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TN 8 (07-23)

GN 04030.010 Administrative Finality - The Effect of a Revised Date of Birth More Than 4 Years after Initial Determination

CITATIONS:

20 CFR 404.435(a) (3) , 404.905 , 404.988 , and 404.989
SSR 82-45a

A. Introduction

The situation may arise where, more than 4 years after an initial determination to which a date of birth (DOB) was material, a beneficiary submits proof which establishes a different DOB. This different DOB may materially affect the computation of the beneficiary's benefit amount, the months to which work deductions apply, month of attainment of full retirement age, etc.

B. Policy

When the revised date of birth (DOB) determination is favorable to the beneficiary, it will be effective the month we receive the new evidence. If unfavorable, do not make a revision in the DOB (unless fraud or similar fault exists). Explain to the beneficiary that correcting the DOB would have negative consequences (less monthly benefit, overpayment, etc.). Explain that this established DOB will not be changed and the beneficiary should use this date when contacting SSA and other government agencies and intermediaries (Medicare, Health care providers, etc.).

Careful consideration should be given to determine if the revised date of birth would be truly favorable. Some things to consider are the new eligibility year or the year the claimant attains age 62 and the new number of reduction factors based on the new date of birth as well as Medicare entitlement, especially if there are outstanding medical bills (see HI 00805.150 – HI 00805.170 and SM 00850.515). The month of entitlement (MOET) should not change when computing the new benefit amount. This policy applies only to Master Beneficiary Records (MBR). Numident (NUMI) records with incorrect dates of birth can be corrected at anytime provided the correct proofs are provided.

If the DOB change is neither favorable nor unfavorable (i.e., day of birth change,) to the claimant, correct the DOB on the record.

For additional information on changing the date of birth on the NUMI, follow RM 10212.200 – Changing Numident Data-Other than Name Change. In most instances, an SS-5 will need to be processed in order to correct the date of birth shown on the beneficiary’s Numident record.

C. Examples

1. Revised Date of Birth - Disadvantageous

A NH was initially awarded benefits in 09/2001 and the date of birth used to compute their benefits was 09/20/1936. The notice of award was dated 09/28/2001. In 09/2006, the NH comes into the office and provides proof that their correct date of birth is actually 09/20/1937. The NH did not have any outstanding Medical bills, prior overpayments, work deductions, etc.

In 09/2001 the NH’s PIA was $833.80 and their MBA was equal to their PIA since they were FRA in 09/2001. In 09/2006, when they came into the office to correct their date of birth their PIA and MBA were $946.60. If we correct the date of birth to 09/20/1937, the NH’s PIA in 09/2006 with the corrected date of birth would be $989.30 and their MBA would be $923.30.

Since changing this NH’s date of birth effective 09/2006 will increase their PIA but lower their actual monthly benefit, the date of birth should not be changed. The change in their PIA and the decrease in their MBA are due to the change in their eligibility year and an increase in the number of reduction factors.

2. Revised Date of Birth - Advantageous

A NH was awarded benefits in 06/1994 and the date of birth used to compute their benefit was 05/12/1932. In 09/2006, the NH came into the office and provides proof that their real correct date of birth is 05/12/1931. In trying to decide whether this is advantageous, the CR computes the PIAs effective in 09/2006. With the incorrect date of birth of 05/12/1932, the PIA effective 09/2006 is $547.10 and the MBA is $440.70. With the correct date of birth of 05/12/1931, the PIA effective 09/2006 is $533.20 and the MBA is $465.00. Since the NH does not have any outstanding Medical bills or other deductions on their record, the advantage of changing their date of birth will result in their monthly benefit being increased by $25.00 even though their PIA will decrease. The change in the PIA and the increase in MBA are due to a change in the eligibility year and a decrease in the number of reduction factors. The new MBA of $465.00 is effective 09/2006. The NH may also be entitled to earlier dates to both HI and SMI. When reopening and revising this case, please ensure that the NH is given the earliest possible date of entitlement to free HI and the option of selecting an earlier date of entitlement to SMI (see HI 00805.195 and SM 00850.515).

NOTE: If the Medicare entitlement dates are not consistent with the currently coded date of birth, the equitable relief codes may be needed on the MBR.

To Link to this section - Use this URL:
http://policy.ssa.gov/poms.nsf/lnx/0204030010
GN 04030.010 - Administrative Finality - The Effect of a Revised Date of Birth More Than 4 Years after Initial Determination - 07/10/2023
Batch run: 07/10/2023
Rev:07/10/2023