Identification Number:
RS 00203 TN 17
Intended Audience:See Transmittal Sheet
Originating Office:ORDP OISP
Title:Childs Benefits
Type:POMS Transmittals
Program:Title II (RSI); Title XVI (SSI)
Link To Reference:
 
PROGRAM OPERATIONS MANUAL SYSTEM
Part 03 – Retirement and Survivors Insurance
Chapter 002 - Benefits and Payments
Subchapter 03 - Child's Benefits
Transmittal No. 17, 07/2018

Audience

FO/TSC: CS, CS TII, DRT, DT, FR, OA, OS, RR, CSR, TA, CTE, TSC-CSR
PSC: ADS, BA, CA, CCRE, CRTA, CS, DS, ICDS, IES, TSA, TST, DS, ICDS, IES, ILPDS, IPDS, ISRA, PETE, RECONR
OCO-ODO:
BTE, CR, CST, CTE, CTE TE, PETE, PETL
OCO-OEIO: BTE, CC, CR, CTE, FCR, PETL, RECONR

Originating Component

OISP

Effective Date

Upon Receipt

Background

As part of the Improper Payment initiatives, the Office of Analytics and Improvements, formerly known as the Office of Business Improvement (OBI), released a project titled “Childhood Disability Benefit (CDB) Entitlement for Supplemental Security Income (SSI) Recipients Previously Established or Entitled on a Parent’s Record.” This outreach project identified individuals who are receiving SSI and were previously established or entitled to non-disability benefits on a parent’s record and may have potential entitlement as a CDB on the same parent’s record. For some of these SSI recipients, the policy on re-entitlement to child’s benefits applies, rather than the policy for initial entitlement.

We are revising these POMS sections in response to requests for clarification. This transmittal does not change policy.

Summary of Changes

RS 00203.001 Entitlement and Non-Entitlement Provisions for Child’s Benefits

We made the following changes:

    • RS 00203.001 CITATIONS - Removed citations not directly related to content of this POMS section;
    • RS 00203.001 CITATIONS - Removed unnecessary citation for POMS section RS 00203.001;
    • RS 00203.001A.1 - Added language to advise that child’s benefits include benefits for minor children, students, and disabled adult children;
    • RS 00203.001A.1.a - Revised language to state that a proper applicant for the child must file the application and added references to proper applicant policy;
    • RS 00203.001A.1.b - Added link to policy in GN 00306.000 on determining who is a child of the number holder (NH) to replace definition of child previously in RS 00203.001C, which contained only a list of the types of children and references to policy for each type of child;
    • RS 00203.001A.1.c - Provided more appropriate links to information pertaining to child’s dependency on the NH;
    • RS 00203.001A.1.d - Provided more detail about what information is available at link to RS 00203.020 When a Child Who Has Been Married May be Considered “Unmarried”;
    • RS 00203.001A.1.e - Added link to information on child’s benefits based on student status;
    • RS 00203.001A.1.e - Added note about deeming a student not to have attained age 19 and link to information on when we may deem a student not to have attained age 19;
    • RS 00203.001A.2 - Provided additional information about establishing and terminating initial entitlement to child’s benefits when a child meets all of the requirements for child’s benefits for a retroactive period, but no longer meets all of the requirements for such benefits at the time he or she files an application;
    • RS 00203.001A.2 – Added link to policy on terminating events for child’s benefits;
    • RS 00203.001A.2 - Added language labeled as “IMPORTANT” to prompt technicians to consider protective filing and retroactivity for Title II benefits when determining a child’s eligibility for benefits during a retroactive period. Provided links to information on protective filing and retroactivity;
    • RS 00203.001A.2 - Provided links to policy on the first month of entitlement to child’s benefits;
    • RS 00203.001B - Corrected links to information on homicide by child;
    • RS 00203.001C - Added links to policy on eligibility for Medicare based on entitlement to Childhood Disability Benefits (CDB); and
    • RS 00203.001C - Added note about policy on Medicare entitlement based on entitlement to CDB prior to December 1, 1980.

