Effective Dates: 11/22/2024 - Present

Identification Number:
RS 00210 TN 24
Intended Audience:See Transmittal Sheet
Originating Office:ORDP OISP
Title:Lump Sum Death Payments (LSDP)
Type:POMS Full Transmittals
Program:All Programs
Link To Reference:
 

PROGRAM OPERATIONS MANUAL SYSTEM

Part RS – Retirement and Survivors Insurance

Chapter 002 – Benefits and Payments

Subchapter 10 – Lump Sum Death Payments (LSDP)

Transmittal No. 24, 11/22/2024

Audience

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

Originating Component

OISP

Effective Date

Upon Receipt

Background

This transmittal 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. This transmittal supercedes EM–24014.

Summary of Changes

RS 00210.035 LSDP for a Surviving Spouse Living in the Same Household (LISH)

In addition to minor editorial revisions, inclusive language updates, and formatting changes, we made the following substantive changes:

Subsection C:

We updated the processing instructions for determining if LISH has been met when a surviving spouse files for the Lump Sum Death Payment.

Subsection D:

We added POMS references.

RS 00210.035 Lump Sum Death Payment for a Surviving Spouse Living in the Same Household

A. Policy rules and considerations for payment of the Lump Sum Death Payment (LSDP) for Living in the Same Household (LISH)

A surviving spouse of the number holder (NH) can receive the LSDP if they meet the requirements listed in RS 00210.001. One of the requirements for a surviving spouse is to be living in the same household as the NH at the time of their death. We consider a spouse LISH when they are married and customarily lived together as a married couple in the same place of residence. However, if one of the individuals of the couple was temporarily absent from the residence, technicians are required to determine if the LISH requirement is met or if an absence can be considered temporary.

1. Absence considered temporary

You may consider an individual LISH even when one of the individuals of the couple is temporarily absent from the residence. Consider an absence temporary if:

  1. a. 

    It was due to service in the U.S. Armed forces;

  2. b. 

    It was for 6 months or less, neither NH or spouse was outside the U.S. during the time considered, and the absence was due to:

    • •

      business,

    • •

      employment,

    • •

      confinement in a hospital, nursing home, other medical institution,

    • •

      penal institution.

  3. c. 

    It was for 6 months or more due to the confinement of either spouse in a hospital, nursing home, or other medical institution and the couple would have otherwise resided together.

  4. d. 

    There were other circumstances, and evidence indicates that the NH and the surviving spouse expected to live together in the near future.

2. Who is considered to meet the LISH requirement

  1. a. 

    A couple must have shared a temporary or permanent residence  for at least part of a day following the beginning of the marital relationship (following the marriage ceremony). If the couple never resided together after they became a married couple, they were not LISH.

    EXAMPLE:  An unmarried couple, person A and person B, lived together until person A entered the hospital. While person A was still in the hospital, person A and person B were married. Person A died the next day in the hospital. Since person A and person B did not share a residence as a married couple for at least part of a day, they were not LISH.

  2. b. 

    If the married couple lived at the same address, assume they were living together unless there is evidence to the contrary. Consider a married couple LISH if they were occupants of the same hospital, nursing home, or other medical institution , even if they did not occupy the same quarters, provided there was a good reason for not occupying the same quarters, (perhaps it was against the rules and regulations of the institution). Occupancy of different rooms at the same hotel, or different apartments in the same apartment house does not qualify as LISH. Consider LISH even if one of the parties sharing a residence was away from home at the time of death if:

    • •

      the absence was intended as temporary.

    • •

      there was intent to continue living together in the same place. Intent to resume living together physically at some reasonably definite time in the near future.

    EXAMPLE: This condition generally applies for deaths that occurred in a hospital, while on a business trip, while in the military service, etc.

    IMPORTANT: LISH does not apply in situations where the parties do not intend to live together in the same place, even when the parties separated, and they intended this separation to be temporary.

B.  LISH determination when there is an absence from the residence

1. Residence in different countries

Generally, you cannot establish LISH where the married couple resided in different countries. However, LISH is possible:

  • •

    if the parties were living together and one of them was away temporarily, on a visit, or,

  • •

    where one spouse preceded the other in returning to the foreign country with the expectation that the other would follow soon. If one of the parties was in a foreign country due to military service, in this section, see RS 00210.035B.3.

