BASIC (06-08)
DI 23505.005 Parent Claim to Entitle Dependent Grandchild
A. Dependent Grandchild Case Provisions
A grandchild or step-grandchild is entitled to child's insurance benefits on the Social Security record of a grandparent or a grandparent's spouse if the grandchild is dependent upon the grandparent; and the grandchild's natural or adoptive parents are deceased or disabled:
At the time the grandparent became entitled to retirement or disability insurance benefits or died; or
At the beginning of the grandparent's period of disability until the grandparent became entitled to disability or retirement insurance benefits or died.
B. Disabled Parent Case Evaluation
If the child's parents are alive, they both must be found disabled in order for the child to become entitled under this provision. In these cases, the Disability Determination Service (DDS) must:
Adopt an existing determination of the parent’s disability; or
Prepare a determination of the parent's disability (as if it were a regular disability insurance benefit [DIB] claim) solely for the purpose of entitling the child to child's benefits on the grandparent's earnings record. There is no disability insured status requirement for the parent(s).
The field office (FO) establishes whether the dependency and other entitlement requirements are met and specifies in the SSA-3367 (Disability Report – Field Office) the date the grandparent-child relationship must be established. This is the date the DDS must use for establishing the parent's disability.
NOTE: Parent claims do not involve disability benefits unless a DIB claim is also filed by the parent, in which case there would be two separate claims.
C. Dependent Grandchild Case, Completion of the SSA-3367
The FO completes the SSA-3367 in the usual manner except for the items which require specific instructions given in this section. For general instructions on completing the SSA-3367 see, “Completing the EDCS 3367” (DI 11005.045).
Item 1 – Identifying Information
Enter the name and social security number (SSN) of the grandparent on whose earnings record the claim is filed; i.e. the number holder (NH). Complete the remaining entries using the claimant’s information.
Item 3 – Potential Onset Date
Select the “CDB” check box, and enter the potential onset date (POD).
Item 4 – Reason for Potential Onset Date
Select the appropriate check box, and enter the POD.
Item 5 – Explanation for Potential Onset Date
Enter “Grandchild Case – Dependency Date” followed by the month and year (mm/yyyy) in which the grandparent-child relationship must be established.
D. Dependent Grandchild Case, Completion of SSA-831
1. General Instructions
Refer to “Completion of Form SSA-831-C3/U3 – General” (DI 26510.000).
A small number of EDCS exclusion cases may utilize a SSA-831 instead of the EDCS routing form. The FO completes the SSA-831 in the usual manner except for the items which require specific instructions given in this section. For the exceptions see “Completion of SSA-831-U3 by the FO” (DI 23505.005D.2.) in this section.
The DDS completes the SSA-831 in the usual manner except for the items which require specific instructions given in this section. For the exceptions see “Completion of SSA-831-U3 by the DDS” (DI 23505.005D.3.) in this section.
2. Completion of SSA-831 by the FO
a. Item 4 – SSN
Enter the social security number (SSN) of the individual (grandparent) on whose earnings record the claim is filed, i.e. the number holder (NH).
b. Item 5 – Name and Address of Claimant
Enter the name and address of the child’s parent.
c. Item 6 – WE’s Name
Enter the name of the NH (grandparent) on whose earnings record the claim is filed.
d. Item 7 – Claim Type
Check one of the two following claim check blocks:
P-R
Disability determination for parent-child filing on earnings record of grandparent (RSI NH); or
P-D
Disability determination for parent-child filing on earnings record of grandparent (DIB NH)
e. Item 11 – Remarks
Enter “Grandchild Case – Dependency Date:” followed by the month and year in which the grandparent-child relationship must be established for entitlement.
3. Completion of SSA-831 by the DDS
a. Item 15 – Claimant Disabled
Check block “A” and enter the controlling date from the SSA-3367 in all cases where the parent is found under a disability on or before this date. (If the established onset date [EOD] is after the controlling date, treat as a denial)
b. Item 16 – Diagnosis
Enter the diagnosis nomenclature as explained in “Completion of Item 16A and 16B - (Primary and Secondary Diagnosis, Body System Code and Impairment Code)” (DI 26510.015A and DI 26510.015B). Enter the International Classification of Diseases (ICD) code in the “Code No.” block for either allowances or denials.
c. Item 17 – Diary
Electronic processing requires you to enter a diary date for allowance cases prior to closure. As there is no CDR required for this type of case, enter a 7 year medical improvement not expected (MINE) diary date to facilitate closure.
d. Item 19 – Claimant Not Disabled
Check block “B” if the parent's disability is not established as of the date shown in the SSA-3367, and enter that date here.
e. Item 21 – VR Action
Make no entry in any of the blocks.
f. Item 22 – Reg. Basis Code
Enter the pertinent regulation basis code under which the parent is allowed or denied. The Reg. Basis Code should reflect the nature of the allowance or denial at the time of adjudication. Refer to “Completion of Item 22 (Regulation Basis Code)” (DI 26510.045A) for a description of the basis codes for determination.
Use this chart for determinations of “not disabled”:
Basis for Determination | Enter in Item 22 “Reg. Basis Code” |
|---|
Impairment Not Severe – Medical Considerations Alone | F1-1520(c) |
Capacity for Substantial Gainful Activity (SGA) – Any Relevant Past Work | H1-1520(e) |
Capacity for SGA – Other Than Relevant Past Work | J1-1520(f) |
Impairment Prevented SGA for a Period of Less Than 12 Months | E1-1509 |
Impairment Prevents SGA at Time of Adjudication But Is Not Expected to Prevent SGA for a Period of 12 Months | E3-1509 |
Insufficient Evidence Furnished | M5-1516 |
Failure or Refusal to Submit to Consultative Examination (CE) | L1-1518 |
NH Does Not Want to Continue Development of Claim | M3-1516 |
NH Willfully Fails to Follow Prescribed Treatment | K1-1530 |
Use this chart for determinations of “disabled”:
Basis for Determination | Enter in Item 22 “Reg. Basis Code” |
|---|
Impairment Meets Level of Severity of Listings | A1-1520(d) |
Impairment Equals Level of Severity of Listings | B1-1520(d) |
Medical and Vocational Considerations | C1-1520(f) |
Medical and Vocational Considerations (35-40 Years of Arduous Unskilled Work, Marginal Education, and Significant Impairment) | DI-1562 |
g. Item 29 – Ltr./Par. No.
This item is not completed by the DDS.
E. Notification
The DDS does not have notification responsibilities in parent claims. Do not prepare a form notice or personalized attachment.