TN 11 (11-12)

A. Policy for establishing the EOD for disabled widow(er) benefit (DWB) claims

1. Qualifying for DWB benefits

For a widow(er) to qualify for disability benefits based on the earning record of his or her deceased spouse, we must establish the onset date (the established onset date (EOD)) before the end of a prescribed period (described in DI 25501.350A.3. in this section) and at least five full calendar months before the widow(er) attains age 60. This five full calendar month period is the waiting period.

NOTE: There are different rules for DWB Medicare claims. For information on establishing onset for DWB Medicare Claims, see DI 25501.360.

2. Age requirements for DWB claims

A widow(er), from the attainment of age 50 until attainment of age 60, may be entitled to disability benefits based on the earning record of his or her deceased spouse. After the widow(er) attains the age of 60, we do not need a disability determination for a widow(er) to receive widow(er) benefits. If supported by the evidence in the file, we establish an EOD before the attainment of age 50 for the claimant to meet the waiting period requirement.

Reminder: A claimant attains a particular age the day before his or her birthday.

NOTE: A widow(er) can file for Medicare Benefits after attainment of age 60 if the claimant’s alleged onset date (AOD) is within the prescribed period. For information on establishing an onset date for DWB Medicare claims, see DI 25501.360.

3. EOD must be established before the end of the prescribed period for a claimant to qualify for DWB benefits

The field office determines the prescribed period. For a widow(er) to qualify for disabled widow(er) benefits, we cannot establish the EOD later than the end of a “prescribed period” defined by the Social Security Act. If we cannot establish an EOD on or before the last day of the prescribed period, we deny the claim.

a. The prescribed period begins with the latest of the following:

• the month of the number holder’s death; or

• the last month of previous entitlement to DWB that terminated because disability ceased; or

• the last month of entitlement to mother’s or father’s benefits based on having a child in care (beneficiary identification code (BIC) “E” benefits).

b. The prescribed period ends with the earliest of the following:

• 84 months (seven years) after the prescribed period begins; or

• 84 months after the claimant was last entitled to mother’s, father’s, or widow(er)’s benefits; or

• the month before the month, the widow(er) attains age 60.

4. Controlling date for DWB claims

The controlling date is the latest date we can establish onset without adversely affecting the first month of entitlement to DWB benefits. The field office determines the controlling date. When determining the controlling date, consider the following factors:

• the beginning date of the prescribed period,

• the ending date of the prescribed period,

• the retroactivity of the application,

• the widow(er)’s age,

• the alleged onset date (AOD), and

• the widow(er)’s date of remarriage, if applicable.

An EOD on or before the controlling date is fully favorable. Therefore, adjudicators should focus development of evidence on establishing the EOD as of the controlling date. (For instructions on determining the prescribed period and the controlling date, see DI 11005.050.)

5. Five month waiting period for DWB benefits

The payment of DWB benefits is subject to a waiting period of five full consecutive calendar months. The waiting period begins no earlier than the later of:

• the first day of the 17^th month before the month of filing; or

• the fifth month before the number holder died; or

• the first day of the fifth month before the month the prescribed period began; or

• if the claimant was previously entitled to mother’s, father’s, or widow(er)’s benefits, the fifth month before the benefits ended. (For specific details, see DI 25501.350A.6. in this section.

NOTE: Even if the widow(er) already served a waiting period for disability insurance benefits (DIB), he or she must still serve a waiting period for DWB. In a concurrent DIB/DWB claim, a claimant can serve the waiting periods concurrently.

6. No waiting period for certain subsequent DWB claims

• If the claimant was previously entitled to widow(er)’s benefits based on disability, there is no waiting period if he or she again becomes disabled. The new disability must meet our definition of disability and must begin within 84 months of the month the prior entitlement ended.

• If the claimant was eligible for Supplemental Security Income (SSI) after December 1990, the claimant does not serve an additional waiting period before he or she begins receiving disabled widow(er) benefits. Each month in the period beginning with the first month of payment for SSI or federally administered State Supplementary Payments (SSP), is counted toward the five-month waiting period for DWB.

7. Marital status for DWB claims

Generally, a widow(er) must be unmarried to be entitled to DWB benefits. However, we may disregard a claimant’s remarriage if the remarriage occurs after attainment of age 50, if the widow(er) was disabled at the time of the remarriage.

8. Chart to establish DWB onset

B. Component roles and responsibilities for establishing the EOD for disabled widow(er) claims

1. Field office (FO)

• Establish a prescribed period, and

• Establish a controlling date.

2. Disability Determination Services (DDS)

Develop medical evidence focused on establishing the EOD as of the controlling date.

C. Component instructions for establishing the EOD for disabled widow(er) benefit (DWB) claims

1. Field office (FO)

Complete the Electronic Disability Collect System EDCS-3367 “Onset” page and EDCS “Miscellaneous, DWB and prior filing” page, following the instructions found in DI 81010.025.

NOTE: If the claimant remarried, use the Capability/Remarks page in the EDCS-3367 to annotate the date the claimant remarried.

For EDCS exclusion claims:

• Calculate the prescribed period and controlling date using the instructions outlined in DI 11005.050.

• Annotate the prescribed period and controlling date in block 6 of the Form SSA-3367-F5 (Disability Report - Field Office).

2. Disability Determination Services (DDS)

Develop medical evidence focused on establishing the EOD as of the controlling date. DDS should establish the exact date the claimant met the medical criteria for disability, if known. If the EOD is after the controlling date, prepare a personalized disability explanation (PDE) explaining why we established the partially favorable EOD. Send the PDE with an SSA-L1157–DI. (See DI 25501.280 Notifying Claimants of Partially Favorable Allowances.)