Effective Dates: 10/31/2023 - Present Previous | Next

TN 31 (10-23)

RS 02610.005 Types of Payments Affected by the Alien Nonpayment Provisions

A. Alien Nonpayment Provisions' (ANP's) Effect on the Number Holder (NH)

The following benefits are subject to suspension under the (ANP):

  • •

    Retirement Insurance Benefits (RIB);

  • •

    Disability Insurance Benefits (DIB); and

  • •

    Health Insurance (HI) and Supplemental Medical Insurance (SMI) Benefits.

    Even if an alien has established entitlement to HI/SMI benefits, payment for services or treatments will not be made, even if the service or treatments are received in the United States (U.S.) if the alien has been absent from the United States for 6 full calendar months before the month of treatment or service. This may not apply if the alien was in the United States during the entire month in which treatment was received.

    For more information on SMI eligibility for foreign residents, see HI 00805.007.

    For more information on the lawful presence payment provisions, see RS 00204.010.

    NOTE: Under Title II Welfare Reform Provisions, Title XVIII payments will not be made if the beneficiary is not lawfully present in the United States throughout the month.

B. ANP's Effect on Dependents and Survivors Benefits

1. Initial Claims

A claimant may choose not to pursue a formal claim for benefits after they are advised that no benefits are payable while they remain outside the United States. Appeal rights can only apply to a formal determination on alien suspension.

When a number holder (NH) is in alien nonpayment suspense, benefits that are payable to the spouse or children on the NH’s Earnings Record (ER) for that month are not affected. Separate alien nonpayment determinations are made for each alien beneficiary.

NOTE: A Lump Sum Death Payment (LSDP) is not payable if the NH was ineligible for payment due to the ANP for the month before the month of death. When the LSDP is not payable because of the ANP, disallow the claim. For more information about when LSDP is not payable, see RS 00210.020.

  1. a. 

    Do not discourage potential claimants from filing an application where it appears that the 5-year U.S. residency requirement or an alien exception may not be met.

  2. b. 

    If extensive development is necessary for entitlement of the dependent/survivor, even though payment outside the United States would not occur, explain fully to the claimant the effect of filing for benefits. If the claimant decides not to file an application:

    • •

      Send a 6-month closeout notice if a protective filing has been established. For instructions on how to close a protective writing, see GN 00204.012; or

    • •

      Secure a signed statement on a Form SSA-795 to close out the claims lead. For more information on processing leads, see GN 00202.020.

2. Family Maximum is involved

  1. a. 

    The suspension of a dependent/survivor benefit under the ANP does not result in an increase in the benefit amount to other beneficiaries on the same record. A benefit suspended due to alien nonpayment is used to compute benefits the same way as if it were payable.

    Be sure to advise potential claimants who may be subject to the ANP about the possible reduction to the family’s benefit.

    EXAMPLE:

    C1, C2, C3 and C4 are receiving survivor benefits. C1 and C2 are U.S. citizens. C3 and C4 are residents and citizens of Mexico and do not meet the 5-year residency requirement. The Family Maximum (FMAX) on the case is $1000.00. Each child’s monthly benefit amount is $250.00. C1 and C2’s monthly benefit amount would not increase to $500.00 because benefits are not payable to C3 and C4 because they are in alien suspense.

    For more information on the 5-year residency requirement for alien dependents and survivors outside the United States, see RS 02610.025.

  2. b. 

    Claimant decides to file

    If a claimant who resides outside the United States establishes a presence inside the United States, that presence will interrupt the running of the 6-month period of absence. Under these circumstances, it would be advantageous for the claimant to file a claim because of the possibility of visiting the United States to be paid benefits.

    For more information about establishing absence and presence in the United States, see RS 02610.020.

    If the beneficiary inquires about their right to make such visits: (1 day, 30 consecutive calendar days, or one full calendar month) to the United States to be paid benefits:

    • •

      Explain that they must submit documentary evidence related to the visits;

    • •

      Suggest the various types of evidence which are acceptable. For more information about acceptable evidence of presence in the United States for any part of one day, 30 consecutive days, or one full calendar month, see RS 02610.023; and

    • •

      Explain that failing to interrupt the 6-month period of absence, or failing to submit documentary evidence related to the visits, can result in a loss of benefits.

  3. c. 

    Claimant decides to file and it may be disadvantageous to the single family unit (SFU)

    Obtain a written or oral statement from the claimant indicating that they wish to pursue their claim, and that they understand the results of the action. The statement can be documented via:

    • •

      A Form SSA-795, Statement of Claimant or Other Person; or

    • •

      The Remarks (RMKS) screen in the Modernized Claims System (MCS).

