TN 9 (12-04)
SI 02101.006 SSI Underpayment Due - Individual Deceased - Surviving Spouse Not Member of an Eligible Couple
A. Policy - General
1. To Whom Payable
If the deceased individual had a spouse for the month of death who was not his/her eligible spouse, that spouse may receive the underpayment if he/she were living in the same household (LISH) any time in the month of death or any time during the preceding 6 months.
2. Underpayment Limit
The amount payable to a spouse who is not the surviving member of an eligible couple is limited by law to SSI benefits due for June 1986 and later months. (See SI 02101.006C.4.)
3. Time Limit for Requesting Payment
The surviving spouse has 24 months after the month of death to request any underpayment which may be payable on the deceased individual's record.
B. Policy - Related Issues
1. Surviving Spouse
The surviving spouse is the person who had a marital relationship with the deceased for the month of death. (Use the definition of marital relationship, including “holding out” spouse, in SI 00501.150B.). The surviving spouse need not be the same person determined to be the surviving spouse for title II or other Federal program purposes. The surviving spouse could have been an ineligible spouse or an eligible individual without a spouse for the month of death.
2. Relationship Establishment
Establishment of the survivor's relationship to the deceased is required. This relationship requirement is met if the person is established in our records as the spouse for the month of death.
3. LISH Requirement
Establishment of living in the same household (LISH) is required.
This requirement is met if the person is established in our records as the spouse whose income was subject to deeming to the deceased in the month of death or in the previous 6 months (even if nothing was actually deemed, or deeming occurred and caused ineligibility for some months).
NOTE: When the deceased's effective date of filing was less than 6 months before death, the LISH requirement is met if deeming would have applied in any of the 6 months prior to death.
4. Relationship and LISH Established on SSA Records
When the surviving spouse meets the relationship and LISH requirements, he/ she does not have to request an underpayment for payment to be made.
1. Identification of Surviving Spouse
Follow the procedures below to pay an underpayment to a surviving spouse and to identify that spouse reliably and issue the underpayment quickly. Use the already-reached conclusions regarding relationship and LISH in these procedures.
Review the system records and the claims file and any other materials (e.g., a recent determination) available in the FO.
If that is ineffective, query for an earnings record.
NOTE: When the deceased had a representative payee or was institutionalized, ask those sources for information about the spouse.
Do not document these efforts in the file.
2. Relationship Not Established In Our Records
Follow the procedures in SI 00501.150 through SI 00501.152 for establishing relationship. Obtain a statement from him/her in which he/she requests the underpayment and states that he/she meets the relationship requirement.
NOTE: The purpose of this statement is to handle conflicting claims on the underpayment.
3. LISH Not Established on SSA Records
For purposes of establishing LISH, use the “household” definition and policy in SI 01310.140. If the deceased and spouse were not living in the same household (as “household” is defined and discussed in SI 01310.140) use the criteria in RS 00210.035 to determine if they were LISH.
4. Underpayment Limit for Periods Prior to June 1986
If the underpayment period begins before June 1986, adjust the amount we can pay for
NOTE: If title II offset is involved, the amounts due in this formula must account for the offset imposed and the amounts that would have been due had the retroactive title II been paid on time. See SI 02006.001.
Issue the underpayment using automated one-time payment (A-OTP) procedures (SM 01901.001), and send Form SSA-L8166-U2 that explains the underpayment and any recovery action.
NOTE: If the spouse is not present on the SSR, the underpayment must be paid by using manual OTP procedures.
If the underpayment cannot be paid (e.g., surviving spouse not qualified, State received payment as IAR, etc.), send notice SSA-L8166-U2 explaining the reasons for the denial of the underpayment.
Send notice SSA-L8166-U2 to any person who has filed an application or otherwise requested a payment due a deceased individual and is not eligible to receive the underpayment.