TN 85 (02-17)
GN 00204.030 Retroactivity for Title II Benefits
A. Policy of retroactivity
Retroactivity involves all months before the month of filing that the claimant is eligible to receive benefits. Our decision to allow retroactivity depends on:
Depending on the claim situation, retroactivity could affect the number holder’s (NH) Primary Insurance Amount (PIA) and the eligibility date for Medicare or other eligible benefits.
The NH protects the filing date of auxiliaries on his or her claim by listing them on the application. Therefore, an auxiliary who files timely has a protective filing date that is the same as the NH's application filing date, which therefore changes the auxiliary benefits.
Effective January 1, 1991, section 5116 of the Public Law (P.L.) 101-508 eliminated two situations when we could pay retroactive reduced benefits. Retroactive reduced benefits are no longer payable when:
The NH is filing for retirement benefits and an unreduced auxiliary (but not an independently entitled divorced spouse) is entitled; or
We charge off excess earnings to service months before the month of filing.
NOTE: When applicable, advise the claimant that payment of retroactive benefits will result in a permanently lower ongoing monthly benefit amount.
B. Retroactivity for retirement insurance benefits (RIB)
1. Applications filed before full retirement age (FRA)
We do not allow retroactivity for reduced RIB benefits. The first possible date that we can pay reduced benefits is the date the NH (or proper applicant) files an application, or protects his or her filing date, and meets all factors of entitlement. If, at the time of application, the NH (or proper applicant) elects an earlier month of entitlement based on a protective filing date, explain that electing the earlier month of entitlement will result in a permanently lower ongoing monthly benefit amount. For more information on protective filing, see GN 00204.010.
2. Applications filed after FRA
For RIB applications filed after FRA, we allow up to 6 months retroactivity. However, for those who file less than 6 months after FRA, we only pay retroactive benefits back to the month of FRA attainment. If a claimant is eligible and elects retroactivity, explain the effect the retroactive payment will have on the ongoing monthly benefit amount when electing to start benefits in a retroactive month at any time before age 70 (i.e., taking the lump sum payment will permanently reduce the ongoing monthly benefit amount).
C. Retroactivity for unreduced retirement and survivor insurance (RSI) benefits
We allow retroactivity up to 6 months for unreduced RSI claimants.
EXCEPTION: Certificates of election of reduced spouse’s (or reduced widow(er)’s and surviving divorced spouse’s benefits can be retroactive for up to 12 months. For more information on certificates of election for reduced spouse’s benefits, see RS 00202.055. For more information on certificates of election for widow(er)’s and surviving divorced spouse’s benefits, see RS 00207.025.
D. Retroactivity for widow(er)’s insurance benefits (WIB)
1. Application after widow(er)’s FRA
We allow up to 6 months retroactivity for WIB claimants who file an application after he or she attains FRA. However, for those who file less than 6 months after FRA, we only pay retroactive benefits back to the month of FRA attainment.
We allow retroactivity up to 6 months if we base the widow(er)’s benefit amount for both the month of filing and the month of election (MOEL) on the Retirement Insurance Benefit limitation (RIB-LIM). For more information on the RIB-LIM, see RS 00615.320.
2. Application filed before widow(er)’s FRA
We can allow retroactivity for reduced WIB claimants filing an application before he or she attains FRA in certain situations. They are:
Widow(er) files in the month immediately following the NH’s month of death
We allow retroactivity for 1-month if the widow(er) meets all other factors of entitlement in the month of the NH’s death.
Widow(er)’s benefit amount is based on RIB-LIM
We allow retroactivity up to 6 months if we base the widow(er)’s benefit amount for both the month of filing and the month of election (MOEL) on the RIB-LIM. For more information on the RIB-LIM, see RS 00615.320.
Disabled widow(er) files before age 61 attainment
We allow retroactivity up to 12 months for a widow(er) who is disabled and not age 61 in the month he or she files. Investigate the claimant’s possible entitlement to disabled widow(er)'s benefits. For more information about disabled widow claims, see RS 00207.009.
Disabled widow(er) and at least age 61 in the month of filing
We allow up to 12 months of retroactivity for counting the 24-month Health Insurance (HI) benefits waiting period. For more information about HI and disabled widow claims, see RS 00207.007.
E. Retroactivity for Disability Insurance Benefit (DIB)
We can allow retroactivity up to 12 months for DIB claimants and his or her auxiliaries (i.e. child, young spouse). However, retroactivity cannot be before the NH’s date of disability onset or 5-month waiting period. For more information on retroactivity for DIB applications, see DI 10105.015.
F. Retroactivity for childhood disability benefits (CDB)
We can allow up to 6 months of retroactivity for CDB claimants if the NH receives RIB. If the NH receives DIB, we allow 12 months of retroactivity for a CDB claimant. For more information on retroactivity for CDB applications, see DI 10115.030.
G. Retroactivity for Hospital Insurance (HI)
We can allow up to 6 months retroactivity for HI when the claimant files for RSI benefits. When a NH files for DIB, we can allow up to 12 months of retroactivity for HI. For more information on HI retroactivity, see HI 00801.022.