Take the following action in all claims for Title II retirement and disability benefits
for which insured status is an issue and the claimant states that he/she worked under
As part of the normal review of SSA queries, verify whether the claimant previously
applied for retirement or disability benefits and was denied because of the provisions
of the "Ensign Amendment."
Check the master beneficiary record (MBR) for “Ensign Case” in the Special message
field and/or obtain a Processing Center Action Control System(PCACS) query to determine
if the Listing Code “424 or 425” is present (see RS 01404.256B.5. in this section). If either is present, then take one of the following actions:
If the MBR has an “Ensign Amendment” special message or the PCACS listing code 424
or 425 exists and the appeal period has expired for the prior claim, then explain
to the claimant that his/her claim was previously denied and SSA must determine whether
the individual was convicted of using an incorrect Social Security number (see RS 01404.254D., When to refer "Ensign Amendment" cases to the servicing RO).
If the NH's current request is within the appeal period of the prior claim, then determine
whether the claimant wishes to file an appeal. If so, assist the NH in filing the
appeal request. Follow normal appeal procedures found in GN 03101.010. The FO that adjudicated the claim is responsible for processing the reconsideration.
See GN 03102.175.
If the NH was previously denied benefits due to a lack of insured status and is currently
appealing the prior denial and presents documentation to add earnings from work performed
under a SSN other than the SSN that belongs to him or her, the “Ensign Amendment”
provisions must be considered.
If this is the initial claim for retirement and/or disability benefits, then take
the application and follow the procedures in RS 01404.256B., in this section..
If the claimant is 64 years and 9 months or older, and it appears that the "Ensign
Amendment" applies, take the RIB claim first. If the RIB claim is denied due to lack
of insured status as the result of a finding of a conviction pursuant to the “Ensign
Amendment,” take the Medicare only claim after processing the RIB denial.