The written statement must show the individual's intent to file for benefits either for themselves or on behalf of another and a reasonable time frame of when the individual intends to file for benefits (e.g., wishes to file for retirement this month). The intent cannot be at some future date (i.e., at full retirement age which is beyond the Title II four-month or Title XVI one-month advanced filing procedure), except for DIB auxiliaries' intent, which can include language that an application will be filed if the NH is awarded benefits.

Technicians can create a written statement when individuals contact SSA over the phone. For example, an individual may call and inform an SSA employee of their intent to file for benefits. In such cases, the employee must either schedule an appointment for the individual, take a valid application or send a protective filing closeout.

If the individual is eligible for benefits and they request benefit information, but do not want to file an application (i.e., there is no intent to file), do not create a protective filing date, except for Title XVI oral inquiries, refer to SI 00601.025.

1. a. 

   A claimant, proper applicant, or a third-party individual assisting a claimant must sign the written statement. NOTE: For automated Interim Assistance Reimbursement (IAR) authorizations, refer to GN 00204.010E.3. in this section.

2. b. 

   Individuals using SSA online tools, such as internet claim (iClaim) or internet Appointment (iAppt) can provide a written statement and electronically sign it.

3. c. 

   In situations when an SSA employee creates a written statement for the claimant, such as scheduling an appointment, their personal identification number (PIN) satisfies the signature requirement.

The claimant must be alive when the application is filed.

EXCEPTION: If the claimant dies before the application is filed or dies after it is filed, follow the instructions in GN 00204.005. If Title XVI payments are involved, see who may receive a Title XVI underpayment SI 02101.003 through SI 02101.010.

A valid application must be received within the 6-month protective filing closeout period for Title II or the 60-day protective filing period for Title XVI. Only the individual claiming benefits or a proper applicant for that person may sign the application for benefits. For proper applicant policy refer to GN 00204.003 and SI 00601.012.

The scope of the protective writing is determined by the application subsequently filed. The established protective filing will cover all benefits the individual is eligible for at the time of filing unless it contains restrictions on the scope of the benefit application, refer to GN 00204.020.

The scope of a Title XVI protective writing is determined by the application subsequently filed. An SSI applicant or recipient must take all appropriate steps to pursue eligibility for other benefits, see SI 00510.001.

The Title II protective filing date can also establish the filing date for Title XVIII benefits (Medicare Part A). However, a Medicare-only protective writing establishes the filing date for Medicare only, refer to HI 00801.022.

1. a. 

   Scheduling an appointment

   • •

     Establish the identity of the individual, per GN 00203.020.

   • •

     Determine the type of benefit(s) the individual wishes to file for.

   • •

     Review internal SSA records (e.g., Enhanced Leads and Appointment System (eLAS), Evidence Portal (EP), Technician Experience Dashboard (TED), WorkTrack, iClaim, etc.) to determine if a protective filing record already exists for the claimant under the same SSN and program (e.g., Title II, Title XVI, etc.) for which the individual is intending to file and verify if it has been closed out.

   • •

     If there is a prior protective filing record that has not expired, and the individual requests an appointment, schedule the appointment, but note the original protective filing date in the remarks, as applicable. Inform them of the prior closeout.

   • •

     If there is no prior protective filing record, follow current procedures to schedule the appointment and create the proper protective filing date. If you are unable to document the protective filing date in the appropriate appointment scheduling system (i.e., system outage), complete form SSA-2514 (Record of Claimant's Intent to File) and enter the information into the appointment system once the system is back online and destroy the SSA-2514. The appointment confirmation notice will provide the closeout notice.

   • •

     Ask if there is a spouse or child(ren) under the age of 18, age 18 to 19 and attending secondary or elementary school full-time or disabled before age 22. If they answer yes, ask if they intend to file for benefits for them. If scheduling an appointment in eLAS, create a protective filing record (i.e., "unscheduled lead") in eLAS for each family member who intends to file. Remember the NH is the proper applicant for his or her child(ren) even when the child(ren) are not living with the NH. The NH can file the application and the technician can follow normal procedures to develop for representative payee afterwards. Include the name and SSN of each of the family members in the "Remarks" section of the appointment.

