EFFECTIVE/PUBLICATION DATE: 4/14/99
POLICY INTERPRETATION RULING
TITLE II: TERMINATION
OF ENTITLEMENT BASED ON PRESUMED DEATH
This Policy Interpretation Ruling explains the Social Security Administration's (SSA) planned use of an established policy for presuming a person dead, after the person has been absent from his or her residence and has not been heard from for a period of 7 years, to terminate entitlement for such individuals. The presumption of death, founded on common law, is widely accepted in State and Federal courts to determine entitlement to property and is codified in our regulations. We use this regulatory presumption to establish the fact of death for entitlement purposes, and will also use it to determine that entitlement ends.
Sections 205(a) and 702(a) of the Social Security Act; 20 C.F.R., sections 404.705 and 404.721.
Currently, SSA suspends benefits to beneficiaries reported missing when notified by a first party reporter, that is, a relative, representative or another beneficiary on the record who establishes that he/she is an acceptable reporter.
In addition, benefits can be suspended if mail is returned because it is undeliverable. Suspensions of this type follow prescribed development to locate the individual. In such cases, SSA first makes a reasonable effort to locate the beneficiary and then sends a notice to the beneficiary's last known address advising him or her that benefits will be stopped if he or she does not respond within 15 days. If these efforts fail, and there is no response from the beneficiary, benefits are suspended.
In situations where benefits are suspended for whereabouts unknown, unless the presumption of death after 7 years is used to terminate benefits, the benefits can remain in suspension indefinitely. Studies by the Office of the Inspector General (OIG) indicate that suspensions should be resolved as a deterrent to fraudulent payment to the wrong individuals. In addition, studies by SSA show that suspensions for lack of address are usually resolved within 24 months, and that benefits left in suspense for longer than 24 months, because the continuing eligibility of the beneficiary cannot be determined, are rarely ever resolved. SSA now has the capability to indicate the reason for suspension on its payment records. Where that reason is whereabouts unknown and benefits are in continuous suspense for at least 7 years, SSA will assume that the reason the beneficiary failed to request payment during that 7 year period is death.
Terminating entitlement for presumed death ensures that suspended payments will not be fraudulently issued to someone other than the beneficiary. That is because erroneous terminations for death can be reinstated only after a face-to-face interview with the beneficiary. However, payment of suspended benefits does not involve the same stringent development before release of payment and is more vulnerable to fraud. By applying the presumption of death policy to terminate entitlement, SSA will ensure that a final resolution to suspension occurs for those cases which otherwise would remain in suspension indefinitely.
Following continuous suspension for 7 years based on whereabouts unknown, entitlement will be terminated for presumed death. Absent evidence to the contrary, death will be presumed to have occurred on the date of disappearance, the date ending the 7 year period, or some other date depending upon what the evidence shows is the most likely date of death.
SSA will presume that a beneficiary has died and will terminate entitlement after the individual's payments have been suspended continuously for 7 years or more because the individual's whereabouts are unknown. This policy interpretation will apply to all individuals whose entitlement is not based on disability. The policies for terminating entitlement for disabled beneficiaries whose whereabouts are unknown are addressed in 20 C.F.R., section 404.1594. This policy interpretation on presumed death termination, however, will apply to those individuals who have been converted to retirement benefits following an established period of disability. If the benefits are suspended for whereabouts unknown based on a reported disappearance by a first party reporter, that is, a relative, another beneficiary on the record, or a representative of the beneficiary who is an acceptable reporter, the date of presumed death generally will be the date of disappearance, barring some convincing evidence that establishes a more likely date of death.
For cases where suspension for whereabouts unknown originated through undeliverable mail, and benefits have remained in suspension for a period of 7 years or more, the date of presumed death will be the date SSA determined that the individual disappeared, barring some evidence to the contrary.
This Ruling is effective upon publication in the Federal Register.
Program Operations Manual System, sections GN 02605.055 and GN 00304.050.