TN 11 (06-11)

A. Rules and considerations for lump sum death payments (LSDP) for LISH

1. How we define LISH

We consider LISH a husband and wife who customarily lived together as husband and wife in the same place of residence.

2. Absence considered temporary

You may consider LISH although one of the couple is temporarily absent from the residence. Consider an absence temporary if:

1. It was due to service in the armed forces;

   It was for 6 months or less, neither of the couple was outside the U.S. during the time considered, and the absence was due to:

   • business,

   • employment, or

   • confinement in a hospital, nursing home, other medical institution, or

   • penal institution;

2. It was for an extended separation, regardless of the duration due to the confinement of either spouse and the evidence shows separation solely for medical reasons and would otherwise resided together. For absence due to confinement, see RS 00210.035B in this section.

3. If the evidence indicates that, the expectation was to live together in the near future.

3. Who is considered eligible for LISH

1. A couple must have shared a temporary or permanent residence for at least part of a day following the beginning of the marital relationship (following the marriage ceremony). If the couple never resided together after they became husband and wife, they were not LISH.

   EXAMPLE:  An unmarried couple, A and B, lived together until A entered the hospital. While A was still in the hospital, A and B were married. A died the next day in the hospital. Since A and B did not share a residence as husband and wife for at least part of a day, they were not LISH.

2. If the husband and wife lived at the same address, assume they were living together unless there is evidence to the contrary. Consider a husband and wife LISH if they were inmates of the same hospital, nursing home, or home for the aged or sick, even if they did not occupy the same quarters, provided there was a good reason for not occupying the same quarters, (perhaps it was against the rules and regulations of the institution). Occupancy of different rooms at the same hotel, or different apartments in the same apartment house does not qualify as LISH. Consider LISH even if one of the parties sharing a residence was away from home at the time of death if:

   • the absence was intended as temporary

   • there was intent to continue living together in the same place.

   EXAMPLE: This condition generally applies for deaths that occur in a hospital, while on a business trip, while in the military service, etc.

3. Where the parties do not intend to live together in the same place, no LISH applies. This applies even though when the parties separated they intended this to be temporary.

B. Operating policy regarding absence from the residence

1. Residence in different countries

Generally, you cannot establish LISH where the husband and wife resided in different countries. However, LISH is possible:

• if the parties were living together and one of them was away temporarily, on a visit, or,

• where one spouse preceded the other in returning to the foreign country with the expectation that the other would follow soon. If one of the parties was in a foreign country due to military service, in this section, see RS 00210.035B.3.

2. Absence because of marital difficulties

LISH does not apply if the parties were apart because of incompatibility, ill treatment, or other domestic difficulty. This is so, regardless of the history of prior separation or reconciliation of the parties. An exception to this rule exists when it is clear that the parties, from the beginning, intended to resume living together physically within a short time. For example, the NH regularly became drunk and violent on weekends, and his wife left each time he did so, returning within a few days.

3. Absence because of military service

Separation due to service in the Armed Forces does not prevent a finding of LISH unless there is evidence indicating the parties no longer intended to live together. Without such evidence, accept the claimant's statement that the parties were apart because of military service.

4. Absence because of employment

a. Absence not exceeding 6 months

Consider LISH unless evidence shows that the couple no longer intended to live together. This applies, for example, if the NH (or spouse's) employment requires travel or the spouse is engaged in a temporary or seasonal activity.

b. Absence of more than 6 months

• Obtain full information as to the circumstances of the absence. The finding of LISH will depend on whether the couple thought they were still living together and were apart only temporarily.

• Consider circumstances such as the length of time the parties were apart, how long they expected to be apart, visits, correspondence, contributions, intent to resume living together etc.

• Intent to resume living together requires an expressed understanding to resume living together physically at some reasonably definite time in the near future.

• LISH is present where the NH has a job that requires travel away from home if there is a pattern of returning home and no indication they were apart for any reason other than employment.

5. Absence due to confinement in hospital or other curative Institution

a. Absence not exceeding 6 months

LISH does not apply if the couple did not intend to resume living together after confinement.

b. Absence exceeding 6 months

• Determine if the NH and spouse lived together before the onset of the medical condition that resulted in confinement in a curative institution. If not, LISH is not established.

• Verify whether the illness or medical condition was the sole reason the couple separated and continue their separation. If the couple separated voluntarily (for a reason other than, or in addition to, a medical problem) LISH is not established.

• Determine if the spouse not confined demonstrated interest in the financial or personal welfare of the confined spouse. Without this concern, it is questionable that the separation continued solely for medical reasons.

NOTE: Curative institution includes a mental institution, tuberculosis sanatorium, nursing home, or other medical facility.

6. Absence because of medical reasons and neither spouse confined to an institution

a. Situation with medical care

Separation may be due to the need for constant, though not specialized, medical care where no one household could (or was willing to) attend to the needs of both the husband and wife, so each lived in different locations (For example, one with the couple's daughter and the other with their son).

b. Resolution for medical conditions

• Establish that the medical conditions were the sole reason for the separation and the surviving spouse demonstrated continued interest in the financial and personal welfare of the deceased. (See RS 00210.035B.5.b this section.)

• Contact at least one person in each of the households to confirm the alleged reason for separation and the alleged continuation of interest that the surviving spouse had in the deceased spouse's welfare.

• Resolve conflicting statements or provide ample details for evaluating the separation reason, try to obtain statements from the spouses' physicians concerning the medical conditions to determine if the separation was for medical reasons. Obtain a consent statement signed by the claimant to obtain this information.

Consider LISH where the medical reason was the sole reason for separation and the surviving spouse showed interest in the financial and personal welfare of the deceased.

7. Absence because of confinement in penal institution

If the circumstances (including the terms of the confinement) do not raise a question as to whether the parties intended to live together, the need for further information depends on whether the absence did or did not exceed 6 months. LISH would not be justified if confinement were for life or for a period exceeding the life expectancy of either spouse, or under a sentence of death.

C. Procedure regarding absence

1. Application required with supplemental information

a. Absence 6 months or less with indication absence is temporary

If the surviving spouse states or evidence indicates that either of the parties was, absent from home at the time of death, record:

• the date the absent party was last home;

• the reason the absence began;

• the reason the parties were apart at the time of death;

• the occasion for the confinement (from automobile accident, nervous breakdown, cancer, or other causes).

NOTE:  If the absence was due to confinement in a hospital or other curative institution, the last two items above are not required.

b. Absence more than 6 months (except in military service cases) and information indicates the absence may not have been temporary or was for a reason other than alleged by the surviving spouse

Secure a full statement of the circumstances. Include the following information that may be pertinent to the case with explanations if needed:

• Where each spouse stayed while they were apart

• What contributions (cash or otherwise) one party made to the other while apart (including payment of rent, hospital expenses, etc.)

• Frequency and circumstances of visits and correspondence between the parties

• Location of personal and household belongings of each

• Whether there had been any transfer of license registration, insurance, bank accounts, etc.

• When the parties expected to resume living together physically

• Who paid or is to pay the funeral expenses. If someone other than the spouse paid the burial expenses, find out why.

2. Statements of other persons

If there is some reason to doubt the statement of the surviving spouse get additional statements from other persons. Include within these statements:

• The basis of the informant's family knowledge relating to the absence

• Length and closeness of his or her acquaintance with the parties

• Frequency of visits with the parties

• Whether the information furnished contains personal knowledge on what the parties said.