TN 12 (08-11)

A. Policy for payment to other priority categories

1. Widow(er) under second priority of payment

For payment based on eligibility to monthly benefits, the claimant must meet every factor of entitlement for monthly benefits except filing a timely application. If the claimant does not meet all the factors other than the application requirement, the claimant cannot receive the Lump Sum Death Payment (LSDP).

If there is more than one widow(er) entitled to the LSDP, divide the LSDP equally between the widows(ers).

NOTE: Entitlement to a DIB which equals or exceeds the deceased wage earner’s (DWE) PIA, does not preclude a widow(er)'s entitlement to the LSDP.

2. Children under third priority of payment

To pay the LSDP to an eligible or entitled child of the NH under the third priority of payment, we must determine that:

• no spouse exists who is eligible for the LSDP, and

• the child is entitled to (or was eligible for) child’s benefits based on the NH's Earnings Record for the month of the NH's death.

3. Multiple child claimants

a. Simultaneous eligibility or entitlement

Follow these procedures when there are multiple child applicants.

• If more than one child is entitled to or eligible for, child's benefits on the NH’s earnings record, each child is eligible for an equal share of the LSDP.

• If one or more of the entitled children choose not to apply, the child(ren) who did apply is (are) still due only his or her proportionate share of the LSDP.

EXAMPLE:  Children C1, C2, and C3 are all entitled to child's benefits in the month the NH dies. C1 applies for the LSDP; C2 and C3 decline to apply.

Pay C1 only $85 (1/3 of $255); the balance ($170) will remain unpaid unless C2 and C3 later apply timely for their shares of the LSDP.

b. Filing for other eligible children

• If the LSDP is paid to one (or more) child(ren), and another eligible child is later identified as eligible, and applies for a share of the LSDP, treat the new claim as an adverse adjustment and redistribute the LSDP. (For information on delayed claimants see GN 01010.140A.)

• A child may apply for the LSDP and indicate that another child living in another household, may also be eligible for a share of the LSDP. If it appears the children in the latter household are eligible, compute the LSDP shares based on the total number of children involved and prepare an award, show the children whose eligibility has not yet been determined as delayed claimants. When we have established the delayed claimants' eligibility, pay the balance of the LSDP.

NOTE: The FO may opt to await a determination on each child's eligibility before preparing an award. However, if monthly benefits are involved, use the delayed claimant procedure, whenever possible, to expedite payment of those benefits.

B. Death before or after LSDP was received or negotiated

1. Individual dies before the receipt of a LSDP

If the spouse to whom the LSDP was payable dies before receiving the check you may pay the LSDP to an individual(s) in a lower priority category for payment. If the only eligible or entitled individual also dies before receiving the LSDP, pay no LSDP. The LSDP is not an underpayment (See GN 02301.001)

NOTE: The fact that a spouse survived the NH does not necessarily preclude payment of the LSDP to someone in a lower category of payment. For example, an eligible child may apply and receive the LSDP following the death of the NH even if an eligible spouse survived the NH, provided the spouse is now deceased and did not already receive the LSDP.

2. An individual dies after receipt of LSDP

If the spouse or child dies after receiving the LSDP check but before cashing it, the LSDP becomes an asset of that individual's estate, distributed only to the legal representative of the estate. For developmental instructions, see GN 02408.650. For the definition of legal representative, see GN 02301.035.

C. Procedure for widow(er)s under second priority of payment

1. Payments based on eligibility to benefits

For payments based on eligibility to benefits for the month the number holder died, establish evidence of age, relationship, and other factors of entitlement, including disability (non-LISH widow(er) age 50 to 60) as if the LSDP claimant is applying for monthly benefits.

EXAMPLE: The NH is deceased. His widow, age 58, was not LISH but alleged being disabled. She elected not to apply for disabled widow’s benefits (DWB) but applied for the LSDP. To evaluate her eligibility for the LSDP, SSA must determine whether the widow was disabled and otherwise eligible for DWB benefits for the month of the NH's death. However, no disability development is necessary if, for other reasons, the widow could not qualify for the LSDP.

2. Forms used to obtain eligibility information

To obtain any eligibility information not shown on the SSA-8 (Application for Lump-Sum Death Payment) or on documentary evidence in file, use one of the following forms:

• SSA-795 or RMKS Screen of Application Summary for Lump-Sum Death benefit;

• SSA-5 (Application for Mother’s or Father’s Insurance) or RMKS Screen of Application Summary for Mother’s or Father’s Insurance benefits; or

• SSA-10-BK (Application for Widow’s or Widower’s Insurance Benefits) or RMKS Screen of Application Summary for Widow’s or Widow(er)’s Insurance benefits.

D. Procedure for contacting a spouse

1. Existence of a spouse whose whereabouts are known

1. Contact the spouse to determine whether he or she is eligible for the LSDP (instead of the children).

2. If the information that we have already received indicates the spouse is not eligible,  pay the LSDP to the child(ren) without attempting to contact the widow(er). If the widow(er) later files, treat his or her claim as an adverse claim.

   EXAMPLE: A child applies for the LSDP, indicating (1) he is the only child of the DWE, (2) the surviving spouse is 42 years old, and (3) the spouse has not lived with the deceased or the child for many years. In this situation, we may pay the child the LSDP without contacting the widow.

3. If the surviving spouse will not cooperate:

   • advise the spouse by letter of the priority of the payment of the LSDP;

   • advise the spouse that if he or she does not submit a statement within 30 days, the LSDP will be paid on the basis of whatever evidence we have;

   • if no reply is received within 30 days, pay the LSDP based on whatever evidence is available;

   • if an application is later received from the surviving spouse, handle it as an adverse claim.

2. Existence of a spouse whose whereabouts are unknown

Make a determination on payment of the LSDP based on whatever evidence is available.

3. When there is no spouse

Use a Report of Contact or the Remarks portion of the application to document the claims file. Briefly explain why a widow(er)’s claim is not in the file. If the claims file already shows that no surviving spouse exists, there is no need to document the claims file.

4. Determining a child’s eligibility and entitlement for benefits

a. Child applies for monthly benefits

If retroactive entitlement no longer extends to the month of death:

• develop to verify whether or not the child was eligible for benefits in the month of death;

• the child qualifies for the LSDP if he or she meets all entitlement factors except for filing an application.

NOTE: If a child, (age 18 or older) applies for the LSDP alleging a disability, but does not wish to apply for monthly benefits, develop to verify whether the claimant meets the disability requirements.

EXAMPLE: A child meets all the factors of entitlement to monthly benefits based on both the record of her deceased father and the record of her deceased mother. Since the father’s PIA is higher than the mother’s PIA, pay no monthly benefits on her mother’s record; however, she is still “technically” eligible for benefits on her mother’s record. Therefore, pay the LSDP based on her mother‘s record (as well as her father’s record).

b. Child does not apply for monthly benefits

Establish evidence of age, relationship, and other factors of entitlement, including disability, as if the LSDP applicant is applying for monthly benefits.

EXAMPLE: The NH is deceased. His child, age 25, is disabled. She elects not to apply for Child Disability Benefits (CDB) but applies for the LSDP. To evaluate her eligibility for the LSDP, determine whether the child was disabled and otherwise eligible for CDB benefits for the month of the NH's death. However, no disability development is necessary if, for other reasons, the child could not qualify for the LSDP.