RS 00203.015 Requirements for Re-entitlement to Child’s Benefits

We made the following changes:

    • Throughout RS 00203.015 - Reorganized content;
    • RS 00203.015 CITATION - Added citation for 20 CFR §404.351;
    • RS 00203.015A - Added definition of re-entitlement;
    • RS 00203.015A - Added note that benefits for minor children, students, and disabled adult children all fall under the same class of benefits; i.e. child’s benefits;
    • RS 00203.015B.1, first bullet - Directed reader to GN 00306.000 for policy on who qualifies as the NH’s child;
    • RS 00203.015B.1, second bullet - Added link to policy on when annulment permits re-entitlement;
    • RS 00203.015B.1, second bullet - Added note to clarify that a child whose marriage precludes re-entitlement on the same parent’s earnings record may establish initial entitlement on their other parent’s earnings record provided the child meets the requirements in RS 00203.001A.1, including being unmarried;
    • RS 00203.015B.1, third bullet - Added links to information on child’s benefits based on student status and when we may deem a student not to have attained age 19;
    • RS 00203.015B.2 - Added links to information on first month of re-entitlement to child’s benefits;
    • RS 00203.015B.3 - Added example of applying re-entitlement policy;
    • RS 00203.015C - Added additional information about establishing and terminating re-entitlement to child’s benefits when a child meets all of the requirements for re-entitlement to child’s benefits for a retroactive period, but no longer meets all of the requirements for such benefits at the time he or she files an application. Included example of when to apply this policy;
    • RS 00203.015C - Added language labeled as “IMPORTANT” to prompt technicians to consider protective filing and retroactivity for Title II benefits when determining a child’s eligibility for re-entitlement to child’s benefits during a retroactive period. Included links to information on protective filing and retroactivity;
    • RS 00203.015D – Moved requirements for re-entitlement to Medicare here from old RS 00203.015C and added links to policy on eligibility for Medicare based on entitlement to CDB; and
    • RS 00203.015E – Consolidated information about when the re-entitlement provisions do not apply. This information was previously spread throughout the old version of RS 00203.015.

RS 00203.020 When a Child Who Has Been Married May Be Considered “Unmarried”

We made the following changes:

    • Throughout RS 00203.020 - Reorganized content;
    • RS 00203.020A.1, first bullet - Added link to information on termination of marriage by annulment, divorce, or death;
    • RS 00203.020A.1, second bullet - Added links to information on void and putative marriages;
    • RS 00203.020A.1 - Added reference to information on how marriage affects re-entitlement;
    • RS 00203.020A.2.a - Added definition of void marriage;
    • RS 00203.020A.2.b - Added link to information on putative marriage;
    • RS 00203.020C.1 - Added links to information on evidence of annulment, divorce, and death; and
    • RS 00203.020C.2 - Added information on determining whether a marriage is void.

RS 00203.001 Entitlement and Non-Entitlement Provisions for Child’s Benefits

Citations:

Social Security Act §§ 202(d) and 216(e)

20 CFR § 404.350

A. Policy for entitlement to child’s benefits

1. Requirements for entitlement to child’s benefits

Child’s benefits include benefits for minor children, students, and disabled adult children.

To be entitled to child's benefits,

  1. a proper applicant for the child must file an application. For information on who is a proper applicant for a child, see GN 00204.003B.2 and RS 00203.065B;

    In addition, the child must be:

  2. the child of a number holder (NH) entitled to Retirement Insurance Benefits (RIB) or Disability Insurance Benefits (DIB), or a NH who died fully or currently insured. For information on determining who is a child of the NH, see GN 00306.000;

  3. dependent upon that NH, see GN 00306.006 through GN 00306.009;

  4. unmarried, including never married and unmarried as defined in RS 00203.020; and

  5. under age 18, or if age 18 or over, be:

    • under a disability that began before age 22, or

    • a full-time elementary or secondary school student under age 19. For more information on student benefits, see RS 00205.000.

NOTE: Under certain circumstances, we may deem a student not to have attained age 19. For more information, see RS 00205.001A.

IMPORTANT: For requirements for re-entitlement to child’s benefits, see RS 00203.015.

2. Retroactivity for child’s benefits

If a child does not meet the requirements outlined in RS 00203.001A at the time he or she applies for child’s benefits, we may be able to find the applicant entitled to child’s benefits by:

  • establishing entitlement for months in a retroactive period during which the child met all requirements in RS 00203.001A; and

  • terminating the child’s entitlement with the month before the month in which any of the terminating events in RS 00203.035 occurred.

For example, a child who is married at the time she files her application for benefits, may be entitled to benefits for months prior to the month of her marriage. If benefits are payable for a retroactive period, the marriage is a terminating event.

IMPORTANT: Consider protective filing (see GN 00204.010) and retroactivity for Title II benefits (see GN 00204.030) when determining a child’s eligibility for a retroactive period.

For policy on the first month of entitlement to child’s benefits, see RS 00203.005 for death cases and RS 00203.010 for life cases.

