TN 2 (02-20)

GN 03316.115 Disclosure Without Consent Concerning Adverse Claims or Adverse Actions

These instructions below in GN 03316.115A.1. and GN 03316.115A.2. do not apply to hearing cases. The administrative law judge should decide what is proper to disclose to parties who are or may be adversely affected. Field offices (FO) or regional offices should consult the Office of Hearings Operations (OHO), Regional Office (RO) for questions concerning hearing case disclosures.

A. Disclosure for adverse claim situations

An adverse claim is an award of benefits to a subsequent claimant, or the reinstatement or resumption of benefits to a prior beneficiary that results in the nonentitlement or termination of an earlier beneficiary.

We may disclose a copy of the relevant evidence to the adversely affected beneficiary.

EXAMPLE: A woman (X) is entitled, but another woman (Y) submits evidence of an earlier marriage to the beneficiary that appears to be still valid. You may show X the evidence establishing Y's earlier marriage to the beneficiary, so X may try to refute it. You may also disclose to Y information relevant to the issue of who is the valid spouse.

B. Disclosure for adverse actions

An adverse action is a determination resulting in either nonentitlement, termination of entitlement, or a benefit reduction to a currently or previously entitled beneficiary, because of a subsequent award to a late-filing claimant on the same SSN.

We may disclose any adverse information that is relevant to the determination to any adversely affected beneficiary.

CAUTION: Do not disclose the new names of adopted children.

EXAMPLE: We sent an adverse adjustment notice to the primary beneficiary's wife. She questions her low benefit rate as a spouse, and the FO explains that the family maximum is a factor because of several children entitled in another household. She requests evidence that reflects her husband is the father of the children, and requests the names and addresses of the children or their payee.

Because the wife’s benefits are adversely affected by the addition of the other auxiliary beneficiaries, we may disclose information establishing paternity (including the names of the children and of the children's mother, which would be on their birth certificates). This is relevant to her own benefit rate. However, she is not entitled to the address of the children, nor the name or address of their payee.

C. Disclosure for conflicting, pending, or simultaneous claims

We may disclose information at our initiation to the extent necessary to resolve discrepancies between the claimants’ allegations.

NOTE: We may disclose this information in order to resolve questions that we need in order to make a determination, as well as, in response to a request from a claimant.

EXAMPLE: We reduced the benefits for widowed mother (E )and one or more children (C) in her care are reduced because of the entitlement of another C of the beneficiary and an unwed mother. You may show E the evidence on which paternity was based.

See GN 01010.310, GN 01010.325, GN 01010.330, and GN 01010.335 for more information on handling adverse adjustments

We may disclose information from the following systems of records in adverse claims situations including, but not limited to:

  • 60-0089 - Claims Folders System;

  • 60-0090 - Master Beneficiary Record; and

  • 60-0320 - Electronic Disability (eDIB) Claim File.

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GN 03316.115 - Disclosure Without Consent Concerning Adverse Claims or Adverse Actions - 05/18/2006
Batch run: 02/06/2020