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This change was made on Aug 14, 2018. See latest version.
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GN 00204.015: Title XVI Redeterminations (RZs) as Protective Filings for Title II Benefits

changes
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  • Effective Dates: 10/20/2016 - Present
  • Effective Dates: 08/14/2018 - Present
  • TN 61 (03-05)
  • GN 00204.015 Title XVI Redeterminations (RZs) as Protective Filings for Title II Benefits
  • A. Policy - history
  • The law mandates individuals to apply for all other benefits for which they may be eligible in order to qualify for title XVI payments. The law also requires claimants to file applications to become entitled to title II benefits. Therefore, supplemental security income (SSI) recipients who did not file applications but were converted from State rolls to SSI in January 1974 were not deemed to have filed for title II benefits. However, to afford claimants the fullest protection to title II benefits and to ensure that the Social Security Administration (SSA) is in compliance with the law, SSA has adopted procedures under which RZ forms would constitute protective filing documents.
  • For a discussion of the policy on adjudicating title II when a title XVI application is filed, see GN 00204.027. For the instructions on adjudicating all classes of title II benefits when an applicant files a valid title II application, see GN 00204.025.
  • B. Policy - Field Office (FO) responsibility
  • Both the law and the procedures require field offices (FOs) to notify title XVI claimants to apply for and pursue other benefits for which they are potentially entitled. Specifically, the instructions in SI 02305.037A., SI 02305.071G.5., and SI 02305.110 state that FOs should be alert to information about potential entitlement to other benefits when conducting RZs and develop for all title II benefits for which the claimant may be entitled.
  • C. Policy - RZs as protective filing documents
  • 1. RZ serves to protect the title II filing date
  • A RZ form establishes a protective filing for title II benefits whenever the requirements in GN 00204.010 (protective filing) are met and the SSI claimant is potentially entitled to title II benefits, a higher title II benefit than he/she is currently receiving or meets the filing before entitlement policy in GN 00204.007C. at the time the RZ is initiated or before it is completed. This policy applies to FO initiated RZs and Data Operations Center (DOC) RZs including low-error profile RZs (SSA-8202-F6, Statement for Determining Continuing Eligibility for Supplemental Security Income Payments).
  • A RZ form establishes a protective filing for title II benefits whenever the requirements in GN 00204.010 (protective filing) are met and the SSI claimant is potentially entitled to title II benefits, a higher title II benefit than he/she is currently receiving or meets the filing before entitlement policy in GN 00204.007D. at the time the RZ is initiated or before it is completed. This policy applies to FO initiated RZs and Data Operations Center (DOC) RZs including low-error profile RZs (SSA-8202-F6, Statement for Determining Continuing Eligibility for Supplemental Security Income Payments).
  • 2. RZ does not serve to protect the title II filing date
  • A RZ does not serve to protect the title II filing date:
  • * for individuals, other than the claimant, who are named on the RZ if there is no expressed intent to claim title II benefits on their behalf by the claimant.
  • * when the RZ is a completed limited issue. In these situations, a signed RZ form is not obtained. See SI 02305.022 for when a limited issue is upgraded to an unscheduled RZ. In these situations the RZ may serve as a protective writing.
  • * if the individual was not entitled to title II benefits or did not meet the filing before entitlement policy in GN 00204.007C at the time the RZ was initiated or before it was completed but information/evidence received after the RZ completion date establishes entitlement during the RZ period.
  • * if the individual was not entitled to title II benefits or did not meet the filing before entitlement policy in GN 00204.007D at the time the RZ was initiated or before it was completed but information/evidence received after the RZ completion date establishes entitlement during the RZ period.
  • NOTE: If the uncertified earnings record e.g., DISCO, SEQY indicates the claimant has some earnings in covered employment but is not insured, you must obtain a certified earnings record to verify lack of insured status/insured status. If the certified earnings record indicates that the claimant is not insured, annotate the MSSICS record to this effect and that your determination is based on the review of the claimant’s certified earnings record. You need not obtain a certified earnings record if the claimant alleges never working in covered employment and the uncertified earnings record indicated no earnings.
  • 3. RZ serves to protect the title XVI filing date for other individuals named on the RZ
  • Follow the instructions in SI 00601.020A.2. for when to establish a title XVI protective filing date for an individual named on the RZ form.
  • 4. Protective filing closeout and documentation
  • When the RZ serves to protect the claimant’s filing date for title II benefits, the protective filing date must be documented and closed out per GN 00204.012.
  • 5. Documenting the claimant’s filing decision
  • The claimant’s filing decision must be documented. The documentation requirement is satisfied when:
  • * A title II application is completed.
  • * An appointment is scheduled to complete a title II application and is documented on the MSSICS RZ DROC screen or remarks portion of the paper RZ.
  • * The MSSICS RZ DROC screen or remarks portion of the paper RZ is annotated with the method of protective filing closeout used per GN 00204.012 and the date the closeout notice was issued or unconditional statement was signed.
