TN 73 (07-22)

DI 11010.125 Developing Cause of Death - Claimant Dies within 1 Year of Denial

A. Overview

When a disabled claimant dies from a non-traumatic impairment within 1 year of the date of denial or cessation, and a reconsideration was not requested by the claimant before his/her death, or one has not been filed subsequently by a survivor, the case is reexamined and possibly reopened. No SSA-561 (Request for Reconsideration) is required. If death resulted from a subsequent traumatic event, no reexamination is made under this procedure.

B. Field Office (FO) Procedure for developing cause of death

When developing a survivor's claim, the Field Office (FO) learns that the disability claimant was sent an initial denial or termination notice within 1 year of the claimant's death because:

  1. 1. 

    The alleged impairment was not severe enough to constitute a period of "disability"; or

  2. 2. 

    The impairment had not lasted, or was not expected to last for a continuous period of at least 12 months, or result in death; or

  3. 3. 

    The claimant had been working at the substantial gainful activity (SGA) level; or

  4. 4. 

    Necessary medical evidence had not been submitted.

  5. 5. 

    Determine the cause of death by:

    • Obtaining and certifying a copy of the death certificate. For CEFs follow the process in Faxing Documents into the Certified Electronic Folder (CEF) Using Barcodes -I 81010.090; or

    • Certifying the medical certification block of the death certificate by documenting the information on an SSA-553 (Special Determination); or

    • Ascertaining the cause of death from the local registrar, attending physician, coroner, hospital records, or the Office of Vital Statistics.

The FO may become aware of the prior denial or termination from information on the DW01, information obtained during the current claims interview, information on the initial denial, or from the cessation notice (by review of the official folder). When in doubt, check the official folder to determine the date of the initial denial or termination notice, but develop for the cause of death.

In submitting an SSA-553, show all of the information in the "medical certification" block. Do not undertake any other disability development. Develop the survivor claim and forward it to the servicing Processing Center (PC) with an SSA-5002 (Report of Contact) explaining that the claimant died within 1 year of the date of the initial denial or termination notice.


To Link to this section - Use this URL:
DI 11010.125 - Developing Cause of Death - Claimant Dies within 1 Year of Denial - 07/14/2022
Batch run: 07/14/2022