TN 4 (02-20)
DI 12026.027 Completion of the SSA-770-U4 Notice Regarding Substitution of Party Upon Death of
Claimant Reconsideration of Disability Cessation
A. Overview of the SSA-770-U4
The SSA-770-U4 allows a substitute party to pursue the appeal of a deceased individual. For more
information on the substitution of party, see DI 29005.025 Individual Dies before a Determination is made on a Request for Reconsideration Continuing
Disability Review (CDR).
Complete the SSA-770-U4 as follows:
Complete the identifying information about the deceased and check the appropriate
box to indicate the substitute party’s relationship to the deceased.
Check the appropriate box if the substitute party has in his or her care the deceased’s
child(ren) under age18, (or an eligible student) or disabled child.
Check the appropriate box whether the substitute party wishes to proceed or does not
wish to proceed with a reconsideration requested by the deceased. For additional instructions
on completing this response, see paragraphs C and D below.
Have the substitute party sign the form, print his or her full name, complete the
mailing address, telephone number, and date, where designated.
If the substitute party signs by a mark ‘X,’ two witnesses must sign the form and
complete the address information where designated.
The individual recognized as a substitute party to the reconsideration must choose
at least one of the three selections and submit the SSA-770-U4. Check box 1 on the
form. In addition, check box 'a,' 'b,' or 'c,' as indicated on the form.
substitute party indicates he or she
attend the disability hearing already
If the substitute party would like to attend the hearing already scheduled, he or she
will select, ‘a’ on the SSA-770-U4.
substitute party requests a change in the scheduled
hearing. If the substitute party requests a change in the time or place of the scheduled
hearing, he or she will select, ‘b’ on the SSA-770-U4. Handle a request to change
a scheduled hearing by a substitute party as follows
Attach form SSA-769-U4 (Request For Change In Time/Place of Disability Hearing)
Complete the appropriate information on behalf of the deceased claimant and the substitute
party in the designated spaces.
Inform the substitute party that he or she will receive notification of the change
in time or place of the disability hearing if approved by a representative of the
Disability Hearing Unit (DHU).
substitute party indicates he or she does not wish to attend the disability
hearing. If the substitute party does not wish to attend the disability hearing, he or she
will select 'c' on the SSA-770-U4. Take the following actions:
Inform the substitute party of the consequences concerning the request to not attend
the hearing and have him or her sign form SSA-773-U4 (Waiver of Right to Appear-Disability Hearing).
Attach the SSA-773-U4 with only the deceased claimant's name and social security number (SSN).
Inform the substitute party that he or she will receive notification of the reconsideration
party states that he or she wants to withdraw the reconsideration request
If the individual does not wish to proceed with the reconsideration of a disability
cessation requested by the deceased, check box 2. Take the following actions:
Inform the substitute party of his or her potential liability for an overpayment as
well as his or her eligibility for a potential underpayment that may result from the
Attach the SSA-773-U4 with only the deceased claimant's name and SSN.
Inform the substitute party that unless the overpayment is $200 or more, recovery
of an overpayment from a deceased claimant's estate is not considered. If, after the
explanation, the substitute party is not interested in pursuing the reconsideration,
have him or her complete the appropriate box on the SSA-770-U4. For additional information regarding a claimant’s potential liability of overpayment
and eligibility for an underpayment, see:
DI 11055.050 Claimant Dies after Filing and Prior to a Disability Determination and,