    Use this language as a guide:

    “It has been explained to me that I cannot receive any Social Security payments outside the United States because I do not meet the 5-year residency requirement of the alien nonpayment provision. Even though my entitlement may mean the payment of reduced family benefits, I wish to pursue my claim for benefits.”

  4. d. 

    Claimant decides not to file.

    If a protective writing has been established, send a 6-month closeout notice. For instructions on how to close a protective writing, see GN 00204.012.

  5. e. 

    Discussing withdrawal.

    • •

      Discuss withdrawal with the claimant, only if the claimant and the dependent/survivor whose benefits would be reduced live in the same household. For more information about withdrawal of Title II benefit applications, see GN 00206.001.

    • •

      Make certain that the claimant understands that if they withdraw the application and later decide to claim benefits, the claimant must file a new application which may not cover the same period.

3. Work

a. Annual Earnings Test (AET)

When charging the NH’s excess earnings:

  • •

    Include all beneficiaries, even those in alien nonpayment suspension, in the computation.

  • •

    Alien nonpayment is a suspension event and not a deduction or a termination event.

The employment or self-employment of an insured NH whose benefit is in alien nonpayment suspense cannot affect dependent benefits otherwise payable to the NH's spouse or children on the E/R for that month.

Exception: Dependent benefits can be suspended if the DIB beneficiary fails to accept Vocational Rehabilitation (VR) services even when the DIB is in suspense due to the ANP.

b. Readjusted Rates

The Social Security Independence and Program Improvements Act of 1994 (P.L. 103-296) repealed the facility-of-payment provision for benefits paid for months after 12/95. For more information on readjustment procedures, see GN 02603.010.

Nonpayment of monthly benefits due to the ANP has no effect on the amount of another person’s benefit (i.e., no adjustment for the family maximum benefits is made). For more information on deductions before reductions and facility of payment, see GN 02603.020.

For more information about the readjusted rate exclusions, see GN 02603.040B.

The benefit amount of the dependent/survivor in alien nonpayment suspense is not increased during the readjusted rate period. No action is taken to increase the rates payable to the remaining beneficiaries unless one of the beneficiaries is no longer subject to alien suspense.

C. Readjusted Rates effective January 1996

EXAMPLES:

Survivor case, Single Family Unit (SFU):

PIA: $330.50

MAX: $597.40

Original Benefit (OB): $247.80

MBA: $199.10 (rounded down)

MOE: 01/2007

Foreign work is involved (over 45 hours per month)

1. E is the worker; C1 and C2 are both in alien nonpayment suspense:

  • •

    E is not paid benefits while working; and

  • •

    C1 and C2’s rates of $199.10 are not increased because of the ANP.

2. E is the worker and C1 is no longer in alien nonpayment suspense but C2 is in alien nonpayment suspense:

  • •

    E is not paid benefits while working; and

  • •

    C1 is paid $247.80; and

  • •

    C2’s benefit is not increased and remains at $199.10 in alien nonpayment suspense.

D. Readjusted Rates Before January, 1996

Same example as shown above except the MOE is 01/90, the OB is $247.90 and the MBA is rounded up to $199.20:

1. E is the worker; C1 and C2 are in alien nonpayment suspense:

  • •

    E is paid $97.40 (C1 and C2’s total OB $495.80 minus $398.40 total C1 and C2 MBA); and

  • •

    C1 and C2’s rates remain the same $199.20 each.

2. E is the worker and C1 is no longer in alien nonpayment suspense but C2 is in alien nonpayment suspense:

  • •

    E is paid $48.70 ($247.90 OB minus $199.20 MBA); and

  • •

    C1 is paid $199.20; and

  • •

    C2 remains in alien nonpayment suspense with a rate of $199.20.

E. Workers Compensation

When dependent benefits have been suspended due to the ANP, they are nevertheless included in the total family benefits (TFB) when computing worker’s compensation offset.

For more information on TFB, see DI 52150.005.

F. Reference

RS 00203.030 Child’s Benefits Deduction and Non-Payment Provisions

To Link to this section - Use this URL:
http://policy.ssa.gov/poms.nsf/lnx/0302610005
RS 02610.005 - Types of Payments Affected by the Alien Nonpayment Provisions - 10/31/2023
Batch run: 10/31/2023
Rev:10/31/2023