TN 45 (11-11)

GN 00205.035 Disability Questions for Retirement, Survivors, Disability Insurance (RSDI) Applications

A. Introduction

The disability question on selected applications is a screening aid for deciding whether to develop entitlement for Disability Insurance benefits (DIB). This question is part of the IDEN screen on Modernized Claims System (MCS) claims.

B. General procedure for deciding whether to develop entitlement for DIB

1. When to discuss DIB

a. Number holder (NH) filing for retirement insurance benefits (RIB)

When the NH is filing for RIB, discuss filing for DIB when the claimant:

  • is no more than 12 months beyond his or her full retirement age (FRA);

  • alleges he or she is unable to work because of a disabling condition that began on or before the first day of the fifth month before the month of attainment of FRA; and

  • has disability insured status within one year of alleged onset.

b. NH's work significantly reduced or ended because of illness or injury

If the NH's work has been significantly reduced or ended because of illness or injury, discuss the possibility of filing for DIB even if the NH feels that he or she will be able to return to work.

c. Consider developing for DIB on auxiliary's own Social Security number (SSN) or disabled widow(er)’s benefits (DWB) or childhood disability benefits (CDB)

Consider developing for DIB on the auxiliary's own SSN (or a disability freeze) or DWB or CDB if there:

  • are lengthy gaps in the claimant's recent work history

  • is a pattern of low and irregular earnings following a period of substantially higher earnings

d. Survivor alleges NH disabled before death

If the survivor alleges that the NH had a disabling condition before death and the survivor files the application within 3 months following the month of the NH's death, follow GN 00204.005.

e. Consider eligibility for CDB

Consider eligibility for CDB for any claimant who alleges a date of onset prior to age 22.

2. What to discuss

Discuss the following with the claimant:

  • the disability requirements

  • the possibility of filing a DIB-RSI (or freeze-RSI) claim

3. Documentation

a. Claimant alleges he or she is disabled

If the claimant alleges that either he or she is disabled, document that either he or she:

  • filed an SSA-16-BK or MCS equivalent;

  • requested an appeal on a disability denial or a determination of cessation; or

  • signed a statement indicating he or she does not wish to file for a DIB or freeze and the reason for this decision.

b. Claimant alleges deceased NH disabled at least five months before FRA or death

If the claimant alleges the deceased NH (DNH) had a disabling condition at least five months before FRA or death (whichever is earlier), document as described in GN 00205.035B.3.a.

NOTE: No documentation is required if the DNH was clearly ineligible for DIB or freeze because the DNH was not insured or the DNH died either within the waiting period, more than 12 months after FRA, or more than three months before an application was filed on the DNH's behalf.

C. Procedure if an RSI beneficiary wants to file for DIB

If an RSI beneficiary wishes to file for DIB, handle as a regular disability claim. Notify the servicing Program Service Center (PSC) if information is received that would affect the benefit being paid.

D. References

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