20 CFR 404.956-404.958

SSR 75-6

Where a subsequent application for disability insurance benefits, alleging an earlier onset date than initially established, is filed on behalf of a deceased wage earner who had been receiving disability insurance benefits prior to his death, section 118 of the 1972 Amendments to the Social Security Act, Public Law 92-603, is not applicable. Section 118 permits an applications for disability insurance benefits to be filed within a specified time period after the death of an insured individual only where the application is one seeking an initial, and not a revised, determination with respect to disability.

Section 118 of the 1972 Amendments to the Social Security Act, Public Law 92-603 under certain circumstances permits the filing of applications for disability insurance benefits after the death of an insured individual.

The wage earner filed an application for disability insurance benefits on May 17, 1963. On the basis of this application, a period of disability was established with an onset date of January 1, 1963. The wage earner continued to receive disability insurance benefits until his death in April 1970. On January 15, 1973, the wage earner's widow filed a new application for disability insurance benefits on behalf of the deceased wage earner, alleging the onset date of his disability was in 1962, and not on January 17,1963, as previously determined. A State agency decision based on this second application established an earlier onset date of July 31, 1962.

Section 118 of the 1972 Amendments does not apply in cases such as the one set out above and the rules of administrative finality as set forth in Social Security Administration Regulations No. 4, section 404.956 and 404.957, would preclude establishing the earlier onset date. If, however, the more recent Sate agency decision regarding the earlier date of onset is based solely on a reexamination of the same evidence submitted at the time of the original 1963 application for benefits, and the earlier determination was incorrect on its face, the Social Security Administration could reopen the initial determination under section 404.957(c)(8) to correct an error on the face of the evidence.[1]

The Legislative history of section 118 indicates that this amendment was enacted to provide benefits in those " relatively few cases" where a disabled worker who would have been eligible for benefits dies before any application was filed. See H.R. Rep. No. 92-231, 92nd Cong., 1st Sess. 57 (1971) and S. Rep. No. 92-1230, 92nd Cong., 2d Sess. 143 (1972). So that disability benefits are not lost in such cases, the amendment permits disabled worker, or if the disabled worker died after December 31, 1969, but prior to enactment of the bill (October 30, 1972), an application (where none had previously been filed) may be filed in the month of enactment or within 3 months thereafter.

Prior to this amendment, entitlement to disability insurance benefits could b established only if an application was filed during the worker's lifetime. In providing an exception to this rule, Congress, in both the Senate and House Reports, supra, referred to those situations where a disabled worker who was eligible had not filed for disability benefits during his lifetime, and, as a result, his living expenses during the period of his uncompensated disability remain unpaid and become obligations of his survivors. It was in situations such as this that Congress expressed concern and sought to provide relief. Neither the language of the amendment nor the accompanying legislative reports indicate that Congress intended to modify existing policy and regulations governing administrative finality or the provide an additional procedure for revision or reopening prior disability determinations. It is concluded, therefore, that the amendment is applicable only where the application filed is one seeking an initial defemination with respect to disability. Where a second application is filed on behalf of a deceased worker who had been a disability insurance beneficiary prior to his death, the regulations governing administrative finality are controlling.

[1] An initial determination which is other wise final may be reopened (and, if appropriate, revised) on the written request of a part to the determination or on the motion of the Social Security Administration within 4 years after the date of notice of the initial determination upon a finding of good cause, as defined in section 404.958 of Regulations No. 4. After the expiration of 4 years, such initial determination may be reopened an revised only in those situations described in section 404.957(c) of Regulations No. 4.

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