POMS Reference

GN 00204: Applications

TN 49 (09-00)

A. Background

The abbreviated application (ABAP) process shortens development time and provides a mechanism for making formal determinations based on essential information.

Three title II applications may be abbreviated in certain situations. They are the applications for disability insurance benefits, lump sum death payment and retirement insurance benefits.

There are three MCS ABAP screens, the abbreviated disability (ABBD) screen, the lump sum death payment (LSDP) screen, and the abbreviated retirement screen.

B. Procedure — ABBD

1. Requirements for using ABBD

Use the ABBD screen to deny DIB claims when ALL of the following apply:

  • The NH and the claimant are the same persons;

  • Insured status is not met (Unless there are lag or current year earnings. Un-posted earnings cannot be entered using ABBD);

  • There are no outstanding issues involving earnings, military service or extending the prescribed filing period;

  • The claimant will not attain full retirement age within the next 5 months;

  • The requirements for DIB are not met and will not be met within the next 12 months; and

  • The claimant does not allege visual impairment or blindness (the ABBD cannot calculate statutory blind insured status).

2. How to use ABBD

Take the following actions when the claimant meets the requirements in GN 00204.009B.1.:

  • Inform the claimant of the eligibility requirements;

  • Advise him/her of the right to file to receive a formal determination and the appeal rights that flow from it;

  • Complete ABBD if the claimant wishes to file; and

  • Deny the claim and issue the appropriate notice.

3. Related procedures

For technical denials see DI 11010.075 Authorizing Certain Title II Technical Denials, and DI 11010.345 Preparing Notices in Disability Claims.

See DI 11010.025, DI 11020.040 Deferring Development, and DI 11010.035 Avoiding Unnecessary Development in Disability Claims for guidelines on title II nondisability development.

C. Procedure — LSDP

1. Requirements for using abbreviated LSDP

Use the LSDP screen to award or deny payment when ALL of the following apply:

  • The MBR shows that the NH was previously entitled to benefits (i.e., there must be an MBR on the claim number on which the LSDP claim is being filed);

  • The claimant and the applicant are the same person;

  • The only benefit payable is the LSDP (includes cases where the living in the same household (LISH) spouse is entitled to a higher PIA on his/her own earnings record; and

  • The deceased NH was also entitled to spouse's benefits on the record of the LSDP applicant.

2. How to use LSDP

Take the following actions when the requirements in GN 00204.009C.1. are met:

  • Complete the LSDP screen;

  • Obtain the appropriate evidence; and

  • Allow/disallow the claim.

D. Procedure — abbreviated retirement

An abbreviated application can be taken for an individual age 64 and 9 months or older who is eligible for monthly benefits but wishes to file for Medicare benefits only beginning at age 65 or later as outlined in GN 00204.021.

1. Requirements for using the abbreviated retirement path

Use the abbreviated retirement path to award a claim for Medicare benefits when the claimant:

  • Is the number holder (NH);

  • Is fully insured; and

  • Wants to restrict his/her retirement claim to Medicare.

NOTE: the abbreviated retirement path may also be used for Medicare Qualified Government Employment(MQGE) claims, even though MQGE claimants are not insured to monthly cash benefits.

2. How to use the abbreviated retirement path

Take the following actions if the Medicare restricts his/her retirement application to HI only and meets the requirement in GN 00204.009D.1.:

  • From the abbreviated retirement path, complete the HIHI screen (and HIGP and HI19 if appropriate);

  • Obtain the appropriate evidence; and

  • Allow the claim.

3. Concurrent auxiliary claims

Take the following actions if the NH restricts the RIB claim to Medicare only and an auxiliary files a concurrent claim:

  • Follow the instructions in GN 00204.009D.1. and GN 00204.009D.2. for processing the NH's claim; and

  • Follow existing procedures to process the auxiliary claim(s) because no abbreviated application procedures exist to process these claims.

E. Procedure - skeleton paper applications

1. Disability

Follow the instructions in GN 00201.005C.3. and GN 00205.038 if the claimant meets the requirements in GN 00204.009B.1.

2. LSDP

Follow the instructions in RS 00210.050 if the claimant meets the requirements in GN 00204.009C.1.

3. Medicare only

Follow the instructions in HI 00801.022 and HI 00801.027 if the claimant meets the requirements in GN 00204.009D.1.

F. References

  • FO Authorization of Certain Title II Technical Denials, DI 11010.075

  • Preparing Notices in Disability Claims, DI 11010.345

  • Deferring Development, DI 11020.040

  • Abbreviated Applications (Title II), MSOM MCS 005.001

  • Separate HI Filing, GN 00204.021

  • Health Insurance (Medicare) Enrollment Minipath Screens, MSOM ICD 003.001

  • SSI Abbreviated Applications, SI 00602.001