Effective Dates: 12/29/2014 - Present Previous | Next

Last Update: 12/29/2014 (Transmittal I-3-88)

HA 01340.004 Party to the Proceeding Dies While Request for Review Is Pending

Renumbered from HALLEX section I-3-4-4

A. General

1. Title II

a. Dismissal Rules

Under 20 CFR 404.971, the Appeals Council may dismiss a request for review if any party to the proceeding dies while a request for Appeals Council review is pending and the record clearly shows that dismissal by the Appeals Council will not adversely affect any other person who wishes to continue the action.

If there is any person who qualifies as a substitute party under 20 CFR 404.503(b), the Appeals Council will not dismiss the request for review because a substitute party is a person who may be adversely affected by an Appeals Council dismissal. See also Program Operations Manual System (POMS) GN 02301.030. Rather, when there is a substitute party, the Appeals Council will consider the case on its merits and either grant review or deny the request for review.

NOTE: 

See subsection C below when it is unclear from the record whether there is a substitute party.

b. Vacating Appeals Council Order of Dismissal

Although not specifically required under the regulations, the Appeals Council will vacate its dismissal if within 60 days a person who qualifies as a substitute party (see 20 CFR 404.503(b)) submits a written request for review and shows that a decision on the issues that were to be considered on review may adversely affect him or her.

2. Title XVI

a. Dismissal Rules

Under 20 CFR 416.1471, the Appeals Council may dismiss a request for review if:

  • •

    There are no other parties;

  • •

    There is no information showing there may be a survivor who may be paid benefits under section 1631(b) of the Social Security Act (Act), as set forth in 20 CFR 416.542(b), who wishes to pursue the request for review; or

  • •

    The applicant or recipient did not authorize interim assistance reimbursement (IAR) to a state pursuant to section 1631(g) of the Act.

See also POMS SI 02101.003.

NOTE 1: 

Even though a state may not pursue the IAR claim of a deceased applicant or recipient, the Appeals Council may not dismiss a request for review if there is an IAR authorization in effect. Rather, the Appeals Council will consider the case on its merits and either grant review or deny the request for review.

NOTE 2: 

Although Medicaid eligibility often flows from title XVI eligibility findings, merely showing that a survivor wishes to pursue Medicaid eligibility does not make the person a party to the proceeding or a qualified survivor. Unless the person otherwise meets the criteria as a party to the proceeding or a qualified survivor, the Appeals Council may dismiss the request for review.

NOTE 3: 

If it is unclear whether there is a qualified survivor, see subsection C below.

b. Vacating Appeals Council Order of Dismissal

Under 20 CFR 416.1471(b), the Appeals Council will vacate its dismissal if within 60 days:

  • •

    A person who may be paid benefits under section 1631(b) of the Act, as set forth in 20 CFR 416.542(b), submits a written request for review and shows that a decision on the issues that were to be considered on review may adversely affect him or her; or

  • •

    The Appeals Council receives information showing that the applicant or recipient authorized an IAR to a state pursuant to section 1631(g) of the Act.

B. Writing Requirements for Dismissal Action

When the requirements for dismissal are met because there is no substitute party or qualified survivor, the analyst will clearly set forth the reasons for dismissal in the Appeals Review Processing System analysis. The analyst will also clearly set forth in the dismissal order the basis for dismissal (i.e., there is no adversely affected individual in title II or, for title XVI, that there is no person that qualifies to receive an underpayment and no indication that an IAR agreement that is in effect).

C. Record Is Unclear Whether Substitute Party or Qualified Survivor Exists

If the analyst cannot determine whether there is a substitute party or qualified survivor from the proof of death or other information in the claim(s) file, the analyst will:

  • •

    Contact the appointed representative, if any, for information concerning a possible substitute party or qualified survivor; or

  • •

    When there is no appointed representative, prepare a memo to the servicing field office using the Document Generation System COR 23A template.

To Link to this section - Use this URL:
http://policy.ssa.gov/poms.nsf/lnx/2501340004
HA 01340.004 - Party to the Proceeding Dies Whil Request for Review is Pending (I-3-4-4) - 12/29/2014
Batch run: 04/20/2025
Rev:12/29/2014