TN 45 (11-11)

GN 00205.038 Retirement, Survivor Insurance (RSI) Applications When Claimant Alleges Disability

A. Procedure

1. No disability insurance benefits (DIB) insured status and a title XVI claim is pending

Unless an exception in SI 00601.035B.1. exists, complete a separate title II application. Complete an abbreviated title II application if the claimant meets the requirements in GN 00204.009 B.1. If the claimant does not meet all of the requirements, complete a full disability application. (See SI 02309.010 for processing the insured status (KZ) diary for title XVI claimants already in current pay status.)

2. Title II claim only and no DIB insured status

a. RSI claimant alleges disability and he or she is or was ineligible for DIB or freeze

If an RSI claimant alleges disability (or a Survivor claimant alleges that the deceased numberholder (DNH) was disabled) but is or was ineligible for DIB or freeze because he or she does not have disability insured status, take the following actions.

  • Process the RSI claim.

  • Do not complete an SSA-16-BK or Modernized Claims System (MCS) equivalent (unless the claimant insists on filing for DIB).

  • Document the file that you are not pursuing disability benefits (use the RPOC screen for MCS applications) and state the reason.

b. DIB insured status could be met based on earlier onset or freeze

If the claimant does not meet DIB insured status based upon an earlier onset or because a prior freeze period ended within the past 5 years:

  • complete an SSA-16-BK or MCS equivalent, and

  • forward the DIB claim to the Disability Determination Services (DDS) or program service center (PSC) for the disability determination.

c. Uninsured claimant insists on filing a DIB application

If the uninsured claimant insists on filing a DIB application:

  • complete an SSA-16-BK or MCS abbreviated application, but do not send it for a disability determination.

  • process the RIB application, wait one day and trigger the DIB denial.

3. Title II application and onset alleged after first day of fifth month before full retirement age

If the claimant does not wish to limit the scope of his or her application, it is a claim for a freeze and DIB, and Retirement Insurance benefits (RIB), auxiliary, or survivor benefits.

  • Process the RSI claim if an earlier onset date is not possible and there was no prior freeze, or DIB, which ended within 5 years before the month the current disability began.

  • Do not complete an SSA-16-BK or MCS equivalent and do not request a disability Earnings Computation (EC) or Informational/Certified Earnings Records (ICERS).

  • Document the file (on the RPOC screen for MCS applications) that you are not pursuing disability benefits and state the reason.

EXAMPLE: John worked steadily until 01/15/11 when he was in a car accident that paralyzed him. Since there is no reason to question the alleged onset date and he will be FRA on 04/12/11, no DIB application is completed.

B. References

  • Adjudicating Title II When a Title XVI Application Is Filed, SI 00601.035

  • Disability Insurance Benefits (DIB) and Freeze, DI 11010.000

  • Title II Technical Denials, and Claims Not Requiring a Disability Determination, DI 11010.075


To Link to this section - Use this URL:
http://policy.ssa.gov/poms.nsf/lnx/0200205038
GN 00205.038 - Retirement, Survivor Insurance (RSI) Applications When Claimant Alleges Disability - 11/10/2011
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