  • NOTE: Take an unconditional statement that the claimant does not want to file for title II benefits only if the claimant is in the FO at the time the RZ is completed. See GN 00204.012 for protective filing closeout procedures.
  • D. Procedure - RZs as protective filing documents
  • If the RZ serves as a protective filing for title II benefits, ask the claimant if he or she would like to file an application.
  • If the claimant wants to file, take an application. If the claimant does not file an application when the RZ is conducted or files but does not elect the earliest possible month of entitlement, follow the filing for other benefit procedures in SI 00510.001 through SI 00510.030. Also see GN 00204.040 for an explanation of the month of entitlement (MOET).
  • NOTE: Retroactivity for title II benefits may be applicable based on the title II application filing date and class of benefits involved.
  • 1. How to establish the protective filing date
  • a. Establishing the protective filing date based on a current RZ
  • If the RZ is available in the office and the claimant meets the requirements in GN 00204.015C.1., use the date of the personal contact interview as the title II application filing date. For Data Operation Center RZs including low error profile RZs (SSA-8202-F6s received through the mail), use the date the RZ is received in the FO as the protective filing date. See GN 00204.007B for determining the receipt date.
  • b. Establishing the protective filing date based on prior RZ
  • Review the RZ history on the SSID or SSI4 query to determine the earliest RZ date where the claimant met title II entitlement or the filing before entitlement policy. Use the first day of the month and year in the RZ Initiation Date (RZI), RZ Completion Date (RZC) or RZ Clearance Date (RZD) field of the CRZD segment of the query as the protective filing date as follows (see SI 02305.034 for the definitions of these fields):
  • * Use the RZI date if the claimant met title II entitlement criteria on the RZI date or before the RZC date.
  • * Use the RZC date if the claimant first met title II entitlement criteria on the RZC date.
  • * Use the RZD date if you know that a RZ was completed but the RZD date is the only date shown for the RZ entry on the query or the RZ was completed before 3/84.
  • EXAMPLE 1:
  • While conducting an RZ in 2/2001, the claims representative (CR) determines that Ms. Potter met title II insured status in 1999. Ms. Potter has been receiving SSI benefits since 2/97. The claimant’s certified earnings record (E/R) shows she earned 4 quarters of coverage in 1999. The claimant’s Supplemental Security Record (SSR) shows verified earnings of $1,000 in 2/99, which gave her the needed 1 quarter of coverage (QC) to meet insured status. A review of the SSID query shows a RZI date of 4/99. The CR uses the RZI date of 4/1/99 to establish the claimant’s title II filing date for retirement benefits since the NH first met insured status on that date.
  • EXAMPLE 2:
  • While conducting a RZ on Mr. Jones’ SSI record, the CR reviews his certified E/R, which shows that he earned the one QC he needed to meet title II insured status in 1999. He has been receiving SSI since 10/96. In reviewing the SSI query, the CR notes that a RZ was initiated in 10/99 (RZI date) and completed in 11/99 (RZC date). The claimant has no documentation to prove when he earned the money in 1999. The claimant alleges that the company he worked for is out of business. Since we have no evidence to prove when the money was actually earned, the CR assumes that Mr. Jones earned the 1 QC needed in the first quarter of 1999 as shown on the certified E/R. The CR uses the RZI date of 10/1/99 as the claimant’s title II filing date for retirement benefits since that is the earliest RZ date after the claimant met insured status.
  • EXAMPLE 3:
  • While conducting a review of the claims folder, the CR notes that the last RZ was completed in 4/98 (RZC date). The SSR shows verified earnings for 8/98 of $1500, which gave the NH the 2 QCs needed for insured status. No earnings were posted for any other month in 1998. The certified E/R shows the NH met insured status in 4/98. Since the CR has evidence that the NH earned the money to meet insured status after the RZC date of 4/98, the RZ is not a protective filing for title II benefits. The filing before entitlement policy does not apply because the NH earned the money to meet insured status after the RZ was completed.
  • 2. Documenting the title II protective filing date
  • a. Documenting the title II protective filing date in MCS
  • If a title II application is taken in MCS, document the title II protective filing date using the Report of Contact (RPOC) screen. If the RPOC screen is not available or you are processing the application manually, use the Evidence screens to document the protective filing date.
  • b. Documenting the title II protective filing date in MSSICS
  • If the claimant is potentially entitled to title II benefits, document the claimant’s filing decision per GN 00204.015C.5. If the claimant does not file a title II application at the time of the RZ interview, document the MSSICS Report of Contact (DROC) screen or remarks portion of the paper RZ with the date the protective filing closeout notice is issued or unconditional statement is obtained per GN 00204.012. Also, issue an SSA-L8051 notice whenever a title II application is not filed at the time of the RZ interview or an application is filed but the claimant does not elect full retroactivity.
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