2. Absence because of marital difficulties

LISH does not apply if the parties were apart because of incompatibility, ill treatment, or other domestic difficulty, regardless of the history of prior separation or reconciliation of the parties. An exception to this rule exists when it is clear that the parties, from the beginning, intended to resume living together physically within a short time. For example, the NH often became violent during agruments, and their spouse left each time this happened, returning within a few days.

3. Absence because of military service

LISH is met when the separation due to service in the U.S. Armed Forces unless there is evidence indicating the parties no longer intended to live together. Without such evidence, accept the claimant's statement that the parties were apart because of military service.

4. Absence because of business travel

a. Absence not exceeding 6 months

Consider LISH met unless evidence shows that the couple no longer intended to live together. This applies, for example, if the NH's (or spouse's) employment requires business travel or the spouse is engaged in a temporary or seasonal activity.

b. Absence of more than 6 months

  • •

    Obtain information as to the circumstances of the absence including the length of time the parties were apart, visits and if they were expecting to live together in the near future.

  • •

    LISH is met where the NH has a job that requires business travel away from home if there is a pattern of returning home and no indication they were apart for any reason other than employment.

5. Absence due to confinement in hospital or other curative institution

a. Absence not exceeding 6 months

LISH is met only if the couple intended to resume living together after confinement.

b. Absence exceeding 6 months

  • •

    Determine if the NH and spouse lived together before the onset of the medical condition that resulted in confinement in a curative institution. If not, LISH is not met.

  • •

    Confirm with the surviving spouse that the illness or medical condition was the sole reason the couple separated and continue their separation. If the couple separated voluntarily (for a reason other than, or in addition to, a medical problem) LISH is not met.

NOTE: 

Curative institution includes a mental institution, nursing home, or other medical facility.

6. Absence because of medical reasons and neither spouse confined to an institution

A couple may be separated due to the need for constant, though not specialized, medical care where no one household could (or was willing to) attend to the needs of both members of the married couple, so each lived in different locations (For example, the NH and spouse reside with different family members).

Confirm with the surviving spouse that the medical conditions were the sole reason for the separation and the surviving spouse demonstrated continued interest in the financial and personal welfare of the deceased.

7. Absence because of confinement in penal institution

Consider LISH met if confinement is 6 months or less and the circumstances (including the terms of the confinement) do not raise a question as to whether the parties intended to live together after confinement. LISH would not be met if confinement was for life or for a period exceeding the life expectancy of either spouse, or under a sentence of death.

C. Processing Instructions for determining if LISH has been met

Follow the instructions below when a surviving spouse files for LSDP and you need to determine if LISH is met,

  1. 1. 

    Ask the surviving spouse if they were LISH at the time of death.

    1. a. 

      If yes, LISH is met.

    2. b. 

      If no, go to step 2.

  2. 2. 

    Ask how long they were separated:

    1. 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 . No further development or documentation is required.

    2. b. 

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

    3. c. 

      If more than 6 months and the reason of the absence was due to confinement in hospital, nursing home, or medical institutions and couple would have otherwise resided together, then 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. 3. 

    Ask what were the circumstances that led to separation and if they were expecting to live together in the near future.

    1. a. 

      If the circumstances confirm that there was a reasonable expectation to live together in the near future, 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.

    2. b. 

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

  4. 4. 

    Determine if the surviving spouse is eligible for monthly widow(er)'s (RS 00207.001), mother or father benefits (RS 00208.001).

    1. a. 

      If yes, pay the LSDP

    2. b. 

      If no, deny the claim and document the reason why LISH was not met.

D. References

  • •

    MS 03505.049 - Miscellaneous Lump Sum (LSDP)

  • •

    MS 03505.024 - Information About the Deceased (DECD)

  • •

    RS 00207.001 - Widow(er)'s Benefits Definitions and Requirements

  • •

    RS 00208.001 - Mother/Father Definitions and Requirements

  • •

    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 TN 24 - Lump Sum Death Payments (LSDP) - 11/22/2024