SI 02101: Title XVI (SSI) Underpayments
TN 9 (12-04)
A. Policy — general
1. To Whom Payable
If an individual was a blind or disabled child when an underpayment occurred and was living in the same household with a parent(s) at any time in the month of death or within the 6 months preceding the month of death, the parent(s) can be paid benefits due the deceased for June 1986 on.
Payment may be made to parent(s) only for months of eligibility during which the deceased individual was a child (as defined in SI 00501.010).
2. Underpayment Payable to Parent(s) and Spouse
If the deceased individual was living with both his spouse and parent(s) in the month of death or within the 6 months preceding the month of death, payment may be made to the parent(s) for the SSI underpayment due which occurred while the deceased was a blind or disabled child.
Payment may be made to the spouse for any underpayment due which occurred when the deceased no longer met the definition of “child” (SI 00501.010 through SI 00501.020).
If both the parent(s) and the spouse qualify for payment but the parent(s) cannot be paid due to death or some other reason (e.g., cannot be located), the entire underpayment will be paid to the spouse.
B. Policy — related issues
1. Child for Month of Death
If the deceased was a blind or disabled child for SSI purposes for the month of death, an underpayment may be paid to the surviving parent(s).
2. Child When Underpayment Occurred
If the deceased was a blind or disabled child for SSI purposes when an underpayment occurred but an adult when death occurred, an underpayment may be paid to the surviving parent(s) or the surviving spouse, if the parents cannot be paid.
3. Relationship Requirement — Parents
The surviving parent(s) must be the natural or adoptive parent(s) of the deceased individual. A stepparent who was not an adoptive parent does not meet this relationship requirement, including a “holding out” stepparent. (See SI 02101.007C.1.)
4. Relationship Establishment — Parents
If the person in our records is shown as parent for the month of death, (e.g., if the parent is established on the SSR as the natural or adoptive parent of the deceased for the month of death for deeming purposes), then establishment of the parent/child relationship will be met.
5. LISH Requirement — Parents
Living with a parent in the month of his/her death or in the 6 months preceding the month of death will be met if child and parent(s) were in the same household or would have been in the same household had death not precluded meeting this criteria. (See SI 02101.007C.2.)
6. LISH Establishment — Parents
To make a determination of LISH quickly
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IF. . . |
THEN . . . |
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The person whose income was subject to deeming to the deceased in the month of death or in the 6 months preceding the month of death, (even if nothing was deemed) |
Establishment of LISH requirement is met. Use the definition of household (SI 01310.140.A) that is used to decide if deeming of income and resources apply. |
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The effective date of filing by the child is less than 6 months before death |
The LISH requirement is met if deeming would have applied in any of the months prior to filing in the 6-month period. |
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Even if deeming did not apply because the parent was eligible or the family did not live in a “household” for deeming purposes—e.g., the family was living in a homeless shelter |
The definition of household in SI 01310.140 should be applied liberally to cover situations where the household may not technically meet all facets of the definition. |
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If LISH cannot be established based on deeming rules because deeming did not exist solely because the child’s death precluded it (e.g., the child was born on the 5th and died on the 15th of the month) |
LISH will still be found for payment of any underpayment which may be due. |
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If the intent of the parents was to establish a household as defined in SI 01310.140, and the sole impediment to such establishment was the child’s death (e.g., death occurred before the child came home from the hospital) |
LISH will still be found to exist for payment of an underpayment. |
7. Relationship/LISH Established — Parents
If these two requirements are established in our records, then a request for the underpayment is not required by the surviving parent(s).
8. Relationship/LISH Requirement — Spouse
Establishment of relationship and LISH are required for payment. (See SI 02101.005 and SI 02101.006.)
9. 24-Month Time Limit
A survivor (parent or the surviving spouse who was not a member of an eligible couple in the month of death) has 24 months after the deceased's month of death to request an underpayment which may be payable on the individual's record.
NOTE: This timeframe does not apply to cases in which the Agency has been mandated by a Court to take action (e.g., Zebley or ALJ reversals).
C. Procedures
1. Relationship and/or LISH Requirement Not Established — Parents
If these two requirements are not established in our records, the FO must:
Establish the parent-child relationship (refer to SI 00501.010 for definitions of child and natural or adoptive parent and GN 00306.001 for parent/child relationship); and
Obtain a statement in which the parent requests the underpayment; states that he/she meets the relationship and LISH requirements; and identifies anyone else who may meet those requirements.
