SSR 72-8: SECTIONS 413(a), 414(a) and (c). -- FEDERAL COAL MINE HEALTH AND SAFETY ACT OF 1969 -- CLAIM FOR BLACK LUNG BENEFITS -- FILING AS PREREQUISITE FOR ENTITLEMENT -- PROTECTIVE FILING DATE
20 CFR 410.221(a) and 410.229
SSR 72-8
- Held, an application for benefits under title II of the Social Security Act, filed prior to a claim for "black lung" benefits under title IV of the Federal Coal Mine Health and Safety Act of 1969, may constitute a "protective writing" for such "black lung" benefits only if the prior social security application evidences intention to claim "black lung" benefits.
A question has been raised as to whether an application for disability insurance benefits under title II of the Social Security Act may be used to establish a protective filing date for a subsequently filed claim for "black lung" benefits under the provisions of Part B of title IV of the Federal Coal Mine Health and Safety Act of 1969. A similar question involves an application for benefits as a disabled widow under title II, supra, and a later claim for widow's "black lung" benefits under title IV, supra.
The filing of a written "application" for benefits under title II of the Social Security Act is not a mere formality; it is a substantive requirement for entitlement (for example, see sections 202(a)(3), 202(e)(1)(C)(i), 216 (i)(2)(B), and 223(a)(1)(C) of the Social Security Act). Similarly, the filing of a "claim" is a prerequisite to entitlement as a miner or a widow to "black lung" benefits (sections 413(a) and 414(a) and (c) of the Federal Coal Mine Health and Safety Act of 1969). Thus, rights may not be adjudicated, nor benefits paid, without the filing of a legally sufficient "application" or "claim," as the case may be. In the absence of an express statutory provision authorizing the making of oral "applications" and "claims," each of these terms necessarily entails the filing of a legally sufficient writing.
Regulations No. 4 of the Social Security Administration implement this statutory requirement for purposes of title II of the Social Security Act. Section 404.602 (20 CFR 404.602) provides:
- Applications shall be made * * * on such forms and in accordance with such instructions (provided thereon or attached thereto) as are prescribed by the Administration. * * *
Accordingly, the scope of the Application for Disability Insurance Benefits is indicated by the legend:
- I hereby apply for a period of disability and for all insurance benefits payable to me under title II of the Social Security Act, as amended.
Similarly, the scope of the application for Widow's Insurance Benefits is indicated by the legend:
- I hereby apply for entitlement to all insurance benefits which may be payable to me under title II and part A of title XVIII of the Social Security Act, as amended.
The filing of such a form constitutes a claim for benefits in accord with its own terms. Without more, such an application when filed constitutes a claim only under title II, or under titles II and XVIII, of the Social Security Act.
The same approach has been utilized in the "black lung" benefits program. Section 410.221(a) of Regulations No. 10 (20 CFR 410.221(a)) provides that:
- Claims shall be made as provided in this subpart on such application forms and in accordance with such instructions (provided thereon or attached thereto) as are prescribed by the Administration.
The prescribed "black lung" claim forms provided by the Administration each bear the legend:
- I hereby claim all benefits which may be payable to me under title IV of the Federal Coal Mine Health and Safety Act of 1969.
Thus, the filing of such a form constitutes a claim for benefits in accord with its own terms. Without more, such an application form when filed constitutes a claim only under part B of title IV of the Federal Coal Mine Health and Safety Act of 1969.
The statutory requirements of the Social Security Act with respect to the filing of applications have traditionally been liberally construed. Thus, a writing not on a prescribed application form may be considered an "application" if it indicates an intention to claim benefits, is signed by a proper party, if filed with the Administration, and is perfected by the filing in due course of a prescribed application form in an authorized manner (20 CFR 404.613). This procedure has been adopted in the "black lung" program (20 CFR 410.229). These procedures serve to protect claimants' rights when such rights are dependent on filing dates and the immediate execution of a completed application on a prescribed form is not practicable. A single writing could operate as a "protective writing" for both social security and "black lung" purposes, if it is clear from the writing that the claimant's intention is to apply for all benefits for which he might be eligible. Anything less than this minimal requirement would ignore the statutory requirement.
Accordingly, it is held that where a social security application is filed prior to a "black lung" claim, the social security application may constitute a "protective writing" for "black lung" benefits only if reference is made within the prior social security application to an intention to claim "black lung" benefits.