B. Policy for non-entitlement to child’s benefits

Even if a child meets the requirements in RS 00203.001A in this section, there is no entitlement if:

  • the Railroad Retirement Board (RRB) has jurisdiction over the survivor's claim according to instructions in RS 01601.130 through RS 01601.300; or

  • the child has a conviction of felonious and intentional homicide of the NH, or was found to have killed the NH by an act that, if committed by an adult, would be considered a felony. For information on homicide by a child, see GN 00304.060 through GN 00304.080.

C. Policy for child’s entitlement to Medicare

A child who has been entitled to Childhood Disability Benefits (CDB) for 24 calendar months is entitled to premium-free Hospital Insurance (HI) or Part A beginning with the 25th consecutive month of CDB entitlement.

A child who is entitled to premium-free HI based on CDB entitlement is also eligible for Supplementary Medical Insurance (SMI) or Part B.

For more information on HI and SMI based on CDB entitlement, see HI 00801.146, HI 00801.152, and HI 00805.005.

NOTE: Prior to 12/1/80, the 24 months had to be consecutive (see HI 00801.146B).

RS 00203.015 Requirements for Re-entitlement to Child’s Benefits

Citations:

20 CFR § 404.351

A. Definition of re-entitlement

Re-entitlement to child’s benefits is a subsequent award for an auxiliary or surviving child:

  • who was previously entitled on the same Social Security Number (SSN);

  • whose prior benefits were correctly terminated; and

  • whose break in entitlement on that SSN was for at least one month.

The termination and break in entitlement may have been due to an interruption of full-time student attendance, or a break between an age 18 termination and the establishment of a subsequent date of onset for Childhood Disability Benefits (CDB).

If the prior entitlement to child’s benefits terminated because the number holder’s (NH) disability ceased, see RS 00203.015E.2 in this section.

NOTE: Benefits for minor children, students, and disabled adult children, all fall under the same class of benefits; i.e. child’s benefits.

B. Requirements for re-entitlement to child’s benefits

1. General information on re-entitlement requirements

A child whose entitlement to child's benefits ended with the month preceding the month the child attained age 18, or with a subsequent month, may be re-entitled on the same earnings record upon filing a new application without re-establishing dependency if he or she:

  • still qualifies as the number holder’s (NH) child per GN 00306.000; and

  • has not married since he or she last became entitled to benefits, unless the marriage was void or annulled. For more information on void marriages and annulment, see GN 00305.125 through GN 00305.135.

    NOTE: A marriage that ended by death or divorce precludes re-entitlement on the same parent’s earnings record. However, a child whose marriage precludes re-entitlement on the same parent’s earnings record may establish initial entitlement on their other parent’s earnings record provided the child meets the requirements in RS 00203.001A.1, including being unmarried. For information on when a child who has been married may be considered unmarried for initial entitlement, see RS 00203.020A.1.

In addition, the child must meet one of these criteria:

  • be under age 19 and a full-time student in an elementary or secondary level school program. For more information on child’s benefits based on student status, see RS 00205.000. Under certain circumstances, we may deem a student not to have attained age 19, see RS 00205.001A; or

  • be under a disability that began prior to attainment of age 22; or

  • be under a disability that began before the end of the 84th month following the month in which his or her most recent entitlement to CDB terminated because of medical improvement; or

  • had his or her entitlement terminated prior to 10/72 due to adoption.

Effective October 1, 2004, re-entitlement to CDB is allowed at any time if the beneficiary's prior entitlement terminated because he or she ceased to be under a disability due to the performance of substantial gainful activity (SGA) and other re-entitlement requirements are met. For information on SGA, see DI 10500.000. If the previous entitlement to CDB terminated because of medical improvement, the 84-month time limit still applies.

IMPORTANT: For requirements for initial entitlement to child’s benefits, see RS 00203.001.

2. “Throughout the entire month” requirement

The first month that a child can be re-entitled to a monthly benefit is subject to the “throughout the entire month” requirement if:

  • the child is being re-entitled on the earnings record (ER) of a living NH, and

  • the child was not entitled to child's benefits on any ER prior to September 1981.

For policy on the first month of re-entitlement to child’s benefits, see RS 00203.005 for death cases and RS 00203.010 for life cases.

3. Example of applying re-entitlement policy

A child received benefits as a minor child on her deceased father’s record. Her benefits were correctly terminated at age 18. She married at age 19 and divorced at age 20. After suffering a traumatic brain injury at age 21, she applied for CDB benefits on her father’s record. We would consider her application for CDB benefits on her father’s record as an application for re-entitlement to child’s benefits. She would not be eligible for re-entitlement on her father’s record because she married since she was last entitled to benefits on his record. While the marriage ended in divorce, we cannot disregard this marriage when considering her eligibility for re-entitlement on her father’s record.

