TN 22 (04-09)

A. Background

For benefits payable before 1/1/91 a stricter definition of disability applied. The DIB claimant was notified on the DIB award notice if he/she met the disability requirement for DIB but not for widow(er)'s benefits.

B. FO procedure

1. DIB claimant eligible for widow(er)'s benefits

The FO will:

• Follow instructions in DI 11015.015 for DIB – DWB claims, DI 10005.005 for disability development and DI 10005.001 for an overview of FO responsibilities and tasks; and

• Process the lump sum death payment (LSDP) while the disability decision is pending. Refer to instructions in DI 11025.020 for special situations; and

• Obtain an earnings record (ER) if needed on both the deceased spouse’s record and the disabled widow(er)’s record; and

REMINDER: MCS EC provides, at a minimum, the yearly earnings and the insured status determination. In the event that Modernized Claims System (MCS) Earnings Computation (EC) does not produce an ER, obtain one through Informational/Certified Earnings Record System (ICERS).

• Prepare a Disability Determination and Transmittal, SSA-831, for each claim filed per instructions in DI 11015.015C and

• Fax the SSA-831 to the certified electronic folder (CEF) per instructions in DI 81010.090; and

• For further processing instructions, see DI 11015.025.

2. DIB-DWB adjudication

If the Disability Determination Services (DDS) sends notification of a favorable decision:

• adjudicate the claim(s) in MCS EC if no processing limitations exists. If a processing limitation exists, prepare an EF; and

• take any corresponding action in EDCS per instructions in DI 81001.045.

NOTE: Use the MCS EC routing form to fax any paper claims to the appropriate program center’s (PC) paperless fax number.

3. DIB beneficiary files for DWB

If a DIB beneficiary wishes to file for DWB, the FO will:

• complete the application through MCS or obtain a form SSA-10-BK, (Application for Widow’s or Widower’s Benefits); and

• complete any necessary nondisability development; and

NOTE: For storing non-medical evidence in the CEF, see DI 81010.135.

• determine if the FO can adopt the prior DIB decision following instructions in DI 11011.005. If the FO can adopt, refer to DI 81010.142 for proper instructions on documenting the information in the CEF if applicable; and

• if the FO cannot adopt the prior decision, forward the DWB claim for a medical determination per DI 11011.005. Enter “Widow(er) entitled to DIB on (XXX-XX-XXXX)” on the DDTR screen in MCS, or item 23 of the paper SSA-831 if the case cannot be processed electronically per DI 11010.205; and

• follow instructions in RS 00207.015 when a disability determination is made

C. References

DI 11015.010, Field Office (FO) Processing of a Disabled Widow(er)'s Case in the Electronic Disability Collect System (EDCS)

RS 00207.004, Widow(er) Benefits Table of Proofs and Development – Policy