PROGRAM OPERATIONS MANUAL SYSTEMPart SI – Supplemental Security IncomeChapter 021 – Title XVI (SSI) UnderpaymentsSubchapter 01 – Title XVI (SSI) UnderpaymentsTransmittal No. 17, 10/05/2020
This is a QAT. These revisions do not change or introduce new policy or procedure.
Summary of Changes
SI 02101.003 SSI Underpayment Due - Individual Deceased - General
Revised "Then" entry of chart in section B.3 to read:
Complete the processing of the claim if an underpayment could be paid to:
A State/political subdivision as IAR;
An authorized representative for direct payment of fees (if another party is eligible to receive all or part of the underpayment); or
A surviving spouse or parent.
Unless the exception below applies, after considering any overpayments and penalties that may be collectible (for the deceased and/or survivor), an underpayment may be paid to:
A State or political subdivision with written IAR authorization (see SI 02101.004); and then
An authorized representative for direct payment provided there is another party (i.e., a State for IAR or survivor) eligible to receive all or part of the underpayment (see GN 03940.009A.);
A surviving spouse who was a member of an eligible couple in the month of death (see SI 02101.005);
Spouse who was not a member of an eligible couple (effective for benefits payable for June 1986 and later months) (see SI 02101.006); and /or
Parent(s) of a deceased individual who was a blind or disabled child at the time an underpayment occurred (effective for benefits payable for June 1986 and later months) (see SI 02101.007).
NOTE: Do not pay an eligible family member who is a recipient any underpayment if he or she is subject to prisoner, fugitive felon (FF), or probation or parole violation (PPV) suspension provisions, or confined in a public institution under court order for a criminal act (CPICO). For the No Social Security Benefits for Prisoners (NSSBP) instructions for processing underpayments on the record of a deceased recipient to an eligible family member who is a current or terminated recipient, see SI 00529.020E.
EXCEPTION: As stated in SI 02101.002A.1., when direct payment of a representative’s fee is involved, the priority of payment order is: IAR; direct payment of a representative fee; and then recovery of a prior overpayment.
An underpayment is not payable to:
An estate; or
A survivor convicted of a felonious homicide of the deceased. (See GN 00304.060.)
A survivor (other than an SSI eligible spouse) will have 24 months after the individual's month of death to request an underpayment which may be payable.
NOTE: The 24-month timeframe would not apply in situations where the Agency has been mandated to take action by a court (e.g., Zebley or ALJ reversals).
Proof of death, although not ordinarily required to terminate payment, is required to establish that an underpayment can be paid to a survivor. (See GN 00304.005 for evidence of death.)
Proof of relationship is required before release of an underpayment. (See SI 02101.005 through SI 02101.007 for specific requirements for survivors).
Use an underpayment due the deceased that is payable to a surviving spouse or parent(s) to recover an overpayment to the survivor if the overpayment is determined collectible. See SI 02101.002A.1. for the Priority of Payment when direct payment for an authorized representative fee is involved.
Even though a deceased individual was underpaid for a period, payment of any underpayment amount to a survivor depends on the disposition decisions made for overpayments for other periods.
Eligible Spouse — Member of Eligible Couple Living with Deceased in Month of Death
If a final determination of an excess payment (apparent overpayment) has not been made (e.g., no notice has been sent) payment of an otherwise payable underpaid amount cannot be delayed, unless the determination of the apparent overpayment can be made before the end of the month following the month in which the underpaid amount was discovered. Otherwise, pay the underpayment. If an overpayment is being appealed or waiver has been requested, pay the underpayment.
Ineligible Individual or Survivor
Do not issue an underpayment due the deceased for one period if the disposition of an excess payment (apparent overpayment) for another period is unresolved. Expedite the final determination for the apparent overpayment so that an underpayment can be computed and paid to the ineligible spouse or survivor.
In pending claim situations, follow these guidelines.
IF. . .
THEN. . .
A person dies while his/her claim is pending
A surviving spouse or parent - see SI 00603.033 and DI
The deceased does not have an application but the claim for benefits is protected by an oral inquiry
Follow the notice/closeout procedures for protection by oral inquiry – see SI 00601.025.
The deceased does not have an application but the claim for benefits is protected by a written statement
Follow the notice/closeout procedures for protection for written inquiry – see SI 00601.020.
DO NOT pay an underpayment if development of any factor of eligibility is incomplete.
NOTE: When a claimant is alive, payment can be made on unverified information in certain circumstances (e.g., income estimates) and the information verified post-adjudicatively. Do not base payment on unverified information when the claimant is deceased.
EXCEPTION: This does not apply to the special procedures under Zebley .
If an inquiry is received (e.g., from an estate) regarding nonpayment of an underpayment, send a notice SSA-L8166-U2, Notice of Important Information, to the inquirer explaining the denial.
Administrative Finality, SI 04070.001