NOTE: This statement will avoid a contending claim on the underpayment.
2. Payment Rules — Parents, FO Responsibilities
If the underpayment is to be paid to a surviving parent(s), issue the underpayment using one-time payment (A-OTP) procedures (SM 01901.001). Pay only the amount due for the months in which the deceased individual met the definition of a child. NOTE: If the parent(s) is not present on the SSR, issue the underpayment using manual (MOTP) procedures.
If the underpayment is to be paid to more than one parent
make separate payments to each parent;
divide the underpayment equally between the parents.
NOTE: If there is an odd cent, pay that cent to either one of the parents.
Notify each parent of his/her payment on Form SSA-L8166-U2 which explains the underpayment.
If one parent dies before receiving his/her share, pay the entire underpayment to the remaining parent.
Issue a single payment to one of the parents, representing payment for both parents, if the parents who are qualified to receive the underpayment request one payment, and the parent who would not receive his/her share signs a statement that one payment is being requested.
If a parent who may be qualified for a share of an underpayment cannot be located (i.e., routine efforts) pay that share to the other parent.
3. Relationship/LISH Established — Spouse
Follow the instructions for establishing relationship/LISH in SI 02101.005 and SI 02101.006.
4. Relationship and/or LISH Requirement Not Met — Spouse
If these two requirements are not established, follow instructions in SI 02101.005 and SI 02101.006.
5. Denial — Parents/Spouse
If the underpayment cannot be paid (e.g., not qualified as surviving parent or surviving spouse, State received payment as IAR, etc.), send form SSA-L8166-U2 notice explaining the underpayment denial.
Send form SSA-L8166-U2 to any person who has requested or inquired about a payment due a deceased child and who is not qualified to receive the underpayment.
6. Underpayment Limit — Parent/Surviving Spouse
Limit the amount of an underpayment to a surviving parent(s) or spouse who was not a member of an eligible couple in the month of death to benefits for June 1986 on. (See SI 02101.006C.4. for the formula.)
D. Examples
1. Child When Underpayment Occurred
FACTS: DOB 1/2/85 – DOD: 1/5/04 - Eligibility: 4/95 to death. The disabled individual had been living with his/her parents. On 1/18/04, it was determined that an underpayment existed for the period 4/02 through 1/ 04.
If the relationship/LISH requirements have been established, we may pay the parents for the underpayment period of April 2002 through January 2003 (the individual is no longer a child effective 2/03, the month after the month of attainment of age 18). Payment cannot be made to the parents for the period 2/03 through 1/04.
2. Both Parents and Spouse Meet Requirements for Underpayment
FACTS: DOB: 1/2/85 – DOD: 1/15/04 - Married: 11/1/03 Eligibility: 6 /98 through 1/04.
The disabled individual was always living in the household of his parents.
In November 2003 he married and both he and his spouse lived in the household of his parents. Both spouse and parents meet the relationship and LISH requirements.
On January 21, 2004, we are notified of the individual's death and we determine an underpayment is payable for the period 3/02 through 1/04. We would pay the parents for the period March 2002 through January 2003 (the period of time he was a child) and the spouse would be paid for the period February 2003 through January 2004.
3. Deceased Individual Attending School Full-Time
FACTS: DOB: 6/2/83 - DOD: 12/4/03 - Eligibility: 7/97 to death. On 1/ 3/04 we are notified of the individual's death and it is determined that an underpayment is payable for the period 2/03 through 12/03. SSA determines that the deceased had been living in the same household with his parents at the time of death and was a full-time student. Therefore, the underpayment can be paid to the parents for the period 2/03 through 12/03.
4. Zebley Case — Child When Underpayment Occurred
FACTS: DOB: 5/5/72 - DOD: 3/12/93 Date of SSI Application: 11/10/ 82. On 2/5/93 the claimant was found eligible for SSI from 11/10/82 on. The claimant lived with his parents until September 1992.
Using the Zebley flat rate and any appropriate optional State supplement for the period 6/86 through December 1989 (the last month for which flat rate payments can be made) and, using the regular computation rules to calculate the underpayment for the period 1/90 through 5/90, payment can be made to the parents. No payments can be made for the period 11/10/ 82 through 5/86 or 6/90 through 03/93. (See SI 02101.006C.4. for the formula.)