SSR 69-24: SECTIONS 202(k)(3)(A) and 224(a). -- WIDOW'S INSURANCE BENEFITS -- WIDOW ENTITLED TO DISABILITY INSURANCE BENEFITS SUBJECT TO WORKMEN'S COMPENSATION REDUCTION -- WITHDRAWAL OF APPLICATION
20 CFR 404.407, 404.408(a), AND 404.615(b)
SSR 69-24
- Where a woman becomes entitled to a disability insurance benefit but the benefit is not payable because of her receipt of higher workmen's compensation payments; and where subsequently, at age 60, she becomes entitled to a reduced widow's insurance benefit in an amount less than the disability insurance benefit, held, the widow's insurance benefit is not payable, because of her entitlement to the disability insurance benefit. Further held, she may file a request for withdrawal of her application for disability insurance benefits, and if approved, the widow's insurance benefit will become payable.
R, a female worker, filed application for and became entitled to monthly disability insurance benefits of $65.30 beginning February 1967. No benefits were actually paid to her, however, because her receipt of workmen's compensation payments in an amount greater than her disability benefits required a total offset, under section 224(a) of the Act. Subsequently, R, upon attainment of age 60, filed an application for widow's insurance benefits based on her deceased husband's account and became entitled to a monthly benefit which, before reduction for age under section 202(q), equalled $64.60.
Section 202(k)(3)(A) of the Act, pertaining to simultaneous entitlement to benefits, provides that:
- If an individual is entitled to an old-age or disability insurance benefit for any month and to any other monthly insurance benefit for such month, such other insurance benefit for such month, after any reduction under subsection (q) and any reduction under section 203(a), shall be reduced, but not below zero, by an amount equal to such old-age or disability insurance benefit (after reduction under such subsection (q)). (Emphasis supplied.)
As to the effect of receipt of workmen's compensation, section 224(a) of the Act provides, in pertinent part:
-
(a) If for any month prior to the month in which an individual attains
the age of 62 --
- (1) such individual is entitled to benefits under section 223 [disability insurance benefits], and
- (2) such individual is entitled for such month, under a workmen's compensation law or plan * * * to periodic benefits for a total or partial disability * * *
-
the total of his benefits under section 223 for such month and of any
benefits under section 202 for such month based on his wages and
self-employment income shall be reduced (but not below zero) by the amount
by which the sum of --
- (3) such total of benefits under sections 223 and 202 for such month, and
- (4) such periodic benefits payable (and actually paid) for such month to such individual under the workmen's compensation law or plan, exceeds -- * * *,
- (6) the total of such individual's disability insurance benefits under section 223 for such month and of any monthly insurance benefits under section 202 for such month based on his wages and self-employment income, prior to reduction under this section.
Since it would appear that section 202(k)(3)(A), supra, requires that the widow's benefit be reduced by the amount of the disability benefit as originally awarded, a question has arisen as to whether R may be paid a widow's benefit unless she withdraws her application for disability benefits. It was contended that the amount by which R's widow's benefit is to be reduced is the amount of her disability benefit after it is offset under section 224(a), supra; and since the amount of that benefit thus offset is zero, R could be paid her widow's benefit without withdrawing her disability application.
The issue thus raised is whether, for purposes of section 202(k)(3)(A), R is "entitled" to the amount of the disability insurance benefit which she would have received but for its offset under section 224(a).
The language of section 202(k)(3)(A) specifies that the amount by which the widow's insurance benefit must be reduced is the amount of the disability benefit to which she is entitled. Similarly, the legislative history of section 202(k)(3)(A), (Sen Rep. No. 1669, 81st Cong. 2d Sess., at p. 68), states in pertinent part, that:
- [It] replaces the clause in the subsections on * * * widow's * * * benefits in existing law which provides for reducing the amount of such benefits by the amount of the * * * benefit to which the individual becomes entitled on his own wage record. * * * * This is merely a language simplification, retaining the principle in the present law. (Emphasis supplied.)
The word "entitled" as used in this context in the Act, signifies compliance with all the basic benefit requirements, i.e., meeting all conditions of eligibility plus the filing of an effective application. Thus an individual may be entitled to the benefit although no benefit may be payable or only part of the benefit is payable, due to any one of the events which the Act provides shall result in reduction or suspension of payment. This interpretation is consistent with section 223 of the Act, prescribing the conditions for entitlement to disability benefits. That section specifies that an individual who satisfies these conditions "shall be entitled to a disability insurance benefit * * * beginning with the first month * * * in which he becomes so entitled * * * and ending with the month preceding whichever of the following months is the earliest: the month in which he dies, the month in which he attains age 65, or the 3d month following the month in which his disability ceases." Under section 223 the payment of workmen's compensation is not a factor which terminates entitlement to disability insurance benefits. Rather the payment of workmen's compensation only reduces the payment of disability benefits.
Moreover, this conclusion is the only one consistent with the language of section 202(k)(3)(A). That section provides that the benefit to be offset (in this case the widow's benefit) shall be reduced "by an amount equal to such * * * disability insurance benefit (after reduction under such subsection (q))." Subsection (q) is the reduction for age provision. It may be inferred that if Congress had intended the benefit to be offset by the amount of the disability benefit after reduction for workmen's compensation, it would have included a reference to section 224(a) in addition to the reference to subsection (q). It is well settled that:
- When a status limits a thing to be done in a particular mode, it includes the negative of any other mode. Botony Worsted Mills v. United States, 278 U.S. 282 (1929).
It is held, for purposes of this ruling, that the amount by which R's widow's benefit must be reduced, under the provisions of section 202(k)(3)(A) of the Act, is $65.30, the amount of her disability insurance benefit to which she was entitled before it was offset under section 224(a) of the Act. This, in effect, reduces the amount of the widow's benefit actually payable to zero. It is further held, upon R's filing formal request for withdrawal of her application for disability insurance benefits, and approval thereof, that application will be deemed not to have been filed (section 404.615 of Social Security Administration Regulations No. 4), so that she would not be considered entitled to disability insurance benefits. Since she otherwise meets all requirements for such action , a widow's insurance benefit of $56, after reduction for age under section 202(q) of the Act, may be payable to her. (The $56 benefit rate results when the unreduced widow's benefit of $64.60 is reduced under section 202(q)(1) by 5/9 of 1% for each of the 24 months of entitlement before age 62.)