PROGRAM OPERATIONS MANUAL SYSTEMPart DI – Disability InsuranceChapter 235 – Specific Case InstructionsSubchapter 05 – Title II Child CasesTransmittal No. 3, 05/05/2021
This is a Quick Action Transmittal. These revisions do not change or introduce new policy or procedure.
Summary of Changes
DI 23505.005 Parent Claim to Entitle Dependent Grandchild
Section D.3.f. – We removed obsolete reg. basis codes L1/L2.
A grandchild or step-grandchild is entitled to child's insurance benefits on the Social Security record of a grandparent or a grandparent's spouse if the grandchild is dependent upon the grandparent, and the grandchild's natural or adoptive parents are deceased or disabled:
At the time the grandparent became entitled to retirement or disability insurance benefits or died; or
At the beginning of the grandparent's period of disability until the grandparent died or became entitled to disability or retirement insurance benefits.
If the child's parents are alive, we must find both parents disabled to entitle the child to benefits under the dependent grandchild case provision. In these cases, the disability determination services (DDS) must:
Adopt an existing determination of the parents’ disability; or
Prepare a determination of the parent's disability (as if it were a regular disability insurance benefit (DIB) claim) solely for entitling the child to child's benefits on the parent's earnings record. (There is no disability insured status requirement for the parent(s).)
The field office (FO) determines whether the evidence meets dependency and other entitlement requirements, and specifies in the SSA-3367 (Disability Report – Field Office) the date the grandparent-child relationship must be established. This is the date the DDS must use for establishing the parents’ disability.
NOTE: Parent claims do not involve disability benefits unless the parent also files a DIB claim, in this case there will be two separate claims.
The FO completes the SSA-3367 in the usual manner except for items that require specific instructions given in this section. For general instructions on completing the SSA-3367, see Completing the Paper Form SSA-3367–F5 (Disability Report-Field Office) in DI 11005.045.
Item 1 – Identifying Information
Enter the name and social security number (SSN) of the grandparent on whose earnings record the claim is filed; i.e. the number holder (NH). Complete the remaining entries using the claimant’s information.
Item 3 – Potential Onset Date
Select the “CDB” check box, and enter the potential onset date (POD).
Item 4 – Reason for Potential Onset Date
Select the appropriate check box, and enter the reason for the POD.
Item 5 – Explanation for Potential Onset Date
Enter “Grandchild Case – Dependency Date” followed by the month and year (mm/yyyy) in which the grandparent-child relationship must be established.
A small number of EDCS exclusion cases may use a SSA-831 instead of the EDCS routing form. The FO completes the SSA-831 in the usual manner except for the items that require specific instructions given in this section. For the exceptions see “Completion of SSA-831 by the FO” per DI 23505.005D.2. in this section.
The DDS completes the SSA-831 in the usual manner except for the items that require specific instructions given in this section. For the exceptions see “Completion of SSA-831 by the DDS” per DI 23505.005D.3 in this section. Refer to “Completion of Form SSA-831 – Title II, Title XVI and Concurrent Claims” per DI 26510.000.
Enter the SSN of the individual (grandparent) on whose earnings record the claim is filed, i.e. the NH.
Enter the name and address of the child’s grandparent.
Enter the name of the NH (grandparent) on whose earnings record the claim is filed.
Check one of the two following claim check blocks:
P-R Disability determination for parent-child filing on earnings record of retired grandparent (RSI NH); or
P-D Disability determination for parent-child filing on earnings record of disabled grandparent (DIB NH)
Enter “Grandchild Case – Dependency Date: (mm/yyyy)” (the month and year in which the grandparent-child relationship must be established for entitlement).
Check block “A” and enter the controlling date from the SSA-3367 in all cases where the parent is disabled on or before this date. (If the established onset date (EOD) is after the controlling date, treat as a denial.)
Enter the diagnosis as explained in “Completing Item 16A and 16B (Primary and Secondary Diagnosis, Body System Code and Impairment Code) on the SSA-831 Disability Determination Transmittal)” per DI 26510.015A and DI 26510.015B.
Electronic processing requires a diary date for allowance cases prior to closure. As there is no continuing disability review required for this type of case, enter a 7-year medical improvement not expected (MINE) diary date to facilitate closure.
Check block “B” if the parent's disability is not established as of the date shown in the SSA-3367, and enter that date here.
Do not enter information in Item 21.
Enter the RBC that reflects the nature of the allowance or denial on the date of adjudication on the parent’s claim. For a description of the basis codes for determination refer to “Completion of Item 22 (Regulation Basis Code)” per DI 26510.045A.
Use this chart for determinations of “not disabled”:
Basis for Determination
Enter in Item 22 “Reg-Basis Code”
Impairment Not Severe – Medical Considerations Alone
Capacity for Substantial Gainful Activity (SGA) – Any Relevant Past Work
Capacity for SGA – Other Than Relevant Past Work
Impairment Prevented SGA for a Period of Less Than 12 Months
Impairment Prevents SGA at Time of Adjudication But Is Not Expected to Prevent SGA for a Period of 12 Months
Insufficient Evidence Furnished
NH Does Not Want to Continue Development of Claim
NH Willfully Fails to Follow Prescribed Treatment
Use this chart for determinations of “disabled”:
Impairment Meets Level of Severity of Listings
Impairment Equals Level of Severity of Listings
Medical and Vocational Considerations
Medical and Vocational Considerations (35-40 Years of Arduous Unskilled Work, Marginal Education, and Significant Impairment)
DDS does not complete this item.
The DDS is not responsible for notification on parent claims. Do not prepare a form notice or personalized disability explanation.