GN 00302.380 Development Required When Uninsured Spouse of Worker Previously Applied for HI on the Worker's Record

A. Background

As explained in HI 00801.022ff, an uninsured spouse may apply for HI coverage based on his/her spouse's E/R even if the spouse is not yet applying for coverage or monthly benefits. In this situation, proof of age must be submitted for both the worker and uninsured spouse to establish the spouse's eligibility for HI.

Since the MBR resulting from this type of claim is set up under the uninsured spouse's SSN, no record is established to reflect what evidence of age was submitted or DB estabished for the worker. As a result, when the worker later files for benefits, it is difficult to determine what DB to establish for the current claim.

SSA can not assume that the DB now alleged is the correct DB because it is not known whether the current allegation agrees with the prior determination (or whether an exact DB was even determined previously—see GN 00302.370).

B. FO procedure

FO's must obtain preferred evidence if readily available. If not available or the claimant is unwilling to resubmit, use interim documentation. Develop additional evidence as needed. Review certified copies from the PC and adjudicate the claim under normal procedures.


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GN 00302.380 - Development Required When Uninsured Spouse of Worker Previously Applied for HI on the Worker's Record - 03/23/2012
Batch run: 03/23/2012
Rev:03/23/2012