SSR 63-4: SECTIONS 202(J)(1) AND 203(a). -- BENEFIT AMOUNTS -- REDUCTION FOR MAXIMUM -- ADJUSTMENT REQUIRED FOR RETROACTIVE MONTHS
20 CFR 404.404
- A deceased worker had a primary insurance amount of $85. His two children each became entitled to child's insurance benefits of $63.80, beginning February 1961, the month of his death. The older child's benefits ended with March 1962 because of his attainment of age 18 in April 1962. In March 1962, the worker's widow filed application for, and became entitled to, mother's insurance benefits beginning March 1961. Held, total benefits payable per month on the worker's earnings record cannot exceed $165.60; for the period March 1961 through February 1962, the children's benefit amounts are not affected by the mother's entitlement, and her benefits must be reduced to $38 per month; for March 1962, all 3 benefits are equally reduced to $55.20 each; and beginning April 1962, the older child no longer being entitled, the benefits of the mother and the youngest child are $63.80 each.
A worker died in February 1961, survived by his widow W, age 51, and by two children under age 18. The worker's primary insurance amount was $85, based on his average earnings. Each of the two children became entitled to child's insurance benefits of $63.80 beginning February 1961. The widow, W, did not file application for mother's insurance benefits until March 1962, although she had since the worker's death been eligible for such benefits (that is, met all requirements for entitlement to mother's insurance benefits other than the filing of an application). When she filed, both children's benefits had been paid for the months February 1961 through February 1962.
In April 1962 the older child attained age 18. Since he was not under a disability (as defined in section 223(c) of the Act), his entitlement to benefits under section 202(d) ended with March 1962, the month before the month in which he attained age 18.
The issues to be resolved are: what is the first month for which W is entitled to mother's insurance benefits; what is the amount of such benefits; and what is the effect, if any, of her entitlement and of the termination of the older child's entitlement upon other benefits?
Section 202(j)(l) provides, in effect, as follows: a person filing application in a month may become entitled to benefits under section 202 for each of the preceding 12 months in which he would have been entitled to the benefits if application had been filed in such preceding month. However, a benefit for any month before the month in which application is filed must be reduced to any extent necessary so as not to render erroneous any other benefit already certified for payment before the application was filed.
W had met all requirements for mother's insurance benefits, except for the filing of an application, from the date of the worker's death in February 1961. Accordingly, under section 202(j)(1) when she filed application in March 1962 she became entitled to benefits beginning March 1961, the 12th month before the month of filing.
Section 202(g) provides that the amount of a mother's insurance benefit is three-fourths of the deceased worker's primary insurance amount, the same as the amount of a surviving child's insurance benefit under section 202(d). Under section 215(g), any benefit which is not a multiple of 10 cents must be raised to the next higher multiple of 10 cents. Accordingly, the benefits of W and the two children would be $63.80 each for all months of entitlement (since three-fourths of $85, the deceased worker's primary insurance amount, is $63.75, which amount must be raised to $63.80).
However, section 203(a) of the Act limits the total amount of benefits payable on a worker's earnings record to a maximum, the amount of which depends upon the worker's primary insurance amount; when the total of all benefits for a month exceeds the maximum, each benefit for that month (except an old-age or disability insurance benefit) shall be proportionately decreased. For a primary insurance amount of $85, the maximum payable is $165.60.
The children's benefits for March 1961 through February 1962 had been certified for payment, and in fact had been paid, at the rate of $63.80 per month ($127.60 total per month) before W filed her application. Under section 202(j)(1), W's benefits for those months must therefore be reduced to $38 per month so as not to render erroneous the children's benefits for those months. ($165.60, the maximum, minus $127.60 equals $38.)
The children's benefits are protected by the provisions of section 202(j)(1) only for months before March 1962, the month in which W filed her application. Effective with that month, the benefit amount for each person entitled must be proportionately reduced under section 203(a) from $63.80 to $55.20 each (one-third of $165.60, the maximum), for each month in which benefits are payable to all three beneficiaries.
Since the older child's benefits ended with March 1962, beginning April 1962 only W and the younger child are entitled to benefits on the deceased worker's earnings record. The total of benefits beginning April 1962 is now $127.60 (two times $63.80). This amount being less than the maximum of $165.60, reduction under section 203(a) is no longer necessary; W and the younger child may be paid benefits of $63.80 each, beginning April 1962.
It is there held that the two children's benefits for March 1961 through February 1962, certified for payment at the rate of $63.80 each per month before W filed her application in March 1962, are not affected by W's entitlement, and for those months her benefit must be reduced to $38 per month; and that for March 1962 all three must be reduced to $55.20 each; and that beginning April 1962, since the older child is no longer entitled to benefits, the mother's and the younger child's benefits will be $63.80 each.