TN 55 (07-03)

Citations:

Social Security Act, Section 202(j), 1631(e), 806.

20 CFR 404.603, 404.610, 404.611, 404.612, 404.613, 404.614, 404.615, 404.620, 404.621, 404.623, 404.630, 404.631, 404.632, 404.633, 408.305, 408.310, 408.315, 408.320, 408.325, 408.330, 408.340, 408.345, 408.351, 416.305, 416.310, 416.315, 416.320, 416.325, 416.330, 416.335, 416.340, 416.345, and 416.350

A. Introduction

This subchapter contains title II (Social Security benefits) application filing policies and procedures that apply also to the title VIII (Special Veterans Benefits), title XVI (Supplemental Security Income), and title XVIII (Medicare) programs unless specified otherwise.

B. Policy - general

A claimant (or proper applicant on his/her behalf) must file a valid application to become entitled to benefits except in those situations where automatic conversions apply (e.g., the beneficiary is entitled to Disability Insurance Benefits (DIB) in the month before attainment of full retirement age (FRA) and benefits are converted to Retirement Insurance Benefits (RIB)). (See RS 00615.003 for the FRA chart.) Also, claimants must file a new application to become re-entitled if entitlement was previously terminated and reopening does not apply.

EXCEPTION: A new application may not be needed if expedited reinstatement is requested under the Ticket to Work and Work Incentives Improvement Act of 1999 (see GN 00204.001F).

A faxed application does not meet the signature requirement to qualify as a valid application; a faxed application is considered the same as a photocopy. A photocopy is not acceptable when the Social Security Administration (SSA) requires that an individual submit an original or a certified copy of a document. Therefore, when policy calls for a signed application, a pen and ink signature or signature proxy is required. The use of signature proxy is acceptable for some applications for benefits including Internet claim (iClaim) applications, redeterminations, and other SSA processes (see GN 00201.015 for policy and procedures for the use of alternative signature methods).

C. Policy - requirements

1. Valid application

To be valid an application must be:

1. On a prescribed application form (GN 00204.002);

2. Signed beneath the penalty clause by a proper applicant (GN 00204.003); and

3. Filed with SSA (GN 00204.006);

4. The claimant must be alive when the application is filed unless:

   • Before death, there was a written statement of intent to claim benefits (GN 00204.005A and SI 00601.020);

   • Before death, a Supplemental Security Income (SSI) oral inquiry was received (SI 00601.025); or

   • Within 3 months after the month of death, a title II disability application is filed (GN 00204.005A)

2. Disposition

We will adjudicate a valid application and notify the claimant of the determination. If the claimant files but dies before we effectuate the application, we will process it per GN 00204.005F. See SI 02101.003B.3. for instructions on handling SSI applications, which are pending at the time of the claimant's death.

NOTE: Refer to DI 10105.015 for retroactivity of disability benefits and DI 40101.001 - DI 40105.025 for specific instructions for processing disability applications.

D. Policy – Railroad Retirement Board (RRB) application

An application filed with the RRB on one of the designated forms for an annuity under the Railroad Retirement Act (RRA) is also considered an application for Social Security benefits provided the application is filed:

• By or for a claimant who has less than 10 years of service in the railroad industry and who has less than 5 years of railroad service after 1995;

• By or for a claimant who has 10 or more years of railroad service or who has 5 or more years of railroad service after 1995 and the applicant does not limit the application to benefits payable only under the RRB; or

• By the spouse or by or for the child of a claimant who has worked any length of time in the railroad industry and the applicant does not limit the application to benefits payable only under the RRB.

An application for SSA survivor benefits is also an application for RRB survivor benefits (see RS 01601.230 for processing title II applications with RRB involvement). Consider the possibility of entitlement to RRB benefits on other SSNs (e.g., widow’s benefits on another former spouse’s record).

An application for SSA life benefits does not protect the filing date of a RRB life claim nor is it an application for RRB benefits. For this reason, it is important to tell the number holder (NH) to file an application with RRB to claim benefits under the RRA (RS 01602.500).

NOTE: Since even potential RRB eligibility by the claimant, the spouse or the prior spouse can affect the claimant’s SSA eligibility and/or total benefit amount, advise the claimant to contact the local RRB office prior to filing for SSA benefits.

E. Policy – Department of Veterans Affairs (DVA) application

An application filed with the DVA on one of its forms for survivors’ dependency and indemnity compensation is considered an application for Social Security dependents and survivors’ benefits except the lump sum death payment (see RS 01702.424).

An application filed with SSA for survivor benefits (i.e., SSA-4, SSA-5, SSA-7, and SSA-10) is also an application for survivor benefits with the DVA (see the Note in RS 01702.410A when a SSA life claim is converted to a survivor benefit claim).

F. Policy – request for reinstatement

Effective 1/1/2001, the Expedited Reinstatement Provision in the Ticket to Work and Work Incentives Improvement Act of 1999, (which amends sections 223 and 1631 of the Act), provides that an individual’s request for reinstatement of disability benefits may constitute an application for benefits when reinstatement is denied. See DI 13050.015B for the policy for using the request as a protective filing and DI 13050.015C concerning the scope of the protective filing which protects title II and title XVI benefits that may be payable. All necessary claims development should be initiated when processing the request for reinstatement as an application. See GN 00204.027 for the policy and procedure for adjudicating the title II application which resulted from a title XVI filing.

Whenever a request for reinstatement is filed, potential entitlement to other benefits should be explored with the claimant (see GN 00204.022) if he/she is eligible to receive other benefits or will be eligible for another benefit within 4 months of the date the reinstatement request is filed. See SI 00510.001 for the requirement that a SSI recipient file for all other benefits that may be payable.

G. References

• SI 00601.010 Filing title XVI applications

• VB 00201.010 Filing title VIII applications