DI 11025.030 Disability Determination Needed to Entitle a Dependent Grandchild
A grandchild filing for benefits on his or her grandparents record can only be entitled if both parents are deceased or disabled. SSA must obtain a disability determination for the disabled parent(s).
For basic entitlement policy for a grandchild, see:
GN 00306.235, Entitlement Requirements - Benefits Based on the E/R of Grandparent
GN 00306.240, Determining Relationship of Grandchild to Parent
GN 00306.245, Determining Relationship of NH or Spouse to Grandchild’s Parent
GN 00306.250 Proof of Death/Disability of Natural or Adopting Parents
A. Establishing the date of disability for the parent
The child’s natural or adoptive parents must be deceased or disabled in the month in which:
The number holder (NH) (grandparent) became entitled to a Retirement Insurance Benefit (RIB), Disability Insurance Benefits (DIB) or died, or
The NH’s period of disability began (when benefits are not payable), if that period continued until entitlement to RIB, DIB, or death
EXAMPLE: The NH became entitled to RIB in 3/07. At that time, the grandchild’s mother was deceased but the father was living and not disabled. In 9/08, the father became disabled. The grandchild cannot be entitled on the grandparent’s record since both parents were not deceased or disabled in 3/07.
The grandparent dies in 2/09. The death of the grandparent creates a new timeframe to consider. Survivor benefits may now be payable since both parents are deceased or disabled in 2/09.
B. Proof of disability for parent in a grandchild claim
If the grandparent alleges the natural or adoptive parent(s) is disabled, take the following actions.
1. Disability under Title II
Look for prior filing of the parent under Title II:
Determine whether a disability determination has ever been made under section 221 of the Social Security Act (the Act) (HA, DWB, CDB, or freeze).
If the parent is or was disabled as defined in section 223(d) of the Act, and the date of onset on the MBR meets requirements in DI 11025.030A in this section, process the claim as a collateral estoppel allowance.
2. Disability under Title XVI
Consider a parent disabled for purposes of a child's entitlement as a grandchild if:
The parent received Title XVI benefits at the time specified in DI 11025.030A in this section on the basis of a disability; and
The statutory basis of disability is identical to section 223(d) of the Act; i.e., the former State definition of disability is not the basis of Title XVI eligibility.
NOTE: A beneficiary receiving Title XVI benefits based on blindness or visual impairment does not automatically meet the disability requirements of section 223(d). Submit such cases to the Disability Determination Services (DDS) for a disability determination under section 223(d) of the Act.
3. FO Processing when prior determination or decision cannot be adopted
If the parent’s disability is not established on Title II or Title XVI, follow the chart below:
DDS previously denied the parent's disability claim because he or she was not disabled, and
The determination was made in or after the month specified in DI 11025.030B in this section.
There has never been a prior disability determination, or
The prior claim based on disability was denied for a non-disability reason, or
The denial for disability reasons was made prior to the month specified in DI 11025.030B in this section.
Develop the disability issues using the normal procedures (i.e., disability interview, etc.).
If the parent wishes to file for disability, disabled widow(er)'s, or disabled child's benefits, take a claim and develop as usual.
C. FO action required when a DDS disability decision needed for parent in grandchild claim
Take the following actions when preparing case for DDS transfer. This case will be an Electronic Disability Collect System (EDCS) exclusion.
Create a paper modular disability folder (MDF). Use the grandparent’s SSN but show the parent’s name on the folder tab.
Complete paper Forms SSA-3368 (Disability Report-Adult), SSA- 827 (Authorization to Disclose Information to the Social Security Administration), and SSA-3367 (Disability Report-Field Office).
Prepare an SSA-831 (Disability Determination and Transmittal) to transfer the case to DDS. The field office (FO) completes items 1-14 on the SSA-831.
In item 7 (type of claim) of the SSA-831, show either P-R (RSI NH) or P-D (DIB NH) to indicate a parent-child filing on the earnings record of a grandparent.
In item 11 (remarks) of the SSA-831, show “Grandchild case, dependency date” followed by the month and year in which the relationship must be established.
If help is needed in completing these items, see DI 11010.205, Completing the SSA-831.
D. DDS determination received
1. Parent disability allowed
If DDS allows the parent’s disability:
Fax a copy of the parent’s SSA-831 into the Non-Disability Repository for Evidentiary Documents (NDRED) since the parent’s disability folder is a paper folder.
On the CREL screen in MCS, show that the claimant provided proof and show the relationship type as 5-Grandchild.
2. Parent disability denied
If DDS does not allow the parent’s disability:
On the CREL screen in MCS, show that proof of relationship was not provided. Since both parents are not deceased or disabled, the child does not meet the definition of grandchild for SSA purposes.
If the denial code is not automatically generated, use disallowance code 25-not a grandchild.
Complete the NOT3 (Notice 3) to request PC to add a dictated paragraph to the disallowance notice to explain the denial. DDS does not send a notice.