POMS Reference

DI 11015: Disabled Widow(er) Benefit (DWB) Cases

TN 31 (10-10)

A. Processing an allowance

1. Determine applicability of SSI/SSP credit toward the waiting period

If a disabled widow(er) beneficiary is currently eligible for, or previously received Supplemental Security Income (SSI) or federally administered State Supplemental Payments (SSP), you may credit each month in that period toward the 5-month waiting period for cash benefits as well as the 24-month Medicare qualifying period.

Reference:

DI 11015.020 – Crediting Months of SSI/SSP Toward the Disability Waiting Period and Medicare Qualifying Period for Disabled Widow(er)’s Benefits (DWB)

2. Adjudicate the claim

DWB cases are district office final authorization (DOFA) cases, unless excluded under normal exceptions. You cannot use a non-medical completion input to process DWB's.

a. Modernized Claim System (MCS) Earnings Computation (EC)

Always attempt to process the claim via MCS EC first.

NOTE: Do not change the established onset date solely to permit MCS processing

b. Automated 101 (A101)

If the case is an allowance for monthly benefits and cannot be processed via MCS EC, prepare an A101.

NOTE: If there are SSI/SSP months credited toward the waiting period, include the remark “SSI/SSP months for DWB, see RPOC in MCS” on the BCRN screen of the A101.

c. Electronic Form 101 (EF101)

If you do not use MCS for the award, or when processing an amended award, use the EF101.

NOTE: If there are SSI/SSP months credited toward the waiting period, include the information on the EFBCRN screen of the EF101, as instructed in DI 11015.020B.5.

B. Processing a denial

Always attempt to process the claim via MCS EC first.

If you cannot adjudicate the denial via MCS EC, process via Manual Adjustment, Credit, and Award Direct Data Entry (MACADE). For complete MACADE processing instructions, see Disallowances, Abatements, and Withdrawals SM 00380.000.

C. References