TN 63 (07-23)

GN 01010.300 Handling Unknown Address Claims

A. Policy on handling unknown address

When a benefit entitlement is established but the claimant’s whereabouts become unknown, make every effort to locate them. Query the Master Earnings File (MEF), the Supplemental Security Record (SSR) or contact employers, friends, neighbors, etc., for leads to the claimant's whereabouts. If after all the development you cannot determine the claimant's address, follow the instructions below.

B. Procedure for claims with continuing monthly benefits

Use the following procedure when you cannot find a correct address for the number holder (NH) and immediate processing is necessary.

1. Benefits payable to auxiliaries

Continue to pursue the unknown address development on a post adjudicative basis when benefits are currently due to beneficiaries.

  1. a. 

    If the claimant with the unknown address is the NH and auxiliary benefits are payable:

    • Show the last known address for the NH in the Modernized Claims System (MCS) address (ADDR) screen;

    • Use the report of contact (RPOC) screen to document the file describing the steps you took to locate the NH and the various responses received that led you to conclude that the NH's address is unknown.

    • Access the MCS suspension screen by selecting function # 8 (Suspension events) on the MCS System Menu (MENU) and select suspension code #12 (Develop for address) per MCS 009.016.

    • Establish a diary to control the address development using the MCS DECI screen, see GN 01010.260.

    • Process the claim via MCS Earnings Computation (EC) whenever possible, otherwise process manually via Automated 101 (A101).

    The Master Beneficiary Record (MBR) updates claims processed with proper “Address Unknown” coding to a suspense status “S-6”.

    NOTE: Exercise caution in approving the award if there is uncertainty regarding the NH's present work deduction status. Failure to enter proper deduction data could lead to substantial overpayments.

  2. b. 

    If an auxiliary or survivor has an unknown address, the family maximum is involved and immediate payment is due to the other beneficiaries, process the claim as:

  • A partial award per GN 01010.110 and GN 01010.120; or

  • Delay payment to the claimant with the unknown address per GN 01010.140; and

  • Document the claims file using the RPOC to explain the partial adjudication reason or delay payment.

2. Claims with no auxiliaries involved

If the claimant is a sole survivor or a NH without auxiliaries and the address is unknown, place the beneficiary in suspense status S-6 (Address Unknown) using procedures in GN 01010.300B1.a.1.

C. Procedure for claims involving lump sum death payments (LSDP) or Medicare entitlement

Do not use the procedure in section B of this chapter for Lump Sum (LSDP), Medicare-only, uninsured Medicare or End-stage Renal Disease (ESRD) claims. They are system exceptions and cannot be process properly thru MCS EC.

1. Exception actions

Process the claims for LSDP, Medicare-only, Uninsured Medicare or ESRD via A101 or Electronic Form 101 (EF101) and transfer the claim to the proper Processing Center (PC). You must include the following remark on the RPOC “ADDRESS UNKNOWN” and document the attempts taken to locate the beneficiary

2. Field Office (FO) referral

If there are other unique issues (e.g., fraud) or questions regarding proper handling of an “Address Unknown” claim, refer them to the proper Regional Office (RO) component.

3. PC Actions

Refer all District Office Final Authorization (DOFA) claims processed using the above “Address Unknown” to a claims authorizer (CA) for post adjudicative review. The CA will ensure that the prior adjudicator explored all necessary avenues of development. If after review, the CA concludes that “whereabouts” is unknown, the CA must follow procedures in SM 03020.290.

D. References

  • GN 01010.110 Partial Adjudication

  • GN 01010.120 Common Partial Adjudication Situations

  • GN 01010.140 Delayed Claim and FO Actions

  • GN 01010.260 Listings, Diaries and Notices – Adjudication

  • SM 03020.290 Develop For Whereabouts Unknown (WHRU)

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GN 01010.300 - Handling Unknown Address Claims - 07/26/2023
Batch run: 07/26/2023