SSA - POMS: GN 00204.020 - Scope of the Application

A. Policy for the scope of an application

The scope of an application is the range of benefits covered by an application under:

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Title II (retirement, survivors, and disability benefits),
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Title VIII (Special Veterans Benefits),
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Title XVI (Supplemental Security Income), and
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Title XVIII (Medicare Part A).

Unless a claimant restricts the scope of their application, the application will generally cover all classes of benefits on all Social Security numbers (SSN), for which the claimant is eligible, regardless of the application’s title. For example, an application for widow(er)’s benefits can serve as an application for retirement benefits. For scope of the application exceptions see GN 00204.020B.5 in this section. Interviewers must explore potential entitlement to another class of benefits or entitlement on another earnings record. If a claimant is eligible for additional benefits, we may require a supplemental application to obtain additional information. If a claimant does not want the additional benefits, they may possibly have the option to restrict the scope of the application to exclude a specific benefit. The claimant must restrict the scope of their application prior to adjudication.

B. Benefits covered by an application

1. Title II Social Security Application

An application for one benefit under Title II (for example retirement) serves as an application for all benefits that the claimant is eligible under Title II and Title XVIII (for example, widow(er)’s, spouse’s, disability, and Medicare Part A). An application for survivor benefits under Title II also serves as an application for:

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Survivor benefits under the Railroad Act; and
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Survivor benefits through the Department of Veterans Affairs (DVA). For the policy and effect on the DVA application process when an SSA life claim converts to a survivor claim, see the note in RS 01702.410A.

NOTE: An application for benefits as a widow(er), mother or father can serve as an application for the Lump Sum Death Payment (LSDP).

2. Title VIII Special Veterans Benefits (SVB) Application

A Title VIII SVB application is also an application for Title II and Title XVI benefits. For the scope of an SVB application, see VB 00201.010D.1.

3. Title XVIII, Medicare Part A Application

An application for Medicare Part A is a retirement application that has been restricted to cover Medicare only. The instructions for abbreviated retirement applications are in GN 00204.009D.

NOTE: For information on the validity and scope of an iClaim Medicare-only application, see GN 00204.059K.2.

4. Title XVI Application, Supplemental Security Income (SSI)

An SSI application may serve as an application for the following benefits:

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Title II,
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Title XIX Medicaid,
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Federally administered State supplementation, and
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Title VIII, Special Veterans Benefits.

For more information on the scope of a Title XVI application, see SI 00601.010D1.

5. Scope of the application exceptions

We determine the scope of an application by the wording we include at the beginning of the application. Applications under Titles II, VIII, XVI, and XVIII (Part A) contain an introductory paragraph that covers all classes of benefits for which the claimant is eligible. This includes all SSNs, regardless of the title of the application.

However, there are some exceptions to the scope of benefits covered by an application. They are as follows:

a. Application for Lump Sum Death Payment (SSA-8-F4)

In February 1978, the SSA-8-F4 was limited to benefits on the deceased number holder’s (NH)'s SSN. Prior to February 1978, the scope of the application was for all Title II benefits, (including Disability Insurance Benefits (DIB)), that the claimant may have been entitled based on any earnings record.

b. Oral inquiry for SSI

Title II and Title XVIII applications are not applications for Title XVI. However, an application for Title II can serve as an oral inquiry for SSI. For the policy that explains the criteria for an oral inquiry for SSI, see SI 00601.025.

c. Application for SVB

A Title VIII application is not an application for Title XVIII (Part A).

Title II and XVI applications are oral inquiries for Title VIII.

6. When we require separate applications

Although one signed application establishes the claimant's application date for all benefits within the scope of the application, in some situations we obtain more than one application for record keeping purposes or due to systems limitations.

a. Separate Processing Centers (PC) involved

Whenever separate PCs process or maintain the claims, obtain separate applications. (For example, the spouse is simultaneously entitled to DIB).

b. Concurrent DIB/Disabled Widow(er)’s Benefits (DWB) claims

Take an application for DIB when a claimant for DWB also meets the disability earnings requirement on their own earnings record (E/R).

c. Modernized Claims Systems (MCS) claims

When adjudicating in MCS, there are situations where taking supplemental statements cannot expand the scope of the application. We may require a separate application for each claim.

