BASIC (06-06)

DI 10105.902 Taking and Processing Auxiliary or Survivor Applications Filed During the Benefit Continuation Period (BCP) - Disability Benefit Equals or Exceeds Auxiliary or Survivor Benefit

A. Filing considerations

A disabled number holder (NH), Disabled Widow’s Benefit (DWB) or Childhood Disability Benefit (CDB) at any age may wish to file for an auxiliary or survivor benefit while receiving benefit continuation payments. As in RIB, the Month of Election (MOEL) considerations are similar. Explain to the applicant that while he/she is entitled to the benefit applied for, he/she cannot receive it while receiving benefit continuation payments.

B. Field Office (FO) role

The FO will:

  1. Develop the evidence required as in any other auxiliary or survivor claim.

  2. Prepare an A101 Automated Determination of Award :

    • Enter the amount of the disability benefit in the smaller actuarially reduced monthly benefit amount (“SAMBA”) on the MBEN screen and 0.00 in the benefit amount.

    • Enter the claimant’s own Social Security number (SSN) in the “Cross Reference SSN” entry on the BENE screen, with the applicable status code “A”, or, in the case of a DWB or CDB the SSN on which the disability benefit is being paid and the applicable stat code.

    • Annotate the Remarks portion of the BCRN screen, “Do Not Process” and “BCP claim-Do not process Auxiliary (Survivor) Claims Unless Disability Insurance Benefits (DIB) Cessation is Affirmed.” Forward the A101 to the processing center (PC)

  3. Adjudicate the A101. Modernized Claims System (MCS) will establish a control and transfer ownership to the PC.

C. Processing Center (PC) processing

The PC will:

  1. Establish control of the A101. The control should be annotated “Effectuate Auxiliary (Survivor) Claim When Decision Reached on Disability Insurance Benefit (DIB) Cessation - P.L. 98-460”. Cross-refer the claimant’s own SSN to the SSN on which the auxiliary or survivor claims were filed.

  2. Upon notification of the final decision to either affirm or reverse the cessation, forward the A101 to a claims authorizer (CA) for review and adjudication of the claim.

    • For affirmations in which benefit continuation payments have been terminated, amend the A101 to correct the benefit amounts on the MBEN screen. Delete the entry in the smaller actuarially reduced monthly benefit amount (“SAMBA”) on the MBEN screen and the annotation in the remarks portion of the BCRN screen, and take the proper action to effectuate the award and recover the benefit continuation overpayment.

    • For reversals to a continuance, process the auxiliary or survivor award as in DI 10105.901C.2. (note that it may be appropriate to contact the claimant to withdraw the application if the auxiliary or survivor entitlement is disadvantageous).

D. Applicant remains technically entitled to auxiliary or survivor benefit

If the NH, DWB, or CDB remains technically entitled to the auxiliary or survivor benefit in continuance situations (when the disability benefit equals or exceeds the auxiliary benefit amount but does not exceed the original rate), follow DI 10105.901C.2. for award processing. Use language in the notice that is appropriate to the situation. As described in DI 10105.902C.2., it may be appropriate to recontact the claimant to withdraw the application if the auxiliary or survivor entitlement appears disadvantageous.

E. Applicant not entitled to auxiliary or survivor benefit

If the applicant is not entitled to the auxiliary or survivor benefit (in a DIB continuance situation) as the DIB equals or exceeds the original rate on which the auxiliary or survivor claim is filed, the claim should be denied and the NH informed of this determination. Always include the blanket denial paragraph in your notification.