Identification Number:
DI 10105 TN 5
Intended Audience:See Transmittal Sheet
Originating Office:ODP
Title:Disability Insurance Benefits (DIB) and Freeze
Type:POMS Transmittals
Program:All Programs
Link To Reference:
 

PROGRAM OPERATIONS MANUAL SYSTEM
Part DI – Disability Insurance
Chapter 101 – Disability and Blindness Requirements
Subchapter 05 – Disability Insurance Benefits (DIB) and Freeze
Transmittal No. 5, 02/10/2021

Audience

PSC: BA, CA, CS, DE, DEC, DS, DTE, ICDS, IES, ILPDS, IPDS, ISRA, PETE, RECONR, SCPS, TSA, TST;
OCO-OEIO: BET, BIES, BTE, CCRE, CIES, CR, CTE, ERE, FCR, FDE, FDEC, OAC, PETL, RAC, RECONE, RECONR;
OCO-ODO: BET, BTE, CCE, CR, CST, CTE, CTE TE, CTE TET, DE, DEC, DES, DS, DSE, OAC, PA, PAS, PETE, PETL, RAC, RCOVTA, RECONE, RECOVR;
ODD-DDS: ADJ, DHU, REF;
FO/TSC: CS, CS TII, CS TXVI, CSR, CTE, DRT, FR, OA, OS, RR, TA, TSC-CSR;

Originating Component

ODP

Effective Date

Upon Receipt

Background

This is a Quick Action Transmittal. These revisions clarify procedures to conform with legislation (Public Law No. 116-250 - S. 578 The ALS Disability Insurance Access Act).

Summary of Changes

DI 10105.005 Eligibility for Disability Insurance Benefits (DIB) or the Disability “Freeze”

We added a sentence in DI 10105.005B.4 to ensure procedures are consistent with The ALS Disability Insurance Access Act.

DI 10105.075 When The Five Month Waiting Period Is Not Required

We added a sentence in DI 10105.075A to ensure procedures are consistent with The ALS Disability Insurance Access Act.

DI 10105.005 Eligibility for Disability Insurance Benefits (DIB) or the Disability “Freeze”

A. Purpose of a disability freeze

The following describe the purpose of a Disability Freeze:

  • To eliminate the years of low earnings (due to a worker’s disability) from the computation of benefits and to preserve the worker’s insured status. A period of disability for a worker is therefore often referred to as a “disability freeze.”

  • Insured status is frozen to protect future rights and benefits.

  • When an onset is established several years in the past, it is the DIB freeze that preserves insured status and allows payment to start based on a recent claim.

  • Any year wholly or partially in a period of DIB is excluded from the computation (not counted among elapsed years). This preserves a benefit based on earnings at the time disability began.

  • See DI 10105.000, Disability Insurance Benefits (DIB) and Freeze.

  • See DI 26001.010 for Title II Disability Freeze.

B. Eligibility requirements for monthly DIB or freeze

To be entitled to monthly cash DIB or to the disability “freeze” (i.e., a period of disability), a disabled worker (i.e., number holder) must meet the following requirements:

  1. 1. 

    The worker must have disability insured status:

    • DIB Insured Status (RS 00301.120), or

    • Special Insured Status for Disability Before Age 31 (RS 00301.140), or

    • Insured Status for Statutory Blindness (RS 00301.150)

      NOTE: An overview of insured status is located at RS 00301.101. Information about quarters of coverage (QC) and how they are earned and assigned is located in RS 00301.200 through RS 00301.350.

  2. 2. 

    The individual must file an application with the Social Security Administration. Cash benefits can be retroactive for no more than 12 months before the month the application is filed and cannot be paid under the law as amended in 1965 for months prior to September 1965.

  3. 3. 

    The individual must be disabled and furnish such proof of the existence of disability as may be required.

  4. 4. 

    For initial entitlement to DIB the number holder (NH) must serve a waiting period consisting of 5 full calendar months (DI 10105.070). Subsequent periods of entitlement may be exempt from this requirement (DI 10105.075). Claimants with Amyotrophic Lateral Sclerosis (ALS) are exempt from this requirement if their filing date is on or after 12/23/2020.

