PROGRAM OPERATIONS MANUAL SYSTEMPart GN – GeneralChapter 003 – EvidenceSubchapter 04 – Proof of DeathTransmittal No. 21, 10/08/2020
This is a Quick Action Transmittal. These revisions do not change or introduce new policy or procedure.
Summary of Changes
GN 00304.001 Proof of Death Requirements
We are clarifying subsection B.2 by replacing the word “and” with "or" as the three situations listed in B.1 thru B.3 would apply for no proof of death redevelopment and are not inclusive. Either of those three options are sufficient for no proof of death redevelopment.
We require proof of death when a claimant files for benefits on the record of a deceased number holder (NH) or when a claimant's eligibility or benefit amount is dependent on another person's death.
We require proof of death for Title II benefits when:
A claimant files for survivor's benefits or the lump-sum death payment (LSDP).
An underpayment is due, and the (NH) dies before receipt of the initial life benefit payment.
A reasonable doubt of death exists for:
Any person who, if living, is entitled to benefits or the LSDP instead of the claimant;
Any spouse whose death is alleged to have ended a prior marriage; or
Any beneficiary whose termination of entitlement increases other benefits.
A Medicare record shows a date of death (DOD) discrepant from the DOD alleged in a conversion case.
We require proof of death for Title XVI benefits when:
One member of an eligible couple dies, regardless of whether an underpayment is due; or
Someone other than the eligible claimant dies, and the eligible claimant’s payment amount could increase as a result (i.e., deeming spouse, parent, sponsor, or spouse of sponsor dies).
NOTE: For instructions on how to process cases when the deceased NH has a Prisoner Update Processing System (PUPS) alert and there are entitled claimants applying for benefits on the deceased NH’s record, see GN 02607.500D.
When you need proof of death for Title II or Title XVI benefits, obtain evidence following the instructions in GN 00304.005 through GN 00304.050.
Do not redevelop for proof of death in the following situations:
1. If the Numident death data shows proven (POD: P). For information on the use of the Numident death data as proof of death, see GN 00304.100.
2. If the MBR has a proven DOD prior to December 5, 2015, or
3. If there is no proof of death code, but a benefit was paid, assume that death is proven if it was necessary for the type of benefit paid (e.g. survivor benefits or LSDP).
If a conflict exists in the DOD evidence, determine if the conflict is material to the claimant’s eligibility or benefit amount. If conflict is material, resolve the conflict as instructed in GN 00304.001C.2.
A date of death discrepancy would be material if the month or year is in conflict, or if the difference is between the last day of one month and the first day of the following month. In these situations, the date of death conflict affects the right to benefits for either the deceased number holder or survivors on that record. However, a discrepant day within the same month and year, even if the first of the month is involved, would not make a difference in benefit termination for life benefits or eligibility month for survivor benefits.
a. Conflict is not material to eligibility or benefit amount
Do not resolve a DOD conflict that is not material to a claimant’s eligibility or benefit amount. Accept the DOD indicated by the first piece of evidence, per the order of evidence, as instructed in GN 00304.005 through GN 00304.050.
b. Conflict is material to eligibility or benefit amount
Resolve the DOD conflict if it is material to the claimant’s eligibility or benefit amount. Follow the procedures in GN 00304.001C.2.
Take the following actions to resolve a conflict in evidence used to establish a claimant's DOD:
Develop all available evidence indicating the date that death most likely occurred, including preferred evidence (GN 00304.005) secondary evidence (GN 00304.015), and circumstantial evidence (GN 00304.025).
Based upon all evidence, determine the most reasonable date the death occurred. The procedures in GN 00304.005 through GN 00304.050 provide an order of evidence for proof of death. The order of evidence to determine a DOD may not be applicable when a conflict regarding the DOD exists.
If a conflict exists in evidentiary documents with the same probative value, determine which type of evidence most reasonably establishes the DOD.
IMPORTANT: If you are unable to determine the DOD following the instructions in this section, refer the case to the Regional Office (RO) for a Regional Chief Counsel (RCC) opinion per the instructions in GN 01010.815.
Prepare a DOD determination following instructions in GN 01010.360.
Fax the evidence and determination into the electronic file and add or correct the DOD on the Numident record via the Death Informaton Processing System (DIPS). If you have requested a legal opinion, do not make corrections through DIPS until you receive the decision.
The following are examples of situations involving conflicting evidence that require a Date of Death determination:
When a disaster or accident occurs, the DOD listed on the death certificate (the preferred proof of death) for a victim may be the date authorities recovered the victim’s body. However, secondary evidence (such as a claimant’s statement about the events of the disaster or accident), or circumstantial evidence (such as newspaper or police reports of the disaster or accident), might reveal that it is reasonable to conclude that the victim died days or weeks prior to the date listed on the death certificate. Although the death certificate is the preferred evidence of death, it does not necessarily establish the date the victim died.
When authorities find the body of a person who has been missing, the death certificate may list the DOD as the date authorities found the body. However, the coroner’s report may state that the person died or was likely killed prior to the recovery of the body. Although both the death certificate and the coroner’s report are preferred evidence of proof of death, it is reasonable to rely on the coroner’s report to establish the date the victim died.
In the case of a missing person where the body is later found and there is a conflict between the DOD in the application and other evidence (including the preferred evidence of death), weigh the conflicting evidence and determine a reasonable date of death based on other evidence. See precedents PR 05-092 (PR 02905.016B), PR 95-506 (PR 02905.034A), and PR 01-143 (PR 02905.048A).
When the body of a missing person is not recovered and the person is presumed dead based on circumstantial evidence, determine the Date of Death to be the date that death most reasonably occurred. See GN 00304.025, and precedents PR 06-028 (PR 02905.020B), PR 06-028 (PR 02905.027A), and PR 04-098 (PR 02905.041A).
If authorities do not find the body of a missing person and the fact of death is based on a presumption of death after seven years have elapsed since the disappearance per instructions in GN 00304.050A, determine the DOD per instructions in GN 00304.050B.7.
GN 00304.005 Preferred Evidence of Death
GN 00304.015 Secondary Evidence of Death
GN 00304.025 Circumstantial Evidence of Death