TN 40 (11-17)

Citations:

Adams v. Weinberger, 521 F.2d 656 (2nd Cir. 1975), AR 86-21(2)
Parsons v. Health and Human Services, 762 F.2d 1188 (4th Cir. 1985), AR 86-22(4)
Doran v. Schweiker, 681 F.2d 605 (9th Cir. 1982), AR 86-23(9)
Wolfe v. Sullivan, 988 F.2nd 1025 (10th Cir. 1993), AR 94-1(10)

A. Policy for the Adams/Parsons/Doran/Wolfe acquiescence rulings (AR)

Follow these instructions to apply the Adams/Parsons/Doran/Wolfe ARs.

1. Issue in the Adams/Parsons cases

In the Adams and Parsons cases, the courts ruled that the proper test to determine whether the number holder (NH) was contributing to the support of a posthumous (not posthumously conceived) child under section 216(h)(3)(C)(ii) of the Social Security Act (Act) is whether the support was commensurate with the needs of the unborn child at the time of the NH's death, even though the contributions were not regular or substantial.

2. Issue in the Doran/Wolfe cases

In the Doran and Wolfe cases, the courts ruled that the proper test to determine whether the NH was contributing to the support of a posthumous child is the same as applied in Adams and Parsons, except that the economic circumstances of the NH must also be considered in determining whether, at death, the NH was contributing to the support of the unborn child.

3. Applicability of ARs

Apply the Adams/Parsons/Doran/Wolfe ARs at all levels of adjudication if, at the time of such determination or decision, the claimant is residing in one of the states in the pertinent circuits.

a. Adams/Parsons ARs

Apply the Adams/Parsons ARs if the claimant’s state of residence at the time of the determination or decision is one of the states in the Second or Fourth Circuits, which include:

• Connecticut (Second)

• Maryland (Fourth)

• New York (Second)

• North Carolina (Fourth)

• South Carolina (Fourth)

• Vermont (Second)

• Virginia (Fourth)

• West Virginia (Fourth)

b. Doran/Wolfe ARs

Apply the Doran/Wolfe ARs if the claimant’s state of residence at the time of the determination or decision is in one of the states in the Ninth or Tenth Circuits, which include:

• Alaska (Ninth)

• American Samoa (Ninth)

• Arizona (Ninth)

• California (Ninth)

• Colorado (Tenth)

• Guam (Ninth)

• Hawaii (Ninth)

• Idaho (Ninth)

• Kansas (Tenth)

• Montana (Ninth)

• Nevada (Ninth)

• New Mexico (Tenth)

• Northern Mariana Islands (Ninth)

• Oklahoma (Tenth)

• Oregon (Ninth)

• Utah (Tenth)

• Washington (Ninth)

• Wyoming (Tenth)

4. Deduction, termination, and nonpayment events for affected cases

For cases affected by the Adams/Parsons/Doran/Wolfe ARs:

• Do not terminate benefits paid based on applying these ARs because the beneficiary no longer resides in the Second, Fourth, Ninth, or Tenth Circuit.

• Apply all deduction, suspension, and nonpayment events listed in RS 00203.030 to the beneficiaries entitled under these ARs.

• Terminate benefits as instructed in RS 00203.035.

B. Field Office (FO) development and processing of cases subject to the Adams/Parsons and Doran/Wolfe ARs

Follow these instructions and the procedures in GN 00306.001D and GN 00306.001E to develop and process cases subject to the Adams/Parsons and Doran/Wolfe ARs.

1. Development for cases subject to the Adams/Parsons and Doran/Wolfe ARs

Obtain satisfactory evidence establishing that the NH is the biological parent of the child and of the type of support, if any, that the NH provided during the mother's pregnancy. Support, depending on the facts of the case, may consist of relatively small cash amounts or support in kind.

Examples of possible support provided by the NH are:

• Transportation of the mother to the doctor's office,

• Doctor bills paid related to the pregnancy,

• Payments toward the hospital bill for birth expenses, and

• Cash payments to the mother for food and rent.

For more information on contributions for support, see RS 01301.005.

Weigh the contributions provided by the NH against the actual needs of the unborn child on a case-by-case basis to determine if the support, even if irregular or unsubstantial, was commensurate with the unborn child’s needs.

For special development of cases subject to the Doran/Wolfe ARs, see additional instructions in GN 00306.285B.2 in this section.

Prepare a special determination on a Report of Contact (RPOC) or SSA-553 in all cases. For non-MCS claims, fax the determination into the Non-Disability Repository (NDR) using the Non-Disability Repository for Evidentiary Documents (NDRed).

2. Additional instructions for developing cases subject to the Doran/Wolfe ARs

Consider the NH's financial circumstances, i.e. the NH’s ability to contribute, in determining whether the NH was contributing to the unborn child's support in addition to the instructions in GN 00306.285B.1 in this section.

Small contributions by a NH with limited financial resources constitutes support if such support meets an important part of the unborn child's needs.

3. Processing awards for cases subject to the Adams/Parsons and Doran/Wolfe ARs

Follow these instructions when processing awards for cases subject to the Adams/Parsons and Doran/Wolfe ARs:

• Enter the remark “Adams/Parsons ARs” or “Doran/Wolfe ARs,” as appropriate, on the RPOC screen in the Modernized Claims System (MCS), or the REMARKS field on the Benefit Continuity Factors/Remarks/Notice (BCRN) screen or Electronic Form BCRN (EFBCRN) screen when processing claim manually using an Automated 101 (A101) or Electronic Form 101 (EF101).

• Enter listing code “246” for “Adams/Parsons/Doran/Wolfe ARs” on the Decision Input (DECI) screen in MCS.

• If entitlement of a child results in an adverse adjustment, follow the procedures in GN 01010.330.

• If entitlement of a child creates an adverse claim, follow the procedures in GN 01010.320. Forward the claim to the servicing Processing Center (PC) as a District Office Final Authorization (DOFA) exclusion (non-DOFA). Record non-DOFA reason code “3” for “ADVERSE CLM” on the Decision Input (DECI) screen in MCS. For more information on non-DOFA claims, see GN 01010.027.

4. Processing disallowances for cases subject to the Adams/Parsons and Doran/Wolfe ARs

Follow these instructions when processing disallowances for cases subject to the Adams/Parsons and Doran/Wolfe ARs:

• Before disallowing a claim, consider all options in which we might allow the child’s claim for benefits following the procedures in GN 00306.001D.

• If there are no such options, disallow the claim under code “32” for “Child illegitimate – no ceremonial marriage – not deemed child.” For information on documenting a code “32” disallowance, see GN 00306.001E.1.

• Enter the remark “Adams/Parsons AR” or “Doran/Wolfe AR,” as appropriate, on the RPOC screen in MCS.

• Enter listing code “246” for “Adams/Parsons/Doran/Wolfe ARs” on the Decision Input (DECI) screen in MCS.

C. Processing Center (PC) procedures for cases subject to the Adams/Parsons and Doran/Wolfe ARs

Follow these procedures when processing cases in the PC that are subject to the Adams/Parsons and Doran/Wolfe ARs:

• List all cases adjudicated under these procedures under listing code “246” for “Adams/Parsons/Doran/Wolfe ARs.”

• If the claim results in an adverse adjustment, follow the procedures in GN 01010.335.

• If entitlement of the child creates an adverse claim, follow the procedures in GN 01010.325.

• After completing all actions, forward the claim to the benefit authorizer (BA) to summarize the award and, when necessary, adjust the rates to currently entitled beneficiaries. Instruct the BA to list the case under code “246.”