When a title II claim should have been filed with a prior title XVI claim entitlement
to DIB, CDB or DWB benefits can be based on a prior title XVI application date, when
it is discovered (due to subsequent title II claim) that the claimant met all entitlement
requirements during the period covered by the title XVI determination.
A title XVI application protects a claimant's rights to any benefits he/she might
be eligible for under title II, until a final decision is made on the claimants' entitlement
under title II or the claimant is sent a “blanket denial” paragraph.
EXAMPLE : The claimant filed a title XVI application in June 1980, and disability was established
beginning June 1980. No title II application was filed at that time because it was
erroneously assumed that the claimant was not insured.
A title II claim was filed in November 1985, and it was found that the claimant was
insured through December 31, 1980. Evidence submitted with the November 1985 claim
established that the claimant's condition medically improved and he regained the capacity
for SGA in May 1985. The medical evidence did not warrant establishing a title II
onset before June 1980.
A title XVI determination of current cessation was prepared, based on the evidence
establishing medical improvement and the claimant's capacity for SGA. The DDS established
a closed period of disability under title II from June 1980 through the current decision
date, based on the protective filing provisions of the title XVI application and the
results of the title XVI CDR.