We consider a claim as an adverse adjustment when it meets the following criteria.
The family maximum provision results in a reduction in the past or present benefit payment rates of an earlier entitled beneficiary due to:
The “late filer” is not part of the same household as the adversely affected beneficiary.
Refer to RS 00615.760 for definition of “late filers”.
IMPORTANT: Do not confuse the late filer(s) with a “delayed” claimant. If the original application
does not protect the claimant or files after the closeout period had ended, the claimant
is a “late filer”.
EXAMPLE: Gina Huntley is the number holder (NH)'s daughter by a prior marriage and lives in
a separate household. She filed for student benefits on April 30 on her father's SSN
however, she turned age 18 on January 12 and graduated from high school the following
June. Claimants with Benefit Identification codes (BICs) “A”, “B2”, and “C1” had been
receiving benefits on this SSN since February. Gina receives her first and only payment
as BIC “C2” in July, representing monthly benefits due for April, May and June. Her
student benefit entitlement terminated in July per RS 00205.350D.
We consider Gina’s claim an adverse adjustment because her entitlement caused a reduction
in the benefits of “B2” and “C1” for April, May and June. Therefore, we must send
an advance due process notice of the adverse adjustment to “B2” and “C1” see GN 01010.330.
NOTE: Certified benefit rates for the retroactive period up to, but not including the late
filer's month of filing are protected under Section 202(j)(1) of the Act for unreduced beneficiaries already
entitled on the same SSN (see RS 00615.760 through RS 00615.761). Only the part of the family maximum (FMAX) that the system does not certified for
payment within the retroactive period is due, see RS 00601.020 for rounding of benefits.