NPRM: Proposed New Listings for Mental Impairments

Guest · Posted: Tue Mar 16, 2010 09:44 pm Post subject: Deceased Claimant

What happens to a claimant's case when they die?
Still adjudicated?
How is payment affected?
A. If they have a spouse or minor children.
B. If they have no spouse, no minor children.

Noel S. Anschutz

David Traver · Posted: Wed Mar 17, 2010 12:06 am Post subject:

What kind of case? SSI? Disability Insurance? Both?

What stage of appeal? Was an application signed? Was the claim denied?

How old was the claimant?

Guest · Posted: Wed Mar 17, 2010 04:29 pm Post subject:

Combo claim
45 yrs old
Recon adjudication pending
no spouse, no minor child

jayteef · Joined: 21 Jun 2009 Posts: 272

https://s044a90.ssa.gov/poms.nsf/lnx/0203102200
GN 03102.200 Claimant Requests Reconsideration
B. 7.
Claimant Dies

Determine if there is a person who may be entitled or adversely affected by the determination.

Ask the person if he/she wishes to proceed with the request for reconsideration. If the person does not, obtain a signed statement from the person indicating he/she fully understands the effect of the withdrawal of the reconsideration. Contact the PC to report the claimant's death, and advise whether a substitute person wishes to pursue the request for reconsideration. Determine where the appeal is pending on PCACS and use DOORS to find the telephone number.

jayteef · Joined: 21 Jun 2009 Posts: 272

In Title II claims, they list the deceased individual’s parents and the legal representative of the deceased person’s estate (defined in §404.503 http://www.ssa.gov/OP_Home/cfr20/404/404-0503.htm) as persons who could be paid benefits that would have been due to the individual:

See:
https://secure.ssa.gov/apps10/poms.nsf/lnx/0202301030#a1
GN 02301.030 Title II Underpaid Person is Deceased
A. Policy for statutory order for payment for Title II benefits
If the underpaid beneficiary is deceased, payment must be made under the following order of priority:
a. to the surviving spouse who was either living in the same household as the deceased at the time of death or who, for the month of death, was entitled to a monthly benefit on the same record as the deceased beneficiary.
NOTE: A surviving divorced spouse does not qualify for an underpayment under this provision.
b. to the child who, for the month of death, was entitled to a monthly benefit on the same earnings record as the deceased.
c. to the parent who, for the month of death, was entitled to a monthly benefit on the same earnings record as the deceased.
d. to the surviving spouse not qualified under a.above.
e. to the child not qualified under GN 02301.030A.b.
f. to the parent not qualified under GN 02301.030A.c.
g. to the legal representative of the deceased person's estate. (See GN 02301.035 on payment to a legal representative.)

Title XVI claims have more restrictions as to who can be paid
https://secure.ssa.gov/apps10/poms.nsf/lnx/0502101003#a

jayteef · Joined: 21 Jun 2009 Posts: 272

Concerning Representative Fees in the above noted situation:

https://secure.ssa.gov/apps10/poms.nsf/lnx/0203940009#c

GN 03940.009 Payment of Representative’s Fee
C. Policy – claimant dies before SSA issues a favorable decision
When a claimant or representative submitted an otherwise valid fee agreement and the claimant dies before SSA issues a favorable determination or decision, the decision maker will approve the fee agreement and SSA will send notice to the parties as described in GN 03940.008.

1. Past-due benefits payable
In the above situation, SSA will continue processing the representative's fee under the fee agreement process only if adjudication results in past-due benefits. An underpayment must be payable to such individuals as listed in GN 02301.030A.1., Statutory Order for Payment, for title II cases. For title XVI cases, refer to SI 02101.003A., SSI Underpayment Due – Individual Deceased. In concurrent title II and title XVI cases, the fee agreement approval remains valid if either a title II or title XVI underpayment is payable.
For policy on direct payment of the authorized fee, see GN 03920.017A.

2. No past-due benefits payable
If SSA determines that no one is eligible for the underpayment (in concurrent title II and title XVI cases this would mean that either there was no underpayment due under either title or there was no one eligible to be paid the underpayment under the rules for title II or title XVI underpayments), SSA will rescind the fee agreement approval. In such a situation, the fee agreement no longer meets the statutory provision that the claim or post-entitlement action results in past-due benefits (refer to GN 03940.003). SSA will notify the representative using the paragraphs entitled “Fee Agreement Subsequently Disapproved – No Past-Due Benefits.” The rescission will follow the same general principles expressed in the paragraphs listed in GN 03940.055C.3.a. Also refer to paragraph L29 in NL 00721.440.

If there are no known survivors of the deceased claimant or, for title II purposes, a legal representative of the estate, SSA will mail the determination rescinding the approval to the estate of the deceased at his/her last known address. SSA will also inform the representative that he/she must file a fee petition with SSA for authorization to charge and collect a fee.