TN 49 (08-08)

DI 11010.320 Disability Insurance Benefits-Retirement Insurance Benefits (DIB-RIB) Claimant Dies before Disability Claim Adjudicated

A. Procedure - DIB claim in field office (FO) and a Disability determination is not required

If a disability determination is not required when a claimant dies after filing a DIB-RIB claim and the claim has not been transferred, process as follows:

1. If the RIB and entire DIB claims are in the FO and no disability decision is needed.

Use the following procedure:

  • Adjudicate the survivor and/or Lump Sum Death Payment (LSDP) claim. The disability claim segments in MCS;

  • Process the RIB as abatement or underpayment if applicable. See Abatements - GN 01010.475. See Applications-Underpaid Person Deceased - GN 02301.050 and Underpayment Awards - SM 00805.040.

  • Wait one day and abate or deny the DIB claim as appropriate (Abatements - GN 01010.475). For abatements, document the Development Worksheet path and manually clear the record to the Field Office (FO); and

  • Forward both claims together to the Processing Center (PC) if the official folder is paper.

  • For Certified Electronic Folder (CEF) cases, see Completing Electronic Disability Collect System (EDCS) Cases - DI 81010.020.

2. DIB claim only in FO

If a RIB-DIB claim exists and a Master Beneficiary Record (MBR) can be established:

  • Secure SSA-1724 (Claim for Amounts Due in the Case of Deceased Beneficiary) and proof of relationship for each eligible dependent of the NH. See Applications-Underpaid Person Deceased - GN 02301.050).

  • Process the RIB claim and establish the MBR.

  • When the DIB claim is in the FO and a disability determination is not needed, deny or abate the DIB claim by adjudicating through EC and input the death. If the claim is abated, document the decision in the claims file via the Development Worksheet path and then manually clear the record to the FO.

  • For CEF cases, see Creating Electronic Disability Collect System (EDCS) Cases - DI 81010.020.

  • Include an SSA-5002 (Report of Contact) in the file, explaining why no disability determination is necessary.

  • Forward the DIB claim and any survivor or Lump-Sum Death Payment (LSDP) claim on the DIB claimant's SSN to the PC after adjudicating all claims.

3. If a RIB-DIB claim exists and an MBR cannot be established, then:

  • Adjudicate the RIB claim and send it to the PC. Input the date of death through the Modernized Claim Systems (MCS) Claims Clearance screen.

  • Notify the PC of the claimant's death by sending a Modernized Development Worksheet (MDW).

  • The PC terminates benefits.

  • Document the explanation on a Report of Contact (RC) within MCS as to why no disability determination is necessary.

  • Forward the DIB claim and any survivor or LSDP claim on the DIB claimant's SSN to the PC after adjudicating all claims.

B. Procedure - DIB claim is in DDS or DPB – claimant dies before waiting period completed

Use the following procedure:

  • Advise the appropriate office (Disability Determination Services (DDS) or Disability Processing Branch (DPB)) to stop development and return the folder to the FO when death occurs during the waiting period and no determination is necessary. For CEFs create an SSA- 5002 (Report of Contact) in eForms. See Using the Update-After-Transfer (UAT) Utility (DI 81010.095)

  • Do not send any material to the DDS or PSC/DPB.

  • Document the abatement in the DIB claims file, and then manually clear the DIB segment to the FO.

  • If the PSC has the RIB claim, notify them of the disabled worker's death.

  • For CEF cases see Creating Electronic Disability Collect System (EDCS) Cases - DI 81010.020. If the official folder is paper, associate all material from the adjudicated survivor claims with the DIB folder and forward to the PSC.

C. Procedure - Disability determination is necessary

If the disabled claimant dies after filing the RIB-DIB claim but before the FO has received notice of the disability determination, process the claims as follows. For claims entered into EDCS, see Creating Electronic Disability Collect System (EDCS) Cases - DI 81010.020 and Transferring Cases in Electronic Disability Collect System (EDCS) - DI 81010.085.

1. When the RIB and entire DIB Claim are in the FO, do the following:

  • If the RIB and entire DIB claims are in the FO, complete any necessary development.

  • Forward the RIB claim and any Survivor or LSDP claim to the PC after adjudication.

  • Annotate the following statement on the Route Sheet: “Pending DIB Claim.” Send the DIB claim to the DDS or DPB as appropriate.

2. When only the entire DIB claim is in the FO, do the following:

  • If the RIB claim is in the PSC and the DIB claim has not been transmitted, notify the PSC of the claimant's death with an MDW if an MBR has not been established.

  • Continue processing the DIB claim.

  • If an MBR is established, enter a Post Entitlement Online System (POS) input of the claimant's death.

  • Record the date the claimant died and the cause of death in the DIB file. See Sending Initial Disability Insurance Benefits (DIB), Freeze Claims to the Disability Determination Services (DDS) - DI 11010.260. For claims entered into EDCS, barcode and fax the Death Certificate to Section F (back yellow) of the electronic folder. See Faxing Documents into the Certified Electronic Folder (CEF) Using Barcodes) - DI 81010.090 for barcode and fax instructions.

  • Send the DIB claim to the DDS or PSC/DPB, as appropriate.

  • Forward the claim to the PSC after adjudicating any survivor or LSDP claims on the DIB claimant's SSN.

3. When only RIB Claim or RIB and part of DIB claim in FO, do the following:

  • The FO transmits the DIB claim to the DDS, and the DDS initiates medical evidence development promptly after receiving the claim from the FO.

  • Contact the DDS furnishing any information available about the claimant's death. For claims entered into EDCS barcode and fax the Death Certificate to Section F (back yellow) of the electronic folder. See Faxing Documents into the Certified Electronic Folder (CEF) Using Barcodes) - DI 81010.090.

  • Document the contact on an SSA-5002. For claims entered into EDCS, send a message through eView to the DDS. See Alerts, Flags, and Messages in the Electronic Disability Collect System (EDCS) - DI 81010.080.

  • If the official DIB folder is paper and is in the PC, send the information on an MDW to the PC.

  • Forward the claim to the PSC after adjudicating the RIB claim and any survivor or LSDP claims on the DIB claimant's SSN.

4. When RIB and DIB claim not in FO or only part of DIB claim in FO, do the following:

  • If both the RIB and DIB claims are sent to the PSC (the official folder is paper), or only part of the DIB claim is still in the FO, notify the PSC of the claimant's death.

  • If an MBR is established, input the death to terminate benefits.

  • If the DIB claim is still in the DDS, follow - DI 11010.260.

  • If the official DIB folder is paper, forward the claim, to the PC after adjudicating any survivor or lump-sum death payment claims on the DIB claimant's SSN.


To Link to this section - Use this URL:
http://policy.ssa.gov/poms.nsf/lnx/0411010320
DI 11010.320 - Disability Insurance Benefits-Retirement Insurance Benefits (DIB-RIB) Claimant Dies before Disability Claim Adjudicated - 11/10/2008
Batch run: 01/27/2009
Rev:11/10/2008