I-2-4-35.Dismissal Due to Death of a Claimant

Last Update: 7/22/05 (Transmittal I-2-59)

Different criteria must be considered in Title II and Title XVI cases when deciding whether to dismiss a request for hearing (RH) because the claimant who filed the RH has died.

A. Title II

  1. The ALJ will dismiss the RH when the claimant who filed the RH dies while the request is still pending before the ALJ, if:

    • the case was not remanded by a Federal court under sentence six, and

    • there is no other claimant who may be adversely affected by the determination which is the subject of the RH, or

    • such a claimant exists, but the claimant has stated in writing that he or she does not want to pursue the claim.

    NOTE 1:

    An ALJ may not dismiss an RH in any case remanded by a Federal court under sentence six. The regulations at 20 CFR §§ 404.983 and 416.1483 state that when a Federal court remands a case to the Commissioner for further consideration, the Appeals Council, acting on behalf of the Commissioner, may make a decision, or it may remand the case to an ALJ with instructions to take action and issue a decision or return the case to the Appeals Council with a recommended decision, and there is no request for review pending before the Appeals Council. (See I-2-8-15, Recommended Decisions; I-2-8-18, Administrative Law Judge Decisions in Court Remand Cases; and I-2-8-37, Decision When Claimant Dies.)

    NOTE 2:

    The ALJ will vacate a dismissal if, within 60 days after the date of the dismissal, another person submits a written request for a hearing on the claim and shows that he or she may be adversely affected by the determination that was to be reviewed at the hearing and a request for review has not been filed with the Appeals Council.

  2. The ALJ will not dismiss the RH if the claimant who filed the RH dies while the case is pending before the ALJ and after the record has been completed. In this situation, the ALJ will issue a decision. (See I-2-8-37, Decision When Claimant Dies.)

B. Title XVI Cases

  1. The ALJ will dismiss the RH when the claimant who filed the RH dies while the request is still pending before the ALJ, if:

    • the case was not remanded by a Federal court under sentence six (See Note 1, above.);

    • there are no other claimants;

    • there is no information in the record which shows that there is another person who may be adversely affected by the determination being reviewed (e.g., in a Title XVI case, if the claimant dies before SSA has paid all benefits due or before the claimant endorses the check for the correct payment, SSA may pay the amount due to the deceased claimant's surviving eligible spouse or to his or her surviving spouse who was living with the underpaid claimant within the meaning of § 202(i) of the Act (see 20 CFR § 404.347) in the month he or she died or within 6 months immediately preceding the month of death, or if the deceased underpaid claimant was a disabled or blind child when the underpayment occurred, SSA may pay the amount due to the natural or adoptive parent(s) of the underpaid claimant who lived with the underpaid claimant in the month he or she died or within 6 months immediately preceding the month of death), who wishes to pursue the claim; and

    • the claimant did not authorize interim assistance reimbursement (IAR) to a state pursuant to section 1631(g) of the Act.

    NOTE 1:

    The ALJ will vacate a dismissal if, within 60 days after the date of the dismissal, a person claiming to be the claimant's survivor, who may be paid benefits due to the claimant under 20 CFR § 416.542(b), submits a written request for a hearing, and shows that a decision on the issues that were to be considered at the hearing may adversely affect him or her. There must be no request pending before the Appeals Council.

    NOTE 2:

    An eligible spouse or other surviving spouse or parent who shows that he or she may potentially qualify to receive an underpayment may pursue the request as a substitute party. 20 CFR § 416.542(b) specifies who may qualify to receive a Supplemental Security Income (SSI) underpayment.

  2. When a deceased claimant authorized IAR to a state, the ALJ must issue a decision. (See I-2-8-37, Decision When Claimant Dies.)

  3. State Medicaid eligibility determinations under title XIX of the Act often flow from SSI eligibility determinations. When the Social Security Administration (SSA) is not required to issue an SSI eligibility determination or decision because the claimant who filed the application has died, e.g., there is no substitute party and there is no IAR in effect, Medicaid determinations, appeals and payments are the responsibility of the State. Even if there are unpaid medical expenses, the ALJ will dismiss an RH if there is no information showing the existence of a person who may pursue the SSI claim as a substitute party and there is no IAR in effect. If a survivor, who is not a qualified substitute party, wishes to pursue Medicaid eligibility, the survivor must contact the appropriate agency of the State which administers the Medicaid program.