C. Eligibility to freeze but not cash benefits

Certain persons may be eligible for the freeze but not for cash disability benefits.

They include:

  • Statutorily blind persons able to engage in substantial gainful activity, except those who come under an occupational disability and are not working.

  • Persons whose eligibility for a period of disability is based upon railroad earnings or military service not creditable for Social Security benefit purposes.

DI 10105.075 When The Five Month Waiting Period Is Not Required

A. Policy

Disability Insurance Benefit (DIB) claimants will not have to serve a waiting period if they have:

  • Amyotrophic Lateral Sclerosis (ALS) and a filing date on or after 12/23/2020, or

  • a prior period of disability (PPD) (see DI 10105.001 - Period of Disability) that terminated within 5 years (60 months) before the current period of disability began.

IMPORTANT: See NOTE: in DI 11015.020C.2. regarding a circumstance that does not require disability to exist throughout the month.

NOTE: If a Medicare for Qualified Government Employment (MQGE) beneficiary subsequently becomes insured for DIB, the MQGE period is not treated as a prior period of DIB. The deemed waiting period in the MQGE entitlement does not satisfy the requirement for serving a title II DIB waiting period, even if MQGE entitlement is continuing when a period of title II DIB is established. DIB waiting period instructions are in DI 10105.070.

B. Entitlement date

Eligibility for benefits begins with the first month within the effective life of the application, after 8/60:

  • throughout which he/she is under a disability, and

  • has DIB insured status.

If the NH does not have DIB insured status in the month the current disability begins, he/she will not be eligible for a DIB until the first month thereafter in which such insured status exists. (In these situations the first day of the first month of the qualifying quarter will become the established onset date.)

EXAMPLE # 1

Mike Randolph's period of disability terminated 11/30/97, as he was no longer disabled. He filed for a new period of disability on 2/18/04. The DDS established he was disabled on 8/14/02. However, Mr. Randolph did not have insured status in 8/02. He does not meet fully insured status until the 6/03 quarter. His onset date is established as 4/1/03, the first day of the first month of the qualifying quarter. Mr. Randolph must serve a new waiting period, as more than 5 years (60 months) had elapsed between the dates his prior period of disability terminated (11/30/97) and his new disability onset (4/1/03). Mr. Randolph's first month of entitlement to a disability benefit would be 9/03.

EXAMPLE # 2

Mary Jones' period of disability terminated 12/30/99, as she was no longer disabled. She filed for a new period of disability January 2001. The DDS determined she was under a disability beginning 12/1/00. She meets insured status at that time. Mrs. Jones does not have to serve a new waiting period as less than 5 years (60 months) had elapsed between the time her prior period of disability terminated (12/30/99) and her new disability onset (12/1/00). Mrs. Jones' first month of entitlement to a disability benefit would be 12/00.

C. Beginning date of 60–month period

The 60–month period begins with the month in which DIB terminated or the prior freeze ceased, i.e., the month after the last month of entitlement. The T8 month on the MBR History line or the DBC entry on the DIB line is the first month counted for the 60–month period. For example, if the last payment was for 11/06. the 60–month period would be 12/06 through 11/11.

D. Ending date of 60-month period

The ending date of the 60-month period is the last day of the 60th calendar month after the end of the prior DIB entitlement or the end of the prior freeze period. If a new period of disability is established within the 60–month period mentioned above, the period ends with the month before the first month throughout all of which the NH is under a disability.

Where the current disability begins on the first day of a month, the period will end with the preceding month. If it begins on other than the first day of a month, the period will end with the month in which the current disability began.

Example:

Michael Randolph’s period of disability terminated 11/30/00 (12/00 is the T8 month on the MBR History line and the DBC entry on the DIB line) as he was no longer disabled. The 60 month period would be 12/00 through 11/05. He filed for a new period of disability on 2/18/2006. The DDS established he was disabled on 8/14/2005. Mr. Randolph does not have to serve a waiting period because his new period of disability, the date of onset, falls within the 60 month period. Mr. Randolph’s entitlement date would be 09/05.


DI 10105 TN 5 - Disability Insurance Benefits (DIB) and Freeze - 2/10/2021