Identification Number:
EM-24014
Intended Audience:All FBUs/OEIO/OCO/RCs/ARCs/ADs/FOs/PSCs/CO/TSCs/OCO–CSTs
Originating Office:ORDP OISP
Title:Policy Changes and Procedures to Streamline the Development and Documentation for Living in the Same Household (LISH) requirement for Lump Sum Death Payments- POMS Updates Will Follow Shortly
Type:EM - Emergency Messages
Program:Title II (RSI)
Link To Reference:See Reference at the end of this EM.
 
Retention Date: 11/02/2024


A. Purpose:


    This emergency message (EM) outlines the policy changes and new procedures for technicians to follow when a surviving spouse files a Lump Sum Death Payment (LSDP) application, and we need to determine if they met the Living in the Same Household (LISH) requirement.


B. Background:

    In an effort to streamline policies and processes, we evaluated the current living in the same household (LISH) policy and lump-sum death payment (LSDP) regulations and determined we can eliminate many of the questions and documentation requirements we previously required to develop LISH.

    As per RS 00210.001A.3.a. a surviving spouse of the NH can receive the LSDP payment if they were LISH with the NH at the time of death. However, if one of the couple was temporarily absent from the residence, technicians are required to follow RS 00210.035 to ask several questions and extensively document the claim to determine if the LISH requirement is met or if an absence can be considered temporary if it was:


      1. Due to service in the U.S. Armed Forces;

      2. 6 months or less and neither the NH or spouse were outside the U.S and the absence was due to:


        · Business,

        · Employment,

        · Confinement in a hospital, nursing home, or other medical institution, or

        · Penal institution;


      3. 6 months or more due to:

        · Confinement in a hospital, nursing home, or other medical institution

      4. Other circumstances and it is shown that the NH and survivor spouse expected to live together in the near future.

C. Policy Change
    Effective 05/02/2024, to reduce burden to survivors, streamline the development requirements, and expedite the processing of the LSDP claim, we are eliminating:
        · Some developmental questions;
        · The documentation requirement for LISH when individuals were separated for 6 months or less; and
        · Some documentation requirements for LISH when the absence is more than 6 months, or the survivor spouse is eligible for monthly widow, mother, or father benefits.

D. Processing Instructions
    Follow the instructions below when a surviving spouse files for the Lump Sum Death Payment (LSDP) and you need to determine if LISH is met.
      1. Ask the survivor if they were living together in the same household (LISH) at the time of death.
          a. If yes, LISH is met.
          b. If no, go to step 2.
      2. Ask how long they were separated:
          a. If less than 6 months and the reason of the absence was due to military, business, employment, confinement in hospital, nursing home, or medical institutions or penal institution, LISH is met and technicians will enter “Y” in the “Spouse Living with deceased at the time of death” field in LSDP or DECD screen and pay benefits. No further development or documentation is required.

          b. If less than 6 months but not for the reasons listed in 2.a, go to step 3.

          c. If more than 6 months and the reason of the absence was due to confinement in hospital, nursing home, or medical institutions, LISH is met and technicians will enter “Y” in the “Spouse Living with deceased at the time of death” field and list the reason for separation on the field respective field on the LSDP or DECD screen. If the absence is not due to the listed reasons above, go to step 3.

      3. Ask what were the circumstances that led to separation and if they were expecting to live together in the near future.
          a. If the circumstances confirms that there was a reasonable expectation to live together in the near future and technicians will enter “Y” in the “Spouse Living with deceased at the time of death” field and list the reason for separation on the respective field on the LSDP or DECD screen. No further development or documentation is required.

          b. If no, LISH is not met, go to step 4.

      4. Determine if the survivor spouse is eligible for monthly widow (RS 00207.001), mother or father benefits (RS 00208.001).
          a. If yes, pay the LSDP.
          b. If no, deny the claim and document the claim the reason why LISH was not met.

Direct all program-related and technical questions to your Regional Office (RO) support staff using vHelp or Program Service Center (PSC) Operations Analysis (OA) staff. RO support staff or PSC OA staff may refer questions, concerns or problems to their Central Office contacts.

References:
RS 00210.001 Requirements for the Lump-Sum Death Payment (LSDP)
RS 00210.005 Evidence Requirements for the Lump-Sum Death Payment (LSDP)
RS 00210.010 Payment of the Lump-Sum Death Payment (LSDP)
RS 00210.035 LSDP for a Surviving Spouse Living in the Same Household (LISH)
EM-24014 - Policy Changes and Procedures to Streamline the Development and Documentation for Living in the Same Household (LISH) requirement for Lump Sum Death Payments- POMS Updates Will Follow Shortly - 05/02/2024