TN 13 (07-17)

A. Policy for Important information regarding withdrawal of a benefit claims application

Discuss withdrawals of a benefit claims application when entitlement based on the specific application adversely affects the individual. Inform the individual that he or she will forfeit the right to appeal the WD approval and, that a subsequently filed application may not cover the same period. When reviewing the options available to the claimant prior to completing his or her request for WD application, provide any requested Social Security program or applicable information to the claimant’s situation (e.g. RRB benefits, Federal Pension Offset) and discuss the following information:

• The WD of an application nullifies the entire period of entitlement for monthly benefits and Medicare, if included on the WD request. For more information on effects of withdrawal on Medicare, see GN 00206.020.

• The rules of administrative finality do not apply to the determination we make based on the application the claimant would like to withdraw. See GN 04001.001 for more information on administrative finality.

• There are no appeal rights for the requestor after we approve the WD of an application. However, a claimant has 60 days from the date of the WD approval notice to request a cancellation of the WD. See GN 00206.017 for cancellation of a request for withdrawal (WD). There are appeal rights after we deny the WD of an application.

• A claimant entitled to both Retirement Insurance Benefits (RIB) and spouse benefits must withdraw both applications if deemed filing exists. For more information on deemed filing, see GN 00204.035.

• A NH’s WD may affect other beneficiaries on the record. For information on the effect of WD on other claimants, see GN 00206.005A.

NOTE: If the claimant demonstrates any form of mental impairment or does not fully comprehend the consequences of withdrawing his or her application, and the technician believes the claimant to be incapable, develop for a proper applicant per GN 00204.003. For representative payee procedures, see GN 00502.001.

B. Time limit to request a WD of a Retirement Insurance benefit (RIB)

Effective December 8, 2010, we established a 12-month time limit for the withdrawal of a RIB application. A claimant, or proper applicant on the claimant's behalf, may request a WD of his or her adjudicated RIB claim within 12 months of the current date of entitlement (DOEC). For all other benefit claims a claimant, proper applicant, or beneficiary may request a WD at any time.

The 12-month time limit begins the first month after the current DOEC and ends on the last day of the 12th month.

EXAMPLE: If the DOEC were April 2013, then the 12–month time limit would expire the last day of April 2014.

NOTE: Exceptions to this rule are WD request before adjudication and a conditional WD requests. For more information about WD request before adjudication, refer to GN 00206.011; for information about Conditional WD, refer to GN 0206.055.

C. Requesting WD of a Title II Claims Application when Supplemental Security Income (SSI) involved

It is important for the claimant to understand that a request for WD of a Title II claims application by a current or potential SSI recipient could result in termination or denial of his or her SSI payments. For more information on conditions of eligibility and an overview of program benefit requirements for SSI, see SI 00510.001. For more information on WD and SSI see GN 00206.011B.

D. Effect of WD requests when benefits from other Federal, State, and local government agencies or private companies are involved

Inform the claimant that WD of an application for SSA program benefits may result in a loss of other benefits he or she may be receiving (e.g., State unemployment compensation, Veterans Affairs (VA) benefits, or private pension). Advise the claimant he or she should contact the agency providing the other benefit directly to discuss the effects of withdrawing his or her SSA application, and for more information on these benefits.

E. Effect of WD requests when Medicare benefits are involved

If the claimant requests to WD all benefits (i.e., Retirement Survivor’s Insurance (RSI) and Medicare), he or she must also repay Hospital Insurance (HI) expenses and Supplementary Medical Insurance (SMI) premiums. For guidance on processing withdrawals of Medicare benefits, see GN 00206.020. For policy and procedures when the claim involves HI only (no cash benefits), see HI 00801.034, Withdrawal Considerations. For information on withdrawing from Premium-HI for the working disabled, see HI 00801.174. For information on withdrawal of Medicare based on ESRD, see HI 00801.197.

F. Effect of WD requests when an automatic conversion is involved

In cases involving automatic conversion (e.g. Disability Insurance Benefit (DIB) to RIB at Full Retirement Age (FRA)), where the beneficiary does not want to receive the new benefit and requests this in writing, treat the request as a request for WD of the filed application (i.e. The DIB application in a DIB to RIB conversion situation). Explain to the claimant the effects of the WD request. Approve the request if the situation meets the conditions for approval of a WD, regardless of whether the conversion has been made. Advise the claimant that the conditions for repayment of benefits that were awarded before and after (if any) the conversion occurs would apply per GN 00206.005A.

G. References

• GN 00204.020 Scope of the Application

• GN 00204.047 Changing the Month of Election (MOEL) or Month of Entitlement (MOET)

• GN 00206.005 Requirements for Withdrawal (WD) of a Benefit Application.