A. General

Entitlement to HI under the deemed insured provision is barred to any individual who is, or could be, entitled to HI under the regular insured provision as a “Qualified RR Retirement Beneficiary” (QRRB)—see HI 00801.011. However, an individual who is a QRRB may, through some misunderstanding, attempt to file for deemed insured HI. Other individuals who are not currently on RRB's annuity rolls may fail to recognize that they could be entitled to HI as QRRB's because of their potential entitlement to an RR annuity or because they have been considered under the special social security guaranty provision in the computation of another individual's annuity (e.g., a dependent parent who is considered in a widow's annuity). Therefore, DO's and processing centers should be alert to any indication of RR involvement in an HI claim which might suggest that the individual is, or could be, a QRRB.

B. Initial filing cases

If an individual inquiring about HI filing is currently entitled to an RR annuity or is being considered in computing an annuity under the SSA guaranty provision, he should be informed that RRB should notify him shortly that he is automatically entitled to HI as a QRRB. However, if an individual could be entitled to an RR annuity or could be considered under the SSA guaranty provision but has not filed application with RRB, he should be advised to apply at the servicing RRB district office. Where there is any question about an individual's RR status and he is not eligible for monthly RSDI benefits, obtain an SSA-18F5.

When an application for deemed insured HI is accepted but the individual is eligible for HI as a QRRB, his claim must be formally disallowed. The notice of disallowance will explain why he is ineligible for HI with SSA. If the claims file does not indicate that he has filed an application with RRB, advise him to contact the servicing RRB district office; he should be instructed to present his disallowance notice to that office. Include in the notice a reference to the date the individual filed his HI application since this date may establish an earlier filing date for the RR benefit. If he requested enrollment for SMI, also refer to the date he filed his request. The processing center will retain all claims material in the claims folder although photocopies of this material may be prepared and sent to RRB upon request.

C. Prior filing cases

RR involvement in deemed insured HI cases may become pertinent after HI entitlement with SSA has been established. Thus, an individual who is not an eligible or potentially eligible QRRB when he first becomes entitled to deemed insured HI may subsequently acquire QRRB eligibility with RRB. In that event, his entitlement to deemed insured HI will terminate with the month before the first month he has QRRB status. Similarly, if an individual's QRRB status ends (e.g., a wife's annuity terminates because she divorces the RR worker), he/ (or she) may be found entitled for deemed insured HI beginning with the first month thereafter in which he/or she) also meets all the other requirements in HI 00801.047.