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TN 45 (11-11)

GN 00205.001 Application Forms

A. Introduction

1. Acceptable application

An acceptable application for benefits can be any of the following.

  • A Modernized Claims System (MCS) or Modernized Supplemental Security Income Claims System (MSSICS) printout.

  • An SSA-approved application produced by personal computer (see GN 00204.002 for prescribed applications).

  • An Internet claim (iClaim) application printout. (For more information about iClaims, see GN 00204.055.) or

  • A traditional paper application form.

2. Purpose of the application

The application:

  • serves as a claim when the applicant signs and files the application. (For more information about valid applications, see GN 00204.001.)

  • secures information needed for adjudicating the claim.

  • provides the field office (FO) and Program Service Center (PSC) with leads and information about development needed on some phase of entitlement, computations, or payment.

  • may contain lead questions about other possible benefits for claimants, or may serve as a protective filing for prospective beneficiaries named on the application. (For more information on protective filing, see GN 00204.010.)

B. Description of consequences of certain answers

If

Then

The claimant does not answer all questions affecting entitlement.

Do not process an award.

The claimant refuses to agree to notify us of events that would stop payments, require deduction, or terminate entitlement.

We cannot make payment (we can process an award).

We know of no events that would terminate entitlement or bar payment.

We can make payment (but future termination of suspension actions may occur).

C. Procedure for completion of an application for benefits

Do the following before and during the completion of an application for benefits.

Step

Action

1

Find out if there are other eligible claimants during the pre-claim interview.

2

Review the penalty information with the claimant.

3

Establish a claim if answers about “current” and “prior” months pertain to a protective filing date (PFD) or the date the application is completed.

If answers pertain to a PFD, go to step 4.

If not, go to step 5.

4

Alter the affected questions on the application, or add a statement in “Remarks,” on an SSA-795, or on an RPOC screen stating that the protective filing date is the basis for the answers.

5

Complete paper applications in ink. We require paper applications from personal computers be printed in blue or black ink on white paper.

EXCEPTION: Accept a mailed application completed in pencil, if legible.

6

Review the application to ensure that the claimant answered all pertinent questions, and the answers are clear and legible. (For the procedure on preparing for adjudication, see GN 01010.007D.)

NOTE: Use “Unknown,” if the claimant does not know an answer or is uncertain of an answer.

When mailing an application, tell the claimant to answer all items or mark unknown answers as, “Unknown.”

7

Ask the claimant to review all answers and sig