Basic (04-11)
DI 40120.005 Processing Center (PC) Actions when Concurrent Disability Insurance Benefits (DIB)
or Freeze and Disabled Widow(er) Benefits (DWB) Claim Filed and DIB or Freeze Denied
When the Disability Determination Services (DDS) makes a medical denial determination
on the Disability Insurance Benefits (DIB) claim but does not complete a disability
determination for the Disabled Widow(er)’s Benefits (DWB) claim, you can deny the
DWB claim without returning the case to the DDS in these two situations:
-
1.
The prescribed period ended before the date of adjudication and the earnings requirement
continued to be met after the end of the prescribed period; or
-
2.
The earnings requirement and the prescribed period continue after the date of adjudication.
In these cases, take the following actions:
-
•
Complete the SSA-831 (Disability Determination and Transmittal) in the usual manner
for a DDS determination; include the DDS code, diagnosis, Reg. Basis Code etc.
-
•
Include the following comment in Item 34, “The determination of (date) is hereby incorporated by reference.”
If the widow(er) is within 3 months of age 60 and an SSA-10 (Application for Widow’s
or Widower’s Insurance Benefits), has been filed:
-
•
Award the claimant, aged widow(er)'s benefits, even though the DWB aspects are denied.
-
•
Prepare the SSA-831 denial but do not send the notice unless the aged widow(er)'s
benefits have been awarded.
-
•
Route the case to a Claims Authorizer/Claims Technical Examiner with instructions
to include the notice in the aged widow(er)'s award.