C. Scope of the application examples

1. Application for Retirement Insurance Benefits (RIB) (Form SSA-1-BK)

John, age 64, files an application for RIB. They states that their spouse died. The RIB application covers widower's benefits and the LSDP on their spouse's SSN.

2. Application for Lump Sum Death Payment (LSDP) (Form SSA-8-F4)

James, age 62, files an application for the LSDP on their deceased spouse's account. The LSDP application covers widower's benefits on the deceased NH’s record but does not cover RIB on their own SSN.

D. Policy for restricting the scope of the application

When a claimant is eligible for more than one benefit at the time of filing, they may, for any reason, choose to limit or restrict the scope of the application to exclude a class of benefits unless there is an exception. The reason may be to receive higher current benefits or to maximize the amount of benefits over a period-of-time, including the effect of delayed retirement credits (DRC). For additional information on DRCs, see RS 00615.690.

NOTE: The claimant must restrict the application prior to adjudication.

1. Exceptions for restricting the scope of the application

a. Hospital Insurance (HI) (Medicare Part A) filing

A claimant who is age 65 or older must file for HI if filing for any monthly benefit. Refer to HI 00801.022 for additional information on application retirements for HI.

b. Deemed filing rule

A claimant who is eligible for both RIB and spouse’s (AUXSPO) benefits must apply for both and cannot restrict their application to only one benefit when they:

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are born January 2, 1954 or later and eligibility for both benefits exists in any month, or
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are born before January 2, 1954, under full retirement age (FRA), and eligibility for both benefits exists in the first month of entitlement (MOET) to either benefit.

For more information on the rules for deemed filing, see GN 00204.035.

2. Language for restricting the scope of the application

The claimant may restrict the scope of the application with an unequivocal statement such as:

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“I filed on (DATE) for all benefits for which I may be eligible except ___________”; or
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“I wish to exclude ________ benefits from the scope of this application.”

Qualifying phrases such as “at this time” or they plan to file in the future are not acceptable.

3. Restricting the scope of an application for Widow(er)’s Insurance Benefits (WIB)

a. Eligible for WIB on more than one record

When a widow(er) is eligible for WIB on more than one record, the widow(er) has the option to restrict the scope of the application to one record and delay filing for WIB on the other record(s) so that they may receive a higher benefit at a later date. If the widow(er) does not restrict the application, they will be technically entitled on all other records on which they are eligible. For additional information regarding a widow(er)’s eligibility on more than one record see RS 00615.301A.1.

b. Eligible for auxiliary and survivor benefits

An application for survivor benefits serves as an application for auxiliary benefits within the 6 month retroactive period (or to month of death) and up to the 12 month retroactive period for prior disabled number holders (NH). For example, where a NH was last entitled to a RIB or DIB prior to death, a survivor may be entitled to retroactive auxiliary benefits if they do not restrict the scope of the application and meets all the factors of entitlement.

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Protective filing: The MOET for the auxiliary benefits may extend past the 6 or 12-month retroactive period due to a protective filing.
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Deemed filing: The MOET for spouse’s or divorced spouse’s benefits may extend past the 6 or 12-month retroactive period if the widow(er) is deemed to have applied for spouse’s benefits.

4. Restricting the scope of an SSI application

An SSI application is also an application for Title II benefits. A claimant may choose to limit the scope of an SSI application to exclude Title II benefits. You must inform an SSI claimant that restricting Title II benefits will affect their eligibility to receive Title XVI payments. If the claimant chooses not to file after we notify them of potential entitlement to Title II benefits, follow the instructions in SI 00510.001B.6 and SI 00510.020. Also, if the claimant is a DWB, follow the instructions in HI 00801.154 and DI 11015.005 for counting months of SSI eligibility toward the 5-month waiting period, and the 24-month qualifying period for Medicare.

E. Procedure for restricting the scope of an application

The claimant may restrict the application by answering certain questions on an application or by signing an unequivocal statement. For examples of unequivocal statements, see GN 00204.020D.2 in this section.

Record the claimant’s statement to restrict the scope of the application on the RMKS screen of MCS so that we capture it under the claimant’s signature or attestation.

