To cancel a refusal, the responsible representative (or the beneficiary) must submit
proof that the beneficiary was mentally incompetent at the time the beneficiary filed
the refusal. If the beneficiary makes the request to cancel their prior SMI refusal,
the beneficiary must now be competent, as shown with legal evidence or other medical
evidence as outlined in GN 00502.023.
Cancel the refusal if we receive the proof outlined in HI 00805.055D during the following timeframes:
within 12 months of the first month of potential SMI entitlement; or
if later, within 12 months of the month of the refusal.
SMI entitlement begins with the month coverage would have started as though the beneficiary
never filed the refusal. The beneficiary must pay all premiums owed for any retroactive
months of SMI coverage or authorize us, the Railroad Retirement Board or the Office
of Personnel Management to withhold them from monthly benefits payable.
Example of cancelling a refusal by an incompetent beneficiary:
Linda Tessen was born on January 15, 1959, and we entitle Linda to retirement benefits
at age 63. Linda receives the IEP package in October 2023 (the first month of Linda's
IEP). Linda refuses SMI in November 2023. Linda enrolls again in SMI in March 2024,
the sixth month of Linda's IEP, and we award SMI coverage as of April 2024. In September
2024, Linda's sister notifies the FO that Linda was mentally incompetent at the time
Linda refused SMI in November 2023.
Linda’s sister provides a certified copy of a court order dated July 2023 indicating
that the court ruled that Linda was legally incompetent. Linda’s sister, the legal
representative, authorizes the retroactive SMI premiums to be withheld from Linda’s
monthly benefits. We adjust Linda’s SMI entitlement date to January 2024 (the first
month Linda's SMI coverage would begin as though Linda never filed the original refusal).
Even if Linda had not enrolled later during Linda's IEP, we could award Linda SMI
as of January 2024.