POMS Reference

This change was made on Jul 9, 2018. See latest version.
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RS 00203.015: Requirements for Re-entitlement to Child’s Benefits

changes
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  • Effective Dates: 01/12/2017 - Present
  • Effective Dates: 07/09/2018 - Present
  • TN 16 (09-11)
  • TN 17 (07-18)
  • RS 00203.015 Re-entitlement Requirements for Child’s Benefits
  • RS 00203.015 Requirements for Re-entitlement to Child’s Benefits
  • A. Re-entitlement requirements policy
  • Citations:
  • 20 CFR § 404.351
  • A. Definition of re-entitlement
  • Re-entitlement to child’s benefits is a subsequent award for an auxiliary or surviving child:
  • * who was previously entitled on the same Social Security Number (SSN);
  • * whose prior benefits were correctly terminated; and
  • * whose break in entitlement on that SSN was for at least one month.
  • The termination and break in entitlement may have been due to an interruption of full-time student attendance, or a break between an age 18 termination and the establishment of a subsequent date of onset for Childhood Disability Benefits (CDB).
  • If the prior entitlement to child’s benefits terminated because the number holder’s (NH) disability ceased, see RS 00203.015E.2 in this section.
  • NOTE: Benefits for minor children, students, and disabled adult children, all fall under the same class of benefits; i.e. child’s benefits.
  • B. Requirements for re-entitlement to child’s benefits
  • 1. General information on re-entitlement requirements
  • A child whose entitlement to child's benefits ended with the month preceding the month the child attained age 18, or with a subsequent month, may be re-entitled on the same earnings record upon filing an application, without re-establishing dependency, provided the child still meets the definition of child in RS 00203.001 and meets one of these criteria:
  • * is under age 19 and is a full-time student in an elementary or secondary-level school program, or
  • * is under a disability that began prior to attainment of age 22 (effective 01/73), or
  • * is under a disability that began before the close of the 84th month following the month in which his or her most recent entitlement to child's benefits terminated because his or her disability ceased (effective 01/73), or
  • * effective 10/01/04, reentitlement to childhood disability benefits is allowed at any time if the beneficiary's prior entitlement terminated because he or she ceased to be under a disability due to the performance of substantial gainful activity (SGA) and other reentitlement requirements are met. (For information on SGA, see DI 10505.001). If the previous entitlement to childhood disability benefits terminated because of medical improvement, the 84- month time limit still applies.
  • * had his or her entitlement terminated prior to 10/72 due to an adoption;
  • A child whose entitlement to child's benefits ended with the month preceding the month the child attained age 18, or with a subsequent month, may be re-entitled on the same earnings record upon filing a new application without re-establishing dependency if he or she:
  • * still qualifies as the number holder’s (NH) child per GN 00306.000; and
  • * has not married since he or she last became entitled to benefits, unless the marriage was void or annulled. For more information on void marriages and annulment, see GN 00305.125 through GN 00305.135.
  • and
  • * has not married since the child last became entitled to benefits. (A voided or annulled marriage is an exception.)
  • NOTE: A marriage that ended by death or divorce precludes re-entitlement on the same parent’s earnings record. However, a child whose marriage precludes re-entitlement on the same parent’s earnings record may establish initial entitlement on their other parent’s earnings record provided the child meets the requirements in RS 00203.001A.1, including being unmarried. For information on when a child who has been married may be considered unmarried for initial entitlement, see RS 00203.020A.1.
  • NOTE: A marriage that ended by death or divorce precludes re-entitlement. (For information on reinstating or re-entitling a child's benefits when a marriage is void or annulled, see GN 00305.125 through GN 00305.130.) (See RS 00203.020 - When a Child Who Has Been Married May Be Considered "Unmarried".)
  • In addition, the child must meet one of these criteria:
  • * be under age 19 and a full-time student in an elementary or secondary level school program. For more information on childs benefits based on student status, see RS 00205.000. Under certain circumstances, we may deem a student not to have attained age 19, see RS 00205.001A; or
  • * be under a disability that began prior to attainment of age 22; or
  • * be under a disability that began before the end of the 84th month following the month in which his or her most recent entitlement to CDB terminated because of medical improvement; or
  • * had his or her entitlement terminated prior to 10/72 due to adoption.
  • NOTE: An application is NOT required when a child entitled to child's insurance benefits for the month before attainment of age 18, is eligible for benefit continuation, with no break in entitlement, based on disability or school attendance. (See RS 00205.001 for eligibility criteria for a student and RS 00205.400E.2 for completion requirements for the SSA-1372 (Student's Statement Regarding School Attendance). (Refer to DI 10115.001 through DI 10115.050 for eligibility requirements for a childhood disability beneficiary, and RS 00203.080 for application guidelines for childhood disability benefits (CDB)).
  • Effective October 1, 2004, re-entitlement to CDB is allowed at any time if the beneficiary's prior entitlement terminated because he or she ceased to be under a disability due to the performance of substantial gainful activity (SGA) and other re-entitlement requirements are met. For information on SGA, see DI 10500.000. If the previous entitlement to CDB terminated because of medical improvement, the 84-month time limit still applies.
