RS 00202: Spouse's Benefits
TN 18 (02-04)
A. Introduction
The entitlement requirements for an independently entitled divorced spouse (IEDS) are in RS 00202.005. Several unique problems arise in these cases since the NH is eligible but has not filed for benefits.
IMPORTANT: Remember that IEDS claims are not exempt from the deemed filing provisions in GN 00204.035.
IMPORTANT: An independently entitled divorced spouse (IEDS) is subject to the number holder’s (NH) WEP PIA although the NH is not yet entitled to Social Security benefits. See RS 00605.372B.
B. Procedure
1. Obtaining the worker's SSN
To obtain the NH's SSN, the FO will:
Attempt to obtain the SSN from the NH if the claimant does not know the SSN but knows the NH's whereabouts.
If the NH's SSN cannot be obtained from the claimant or the NH, follow RM 00207.001.
2. Documenting information about the NH
Have the claimant complete questions 1, 2, 4, 9, 11, 12, 13, 14, and 15 on an SSA-1 for the NH (see RS 00202.100B.5.). Fax the SSA-1 into the Non-Disability Repository for Evidentiary Documents (NDRed); destroy the paper copy after verifying receipt of the document in NDRed.
If the claimant does not know the information, see RS 00202.100B.4.
DO NOT HAVE ANYONE SIGN THE SSA-1. This form is being used in lieu of an RC, which may be used if preferred. Line out the remainder of the SSA-1.
NOTE: There may be local procedures for documenting the NH’s information electronically.
3. Verifying information about the NH
Take the following action to verify information about the NH:
a. General
Ask the claimant to provide all proofs necessary to adjudicate the claim.
Try to obtain the proofs from the NH if the claimant cannot provide them.
Disallow the claim if the NH's whereabouts cannot be determined and the claimant cannot provide the proof even with our assistance.
b. Age
Follow the instructions in GN 00302.370 if the NH will not cooperate.
Use the least advantageous date of birth for the NH if convincing evidence cannot be obtained and three documents showing the NH to be at least age 62 are used in determining age.
NOTE: If necessary, benefits will be adjusted at the time the NH actually files for benefits.
c. Disability
If the NH's disability is alleged and is material to the claim (i.e., GPO involved):
contact the NH to obtain medical information.
request a disability determination.
If the NH cannot be located or evidence of disability cannot be obtained, the claimant will be subject to GPO or, if appropriate, disallow the claim.
4. Locating and contacting the worker (if required)
The NH is not required by law to cooperate in the development of the former spouse's claim. Therefore, if the NH is uncooperative, do not press the issue.
a. NH is located
When the NH is located, advise him or her:
of the name of the individual who is filing on his or her record;
of the type of benefit involved;
of the evidence needed;
that entitlement of the divorced spouse will not adversely affect his or her benefit amount or the benefits of any future auxiliaries; and
that his or her current whereabouts will not be divulged to the claimant.
NOTE: Do not divulge the claimant's whereabouts to the NH. Disclosure of the whereabouts of either party is a violation of the Privacy Act.
b. NH not located
If you cannot locate the NH:
obtain the NH's identifying information from the claimant; and
check SSA records to try to determine the NH's SSN and an employer.
If an employer is located and the NH was employed there within the last 5 years, contact the employer to try to determine the NH's address; otherwise, disallow the claim, if appropriate.
5. Other development
If contact with the NH is otherwise unnecessary, develop gaps in the E/R and lag earnings only if entitlement is a factor.
Use the certified E/R (CER) function of the Informational/Certified Earnings Record System (ICERS) to determine insured status and PIA computation.
-
Review the NH’s record to determine if evidence of a non-covered pension exists. Use the instructions in RS 00605.360 to determine if WEP applies. If WEP is involved:
Undertake the necessary development per RS 00605.366 and RS 00605.367.
Compute the claimant's benefit amount using the WEP PIA if you cannot locate the NH or obtain evidence of WEP.
Take no further action if it appears that WEP does not apply.
Get all evidence necessary for adjudication of the claim if the NH is cooperative.
Do not pursue a lead for the NH.
-
If the NH dies before entitlement and the currently entitled divorced spouse is under FRA and not entitled to a RIB or DIB, send to the PC:
proof of death; and
an RC instructing the PC to manually convert the IEDS to surviving divorced spouse's benefits.
6. Processing
a. Claim allowed
If the claim is allowed, the FO will:
Load the auxiliary claim into MCS and adjudicate via A-101.
Process the DOFA action manually (e.g., A101). IEDS claims are MCS EC exclusions.
Annotate in the A101 remarks, “Independently Entitled Divorced Spouse's Claim-Process through MADCAP.”
b. Claim disallowed
If you disallow the claim, send the claim to the payment center.
CAUTION: If you deny the claim because the applicant does not meet the 2-year divorce requirement, use paragraph 216 in NL 00708.100 when you prepare your denial notice.
NOTE: There may be local procedures to process disallowances for IEDS claims.