   A request to reschedule an application appointment does not meet the criteria for a new protective filing date, as the initial contact to schedule the appointment established the original protective filing date.

   NOTE: If the individual calls back within the closeout period, but the rescheduled appointment is scheduled for after the closeout period ends, the new protective filing date will be the day after the closeout period ends. To prevent a loss of benefits, make every effort to schedule the appointment prior to the end of the closeout period.

2. b. 

   During the claim interview

   Ask if there is a spouse or child(ren) under the age of 18, age 18 to 19 and attending secondary or elementary school full-time or disabled before age 22. If they answer yes, ask if they intend to file for benefits for them.

   • •

     If intent is provided, review internal SSA records to determine if the auxiliaries were previously listed on any appointment remarks or other SSA records to determine the appropriate protective filing date and obtain the application with a proper applicant.

   • •

     If there is no intent, document the reason provided in the remarks of the application. If there is no application on record (i.e., survivor's claim) or the NH's claim is archived, document the reason for not filing via the notes in TED.

   IMPORTANT: For individuals applying for disability, follow the same process to ask the NH for intent to file for any auxiliaries (i.e., spouse, child(ren)) at the time of the interview and review internal records to determine the correct protective filing date. However, defer obtaining the auxiliary application until the NH’s disability claim is allowed. For more information, refer to DI 11010.025C and DI 11010.030 . If the claim is identified as TERI, Military Casualty/Wounded Warrior, or 100 Percent Permanent and Total Disability, refer to DI 11005.007 and DI 11005.601.

   NOTE: If the additional family members have an intent to file, but are not available or do not file at the time of the appointment for other reasons, offer to schedule the appointment and in remarks document the original protective filing date, as applicable.

• •

  Review the information provided to determine that it meets the required elements of a protective writing, refer to GN 00204.010B in this section. A mailed written statement must contain the individual's name, Social Security Number (SSN), contact information (address and phone number), and a signature (not a typed-out name).

• •

  Make two attempts to contact the individual to file the application or schedule an appointment. If unable to contact the individual, send a manual closeout notice using the Document Processing System (DPS).

• •

  Store the written statement and a copy of the mailed DPS closeout notice in EP.

NOTE: SSA's receipt of a submitted written statement or application form may protect the claimant’s filing date but is not considered a valid application, as described in GN 00204.001.

A written statement of intent to file that is filed with a hospital (e.g., admittance form or admission records) for Title II and Title XVIII (Medicare) applications is protective filing if:

• •

  the claimant is a patient in the hospital;

• •

  the hospital provides services covered by Medicare Hospital Insurance (Part A);

• •

  a valid application is not pending; and

• •

  the statement is sent to SSA.

NOTE: The protective filing date is the date the individual files the statement with the hospital.

A written statement of intent to file received by the RRB is also a protective filing for Title II and Title XVIII (Medicare) benefits if:

• •

  the statement indicates intent to claim benefits under the Railroad Retirement Act;

• •

  the individual filing the statement signs it;

• •

  an application is not filed with the RRB on one of its forms; and

• •

  the RRB sends SSA the statement.

NOTE: For RRB inquiries, see RS 01602.405.

Manual IAR States - The date the State receives the IAR authorization serves as the written statement of intent to file for SSI benefits and establishes a protective writing. The receipt date is the date the form is signed by the State representative.

NOTE: Not all states include protective filing closeout language on their IAR manual forms.

Automated IAR States - The date shown on the PR-73 alert is presumed to be the date the IAR authorization is signed by the IAR applicant and the State representative.

NOTE: Automated IAR states must include protective filing closeout language on the IAR authorization. See SI 02003.007 for the policy on when an IAR authorization must be used as the SSI filing date. SI 02003.020 contains instructions for when the protective writing is an IAR authorization.