Sample Report of Contact (SSA-5002) for the electronic file, e.g.
EP:
Issue: Is Danny Torrance eligible for surviving child's benefits and the lump sum death
payment (LSDP) on the record of alleged parent Jack Torrance?
Background: Jack Torrance (NH) never married the child's biological parent, and Jack Torrance
passed away five months after the child's birth. As proof of relationship, the biological
parent submitted a posthumous judgment of paternity and a DNA test showing a strong
likelihood of the child's biological relationship to the child's paternal grandparent.
In addition, the NH's parent signed a statement indicating that the NH was the parent's
only son.
POMS: GN 00306.008, GN 00306.100, GN 00306.430, PR 01105.007 (look up & change)
Domicile: Estes Park, Colorado. NH passed away in Estes Park, Colorado. The claimant was born
in Colorado, and the claimant lives in Colorado. All events transpired in Colorado.
Sample required text for the "MY QUESTION"
section in vHelp:
In the first line of the "My Question" text box, input in all-caps font: POSSIBLE LEGAL OPINION REQUEST FOR THE DENVER
REGION
Summary Report of Contact (SSA-5002) - Posted to Evidence Portal on 7/15/2018.
Issue: Is Danny Torrance eligible for surviving child's benefits and the lump sum death
payment (LSDP) on the record of Jack Torrance?
Domicile: Estes Park, Colorado. Jack Torrance (NH) passed away in Estes Park, Colorado. The
claimant was born in Denver, Colorado, and the claimant currently lives in Colorado.
All events transpired in Colorado.
Summary Case Facts:
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•
On 10/31/2017 Danny Torrance was born in Denver, Colorado.
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•
On 3/30/2018 Jack Torrance passed away in Estes Park, Colorado. At the time of Jack
Torrance's death, the NH was domiciled in Estes Park, Colorado.
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•
On 6/15/2018 the Superior Court of Colorado issued a Judgment finding the deceased
NH to be the CL’s parent.
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•
On 7/01/2018 the CL filed for surviving child’s benefits and the Lump Sum Death Payment
(LSDP) on the late NH’s earnings record.
Supporting Evidence:
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•
Danny Torrance’s (CL) Certificate of Live Birth, born 10/31/2017 in Denver, Colorado,
no father shown (see Evidence Portal dated 7/1/2018)
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•
Certificate of Death showing that Jack Torrance (NH) died 3/30/2018 in Estes Park,
Colorado (see Evidence Portal dated 7/1/2018)
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•
DNA test dated 5/15/2018 showing a high probability of biological relationship to
the CL’s paternal grandparents (see Evidence Portal dated 7/01/2018)
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•
Judgment dated 6/15/2018 from the Superior Court of Colorado, finding the deceased
NH to be the CL’s father (see Evidence Portal dated 7/01/2018)
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•
Statement from Mindy Torrance (paternal grandparent) dated 4/15/2018 stating that
the NH was Mindy Torrance's only son, and that the CL is Mindy Torrance's grandchild
(see CFUI dated 7/15/2018)
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•
Child Relationship Statement (SSA-2519) dated 7/10/2018 from the CL’s biological parent,
Wendy Snows (see Evidence Portal dated 7/15/2018)
Direct all program-related and technical questions concerning this transmittal to
the Regional Office (RO) support staff or Program Service Center (PSC) Operations
Analysis (OA) staff. RO support staff or PSC OA staff may further refer issues and
concerns to their Central Office contacts.