  • IMPORTANT: For requirements for initial entitlement to child’s benefits, see RS 00203.001.
  • 2. “Throughout the entire month” requirement
  • The first month that a child can be re-entitled to a monthly benefit is subject to the “throughout the entire month” requirement if the child:
  • * is being re-entitled on the earnings record (ER) of a living number holder (NH), and
  • * the child was not entitled to child's benefits on any ER for August 1981 or any preceding month.
  • The first month that a child can be re-entitled to a monthly benefit is subject to the “throughout the entire month” requirement if:
  • * the child is being re-entitled on the earnings record (ER) of a living NH, and
  • * the child was not entitled to child's benefits on any ER prior to September 1981.
  • For policy on the first month of re-entitlement to child’s benefits, see RS 00203.005 for death cases and RS 00203.010 for life cases.
  • 3. Example of applying re-entitlement policy
  • A child received benefits as a minor child on her deceased father’s record. Her benefits were correctly terminated at age 18. She married at age 19 and divorced at age 20. After suffering a traumatic brain injury at age 21, she applied for CDB benefits on her father’s record. We would consider her application for CDB benefits on her father’s record as an application for re-entitlement to child’s benefits. She would not be eligible for re-entitlement on her father’s record because she married since she was last entitled to benefits on his record. While the marriage ended in divorce, we cannot disregard this marriage when considering her eligibility for re-entitlement on her father’s record.
  • IMPORTANT: While the child in this scenario is not eligible for re-entitlement on her father’s record, she may be eligible for initial entitlement on her other parent’s record if that parent is receiving benefits on his or her own earnings record or deceased, as a marriage that ended by divorce does not preclude initial entitlement (see RS 00203.015B.1).
  • C. Retroactive re-entitlement
  • If a child no longer meets all the requirements for re-entitlement in RS 00203.015B at the time he or she applies for child’s benefits, we may be able to find the applicant entitled to child’s benefits by:
  • * establishing re-entitlement for months in the retroactive period during which the child met all requirements in RS 00203.015B; and
  • * terminating the child’s re-entitlement with the month before the month in which any of the terminating events in RS 00203.035 occurred.
  • For example, a child who is married at the time she files her application for benefits, may be re-entitled to benefits for months prior to the month of her marriage. If benefits are payable for a retroactive period, the marriage is a terminating event.
  • IMPORTANT: Consider protective filing (see GN 00204.010) and retroactivity for Title II benefits (see GN 00204.030) when determining a child’s eligibility for a retroactive period.
  • D. Requirements for re-entitlement to Medicare
  • A child who is re-entitled to CDB may also be re-entitled to Hospital Insurance (HI) or Part A benefits and eligible for Supplementary Medical Insurance (SMI) or Part B. For information on HI and SMI based on CDB entitlement, see HI 00801.146, HI 00801.152, and HI 00805.005.
  • 3. Retroactive entitlement
  • E. When re-entitlement provisions do not apply
  • A child can be re-entitled for months in the retroactive period, which meets the above requirements even though the child no longer meets all of them.
  • 1. Benefit continuation at age 18 based on school attendance or disability
  • 4. NH's disability insurance benefits entitlement terminated
  • The re-entitlement provisions do not apply when a child is entitled to child’s insurance benefits for the month before attainment of age 18 and the child is eligible for conversion to student benefits, or benefit continuation as a CDB, in the month he or she attains age 18. Such benefit continuation does not require an application. For information on benefit continuation at age 18 as a student or CDB, see RS 00205.400 and RS 00203.085 respectively.
  • If the child's prior entitlement began with the NH's entitlement to a disability insurance benefit, which terminated because the disability ceased and the NH has since died or has again become entitled to a disability insurance benefit or retirement insurance benefit, the initial entitlement provisions apply, instead of the re-entitlement provisions. (For Expedited Reinstatement, see DI 13050.060A.2. For information on Dependency Requirements, see GN 00306.232.)
  • 2. Prior entitlement to child’s benefits terminated because NH’s disability ceased
  • B. Child re-entitled based on a disability
  • Initial entitlement provisions apply, instead of the re-entitlement provisions, when:
  • * the child’s prior entitlement was based on the NH’s entitlement to a Disability Insurance Benefit (DIB);
  • * the NH’s entitlement to DIB terminated because of medical improvement;
  • * the child’s entitlement was terminated because the NH’s entitlement was terminated;
  • * the NH, after his or her termination because the disability ceased, has died, has become entitled to Retirement Insurance Benefits (RIB), or has again become entitled to DIB; and
  • * the child is filing a new application for benefits.
  • A child re-entitled based on a disability may also be re-entitled to Hospital Insurance (HI) benefits and eligible for Supplemental Medical Insurance (SMI) once meeting the requirements of the law. (For information on health insurance, see HI 00801.146.)
  • For information on expedited reinstatement, see DI 13050.060A.2.