request financial records about them.

  • •

    Fail to apply for all other benefits for which they may be eligible. For more information see, SI 00510.001 through SI 00510.030.

1. Multi-category eligibility

When individuals appear to be eligible under more than one category (i.e., age, blindness, or disability) explain their filing options (i.e., receive payments under one category while developing for the other). For more information, see SI 00501.300.

Reminder: Individuals who were lawfully residing in the U.S. on 8/22/96 and are blind or disabled may be eligible for SSI benefits. (See SI 00502.142 for the eligibility requirements.)

2. Excess resources

  • •

    Burial funds and spaces

    Individuals who appear to be ineligible based on excess resources may become eligible based on the SSI policies on burial funds (SI 01130.410) and spaces (SI 01130.400) For more information see GN 00203.001D. for accessing the SSI Spotlight on Burial Funds.

  • •

    Conditional benefits

    Individuals may be eligible for conditional benefits (SI 01150.200 - SI 01150.210) if they have:

    • –

      resources that exceed the limit due to excess non-liquid resources, and

    • –

      their liquid resources do not exceed triple the Federal Benefit Rate (FBR) or do not exceed triple the FBR by a great deal.

G. The filing decision

The decision to file belongs solely to the prospective claimants or their proper applicant. Technicians should obtain the Title II filing decision and take the Title II claim before discussing SSI eligibility. Taking the Title II application first will provide insight into factors pertaining to SSI eligibility, such as citizenship or immigration status, residency, income and relationships (i.e., marriage and children).

If an individual is eligible for more than one type of benefit technicians must explain the impact of a filing decision that may adversely affect the claimant’s current or future benefits. If the individual decides to file after explaining the adverse effects, take the application and document the decision. See GN 00203.004B.6 for documenting the filing decision.

To Link to this section - Use this URL:
http://policy.ssa.gov/poms.nsf/lnx/0200203002
GN 00203.002 - Discussing Title II and Title XVI Filing Options - 01/21/2011
Batch run: 02/17/2026
Rev:01/21/2011