1. Restricting a WIB claim to exclude RIB

When a claimant files for WIB and wants to exclude RIB from the application, they must answer “No” to the question “If claimant is filing as a surviving spouse, is the claimant filing for benefits on own record?” on the Additional Benefits (ADDB) screen. MCS will generate the following statement on the application summary:

“I do not want this application to be considered an application for retirement benefits on my own earnings record.”

2. Restricting a WIB claim to exclude WIB on a different record

When a widow(er) is eligible for WIB on more than one record and wants to restrict the scope of the application to WIB on one record, you must include an unequivocal statement on the remarks section of the application.

3. Restricting a RIB claim to exclude DIB

When an RSI claimant is disabled, determine if they want to exclude DIB from the scope of the application, follow the procedures for developing entitlement for DIB in GN 00205.035.

4. Restricting a WIB or surviving divorced spouse claim to exclude RIB

A widow(er) or surviving divorced spouse may wish to exclude a reduced RIB from the scope of the application and defer filing for an unreduced RIB because of the benefit increases payable after FRA because of DRCs. See RS 00615.690 for more information on DRCs.

a. Statement to restrict the scope

When a widow(er) or surviving divorced spouse wishes to exclude RIB from the scope of their application, you must obtain an unequivocal statement to exclude the RIB, such as:

“I do not wish this application to be considered an application for retirement benefits on my own earning’s record.”

MCS will generate this statement onto the application summary when the response is “No” to the question:

“If claimant is filing as a surviving spouse, is claimant filing for benefits on own record?”

This question is located on the Additional Benefits (ADDB) screen. For more information on the ADDB screen, see MS MCS 005.012C.

b. Notices

In the paragraph Future Benefits – Own Retirement Benefit (universal text identifier (UTI) FOB003), the award notice advises the claimant to contact SSA upon attainment of FRA. The interviewer should also review and explain the question of unreduced RIB entitlement and DRCs.

5. When the MCS claim is for the benefit to be excluded

a. Claim completed but not signed

Delete the unsigned MCS claim per MCS 017.002 if the claimant later decides to restrict the scope of the application.

b. Claim completed and signed but not adjudicated

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Discuss the withdrawal procedures as appropriate per GN 00206.000, or
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Manually clear (MANCLR) the claim by following the instructions in MCS 020.004. Use this procedure only if a claim was erroneously established before the restriction of the application. Document the reason for manually clearing the claim on the RPOC or DW01 screen.

c. Claim adjudicated

Process a withdrawal in accordance with GN 00206.000. A withdrawal is not always in the best interest of an individual because the claimant forfeits all rights flowing from the application. In addition, a subsequent application may not cover the same retroactive period.

d. Claim filed on the internet (iClaim) but NOT adjudicated

When the technician establishes an iClaim RIB application on MCS before identifying the claimant’s intent to file for AUXSPO benefits only, the technician must:

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MANCLR the erroneously propagated RIB claim,
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Document the reason on the RPOC screen in MCS, and
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Subsequently establish the AUXSPO claim on MCS.

For instructions on establishing a new claim and manually clearing the iClaim refer to GN 00204.055H.3.b.

6. Restricting the scope of an iClaim application

When eligible, a claimant can restrict their iClaim application to spouse’s benefits only by answering, “Yes” to the iClaim question: “If you are eligible for both retirement benefits and spouse’s benefits, do you want to delay receipt of retirement benefits?” Therefore, you do not have to type a statement on the RMKS screen in MCS. The claims specialist (CS) must re-contact the claimant to discuss delaying RIB for AUXSPO and document the discussion on the RPOC screen. To see how the information from iClaim propagates to MCS refer to GN 00204.055.

F. References

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GN 00201.005 General Application Taking Practices
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GN 00204.022 Explore Entitlement on Another Earnings Record or to Another Class of Benefits
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GN 00205.020 Obtaining Supplemental Information
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RS 00615.480 Reduction Factor Adjustment (ARF)
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RS 00615.690 Delayed Retirement Credit (DRC)
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SI 00601.025 Protective Filing – Oral Inquiry
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SI 00601.027 Title II Application as a Supplemental Security Income (SSI) Oral Inquiry
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MS MCS 005.012 Additional Benefits (ADDB)

Program Operations Manual System (POMS)

GN 00204.020 Scope of the Application