IMPORTANT: While the child in this scenario is not eligible for re-entitlement on her father’s record, she may be eligible for initial entitlement on her other parent’s record if that parent is receiving benefits on his or her own earnings record or deceased, as a marriage that ended by divorce does not preclude initial entitlement (see RS 00203.015B.1).

C. Retroactive re-entitlement

If a child no longer meets all the requirements for re-entitlement in RS 00203.015B at the time he or she applies for child’s benefits, we may be able to find the applicant entitled to child’s benefits by:

  • establishing re-entitlement for months in the retroactive period during which the child met all requirements in RS 00203.015B; and

  • terminating the child’s re-entitlement with the month before the month in which any of the terminating events in RS 00203.035 occurred.

For example, a child who is married at the time she files her application for benefits, may be re-entitled to benefits for months prior to the month of her marriage. If benefits are payable for a retroactive period, the marriage is a terminating event.

IMPORTANT: Consider protective filing (see GN 00204.010) and retroactivity for Title II benefits (see GN 00204.030) when determining a child’s eligibility for a retroactive period.

D. Requirements for re-entitlement to Medicare

A child who is re-entitled to CDB may also be re-entitled to Hospital Insurance (HI) or Part A benefits and eligible for Supplementary Medical Insurance (SMI) or Part B. For information on HI and SMI based on CDB entitlement, see HI 00801.146, HI 00801.152, and HI 00805.005.

E. When re-entitlement provisions do not apply

1. Benefit continuation at age 18 based on school attendance or disability

The re-entitlement provisions do not apply when a child is entitled to child’s insurance benefits for the month before attainment of age 18 and the child is eligible for conversion to student benefits, or benefit continuation as a CDB, in the month he or she attains age 18. Such benefit continuation does not require an application. For information on benefit continuation at age 18 as a student or CDB, see RS 00205.400 and RS 00203.085 respectively.

2. Prior entitlement to child’s benefits terminated because NH’s disability ceased

Initial entitlement provisions apply, instead of the re-entitlement provisions, when:

  • the child’s prior entitlement was based on the NH’s entitlement to a Disability Insurance Benefit (DIB);

  • the NH’s entitlement to DIB terminated because of medical improvement;

  • the child’s entitlement was terminated because the NH’s entitlement was terminated;

  • the NH, after his or her termination because the disability ceased, has died, has become entitled to Retirement Insurance Benefits (RIB), or has again become entitled to DIB; and

  • the child is filing a new application for benefits.

For information on expedited reinstatement, see DI 13050.060A.2.

RS 00203.020 When a Child Who Has Been Married May Be Considered “Unmarried”

A. Marriage definitions for initial entitlement

1. Definition of unmarried

A child who has been married is considered unmarried at the time of filing an application for initial entitlement to child’s benefits if:

  • at that time, the marriage has been terminated by annulment, divorce, or death (see GN 00305.120); or

  • the marriage was void; including putative marriages in all states except Louisiana (see GN 00305.125 and GN 00305.085).

NOTE: For information on how marriage affects re-entitlement, see RS 00203.015B.1.

2. Definition of void and putative marriages

a. Void marriage

A void marriage is a marriage that is legally nonexistent from the beginning under State law. The parties to a void marriage are considered never to have been validly married. For more information on void marriages, see GN 00305.125.

b. Putative marriage

The essential basis of a putative marriage is a good faith belief in the existence of a valid marriage at its inception and:

  • in a life case, continuous good faith belief; or

  • in a death case, good faith belief until the number holder dies.

If the child's marriage was a putative marriage in Louisiana, there can be no entitlement for months before the termination of the putative relationship by acquisition of knowledge of the defect in the marriage. For an explanation of Louisiana law, see GN 00305.085F.

A putative marriage in any other State that recognizes such marriages does not bar entitlement to child's insurance benefits.

For more information on putative marriage, see GN 00305.085.

B. Retroactive entitlement when child is considered “unmarried"

Where a child is considered “unmarried” because the marriage has been dissolved, the child cannot become entitled to benefits for months in the retroactive period before the marriage was terminated.

C. Proof of marriage termination

1. Termination by annulment, divorce, or death

We require proof of the termination of the child’s marriage by annulment, divorce, or death. For more information on evidence of annulment and divorce, see GN 00305.140B. For more information on evidence of death, see GN 00304.005.

2. Void Marriage

Generally, a void marriage requires no formality to terminate. However, in some states, under certain circumstances, a court may issue an order affirming that a marriage is void, e.g., an annulment decree. For procedure on determining whether a marriage is void, see GN 00305.125C.


RS 00203 TN 17 - Childs Benefits - 07/10/2018