POMS Reference

RS 00301: Retirement, Survivors and Disability Requirements

TN 18 (08-04)

A. Introduction

1. NH Has DIB Insured Status

NH has DIB insured status if he or she:

  1. Has at least 20 QC's during a 40 quarter period ending with the quarter the waiting period begins; and

  2. Is fully insured in that quarter.

IMPORTANT: If the worker is an alien whose SSN was first assigned on or after January 1, 2004, then he/she must meet additional requirements under Section 211 of the Social Security Protection Act of 2004 (Public Law 108-203), to be insured and to establish entitlement based on his/her earnings. See RS 00301.102 for a full discussion of these requirements.

2. Statutory Blindness - Insured Status

An individual disabled because of statutory -blindness may qualify for DIB freeze or entitlement to DIB if he or she has fully insured status only. (See RS 00301.106 and RS 00301.150.)

NOTE: If the worker is an alien whose SSN was first assigned on or after January 1, 2004, then he/she must meet additional requirements under Section 211 of the Social Security Protection Act of 2004 to meet insured status. See RS 00301.102 for a full discussion of these requirements.

3. Meeting Tests - First Month of Waiting Period

In the first month of the waiting period:

  • An individual who becomes disabled when he/she had freeze insured status and remains continuously disabled will continue to meet these tests in the first month of the waiting period (even if it begins in a quarter after the quarter of onset).

  • An individual will have DIB insured status because the insured status met at onset to establish the period of disability (i.e., a freeze) protects the insured status the NH has at onset.

4. No Waiting Period

If no waiting period is required for the current period of DIB because a period of DIB entitlement or a disability freeze (no cash benefits) terminated within the past 5 years, then the NH must have DIB insured status in the quarter of the first month of entitlement for the current period of DIB.

5. Reference

For the special DIB insured status provision, an alternative to the 20/40 requirement, see RS 00301.147.

B. Policy—Requirements for DIB Insured Status

1. 20/40 TEST

a. Period of Disability Considered

The NH will meet the 20/40 Test if:

  • The NH must have at least 20 QC's during a 40-quarter period ending with the quarter in which the waiting period begins; or

  • If the NH does not have to serve a waiting period due to the termination of a prior period of entitlement to DIB or freeze within the past five years, then he/she must have 20/40 ending with the quarter of the first month of entitlement for the current period of disability.

In determining the 40-quarter period, do not count any quarter, all or part of which is in a prior freeze or DIB period, except the beginning or ending quarter if they are QC's.

b. Period of Disability Disregarded

If the NH's insured status is more advantageous without considering the period of disability, the period may be disregarded. When there are two or more prior periods of disability, either all must be disregarded or all must be used when determining insured status and benefit amount. Non-creditable military wages or RR compensation may not be used to establish QC's where the period of disability is disregarded even though they may be used to establish a freeze.

2. Fully Insured Test

To meet the fully insured status test, the NH:

  1. Must have enough QC's to be fully insured in first month of waiting period; or

  2. If the NH does not have to serve a waiting period due to the termination of a prior period of DIB or freeze within the past five years, then he/she must be fully insured in the quarter of the first month of entitlement for the current period.

C. Example

Guinness T. Lis became disabled on 12/15/77. As of that date, the NH was fully insured and had 20 quarters of coverage in the 40-quarter period ending with the 12/77 quarter. Although the NH remained continuously disabled and did not work after 12/77, he did not file an application for DIB until 7/ 10 /88. Hence, the first month of the waiting period is 2/87, the 17th month before the month of filing. Since the application for DIB is also an application to establish a “freeze,” a period of disability may be established beginning with 12/77. This enables the NH, who met the insured status test at onset, to meet the test in 2/87, the first month of his/her waiting period.

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