A simultaneously entitled child will be paid on the SSN with the higher PIA, unless one of the exceptions in RS 00615.772A.2. applies.

There are three situations when we may make payment on the lower PIA. They are:

If there are other non-simultaneously entitled auxiliaries or survivors entitled on any SSN, and either RS 00615.772A.2.a. or RS 00615.772A.2.b. applies, follow these steps to determine whether payment will be on higher or lower PIA.

Step a. - On the SSN with the higher PIA, determine each benefit amount as though the simultaneously entitled child was not entitled (without combining maximums).

Step b. - On the SSN with the higher PIA, determine each benefit amount with the simultaneously entitled child and a combined maximum.

If the rate for any beneficiary in Step a. is less than in Step b., the simultaneously entitled child must be paid on the higher PIA; stop here. If not, go to step c.

Step c. - On the SSN with the lower PIA, determine each benefit amount as though the simultaneously entitled child was not entitled (without combining maximums).

Step d. - On the SSN with the lower PIA, determine each benefit amount with all entitlements and a combined maximum considered. Pay on the higher PIA if:

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  Rate in Step d. is less than rate in Step c. for any beneficiary, or;

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  Rate in Step d. is less than rate in Step b. for the simultaneously entitled child.

When a simultaneously entitled child's benefits are suspended on the higher PIA because of the worker's EPE or EXR/IRP suspension, pay benefits to the child on the lower PIA for all months of suspension. If a combined family maximum (CFM) applies because of that child's entitlement, apply the CFM on the record with the lower PIA during those months per RS 00615.770B.5.

As explained in section RS 00615.772A.2.c., this change is effective for benefits payable for

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  9/94 or later if two disability claims are involved; or

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  4/96 or later if a disability claim and a retirement or survivor claim are involved.

NOTE: This process only applies to EPE and EXR/IRP suspension cases. It cannot be used because benefits are withheld or reduced for other reasons (such as WC/PDB offset).

All children who receive payment on the lower PIA because of this change require a notice to explain the change in their payment status. Use Miscellaneous Adjustment Notice (E3311) as shown in NL 00703.311. Fill-in #2 of that notice requires dictated language to explain the reason for the change. Use the following paragraph for that fill-in. If another notice is being prepared, add the following language to that notice and do not send the E3311.

“[CHILD'S NAME] is entitled to a child's benefit on two different records. Because the benefits on one record have been suspended due to the worker's suspension, [HE OR SHE] will now receive benefits on the other record.”

Three children of Don and Wilma Kessler are eligible for life auxiliary benefits on both their records. Another child of Don's from a prior marriage to Agnes (now deceased) is eligible on both their records but not on Wilma's record. Therefore, this is not a triple entitlement situation. However, there are two possible combined family maximums. We can combine the maximums from SSN 1 and SSN 2 on SSN 1 or we can combine the maximums from SSN1 and SSN 3 on SSN 1. The larger of the two is the one that will be used to compute the benefits payable to the children. Because whichever combined maximum we choose will be on SSN 1 we can only have one combined maximum using only two of the maximums involved. If any child was entitled on all three records we could combine all three maximums in SSN 1. (See Example 2 for that scenario and see Example 3 for a scenario where we have three records with two combined maximums.)

The PIAs, maximums, and original rates on the three SSNs are as follows.

The maximums are combined as follows:

1. Don and Wilma — $744.10 +$310.10 = $1,054.20

2. Don and Agnes — $744.10 +$313.70 = $1,057.80

The children of Don and Wilma Kessler are entitled on both SSN 1 and SSN 2 which results in combination 1. above. However combination 2 is higher. Since Don's child by the previous marriage is also entitled on Don's record, that child will share in the combined family maximum.

The higher combined family maximum is $1,057.80. The children's benefits will be computed using this combined maximum. Since Don's record has the higher PIA, the children will be paid on their record. All the children entitled on Don's SSN will share in the combined family maximum.

However, there is another possibility. The fourth child, eligible on Agnes' SSN, need not file on Don's SSN. If this child is restricted to entitlement on Agnes' SSN only, the original benefit of $156.90 will be paid on the SSN. The maximums will then be combined on Don's and Wilma's SSN as follows:

This alternative appears to be more advantageous to the family as a whole. However, before advice is given to restrict an application to one SSN see RS 00203.060.

Same facts as example 1 except Don's child by Don's previous marriage is entitled on all three SSNs: their parent’s Don, their deceased parent's Agnes and as a stepchild on Wilma's SSN, resulting in a triple entitlement situation. Therefore, the maximums of all three SSNs are combined (subject to the highest family for that month). The children's rates will be paid on Don's SSN, the record with the highest PIA. The children's rates are computed as follows:

Each child will receive $205.10.

Fred and their spouse Wilma and Wilma's ex-spouse Barney are all entitled to disability benefits. Fred and Wilma have two children. Barney and Wilma also have two children.

The PIAs and maximums for each are:

Fred $300.00/450.00

Wilma $200.00/225.00

Barney $310.00/455.00

Wilma’s PIA is too high for them to be entitled on either record as a spouse. Because Fred and Wilma have two children who are simultaneously entitled on their records we can combine their maximums on Fred’s record. The maximum on Fred's record is therefore $675.00. Because Wilma and Barney also have two children who are simultaneously entitled on their records we can combine the maximums from their records on Barney’s record to be $680.00. We would then have Fred and Fred's two children paid on Fred's record, Wilma paid on their record and Barney and Barney's two children paid on Barney's record.