POMS Reference

This change was made on Apr 16, 2018. See latest version.
Text removed
Text added

VB 00201.045: Application for Special Benefits for World War II Veterans (Form SSA-2000-F6)

changes
*
  • Effective Dates: 07/01/2014 - Present
  • Effective Dates: 04/15/2018 - Present
  • TN 2 (02-07)
  • VB 00201.045 Application for Special Benefits for World War II Veterans (Form SSA-2000-F6)
  • A. Introduction
  • The Form SSA-2000-F6 (Application For Special Benefits For World War II Veterans) is the application form to apply for title VIII and the basis for establishing entitlement to SVB payments.
  • B. Description
  • The SSA-2000-F6 contains a "Changes to Report" and a "Receipt for Claim" page. Most answer blocks have printed "go to" instructions. The "go to" instructions direct the claimant/applicant to the next required question/item.
  • The detachable "Changes to Report" (reporting instructions) and "Receipt for Claim" page provides the applicant with:
  • * Written acknowledgment that a claim for SVB has been filed;
  • * An estimate of the anticipated processing time after all necessary information is received;
  • * Information about computer matching;
  • * Information about the paperwork burden estimate; and
  • * A summary of the claimant's reporting responsibilities.
  • C. Procedure - Completing Form SSA-2000-F6 -- General
  • The SSA-2000-F6 was designed primarily to be completed by a representative of SSA. However, the Form SSA-2000-F6 may also be completed by an applicant/claimant. Use the following information to complete the items on Form SSA-2000-F6.
  • 1. Filing Date Block
  • Complete for all applications.
  • Since no payments will be made prior to May 1, 2000, the protective filing date should be shown if the claimant filed in June or later and the protective filing date is needed for qualification/entitlement to SVB.
  • a. Application Completed in Field Office (FO), or the Foreign Service Post (FSP)
  • a. Application Completed in Field Office (FO), or the Federal Benefits Unit (FBU)
  • Enter the filing date (month, day, year) of the application. Mark "Protective" block if the filing date is prior to the date SSA receives the completed and signed application. Mark one block only.
  • Document the file if the filing date is other than the date the SSA-2000-F6 is signed, for example, a protective writing or oral inquiry.
  • b. Completed Application Received in FO/FSP
  • b. Completed Application Received in FO/FBU
  • Upon receipt of a signed Form SSA-2000-F6, enter the filing date the application is received at an SSA office or one of the other locations listed in GN 00204.006. Mark the "Actual" block unless the filing date is prior to the date SSA receives the completed and signed application. (See GN 00204.007 for more information about when an application is filed.) Mark one block only.
  • Document the file if the filing date is other than the date the SSA-2000-F6 is received, for example, a protective writing or oral inquiry.
  • 2. Name, Date of Birth, Sex - Questions 1 and 3
  • Enter the claimant's name, date of birth, and sex. This information is needed to verify the claimant's identity.
  • 3. Social Security Number - Question2(a)
  • * Leave the "SSN" block blank if the claimant says that he or she does not have an SSN or does not remember it. (See VB 00201.055 for the procedures for processing an "alpha" claim.)
  • * If the correct SSN is determined after the SVB application is filed, enter the SSN on any other related forms as appropriate.
  • * If the claimant is in the United States and is also filing for SSI benefits at the same time as the SVB benefits, complete a form SS-5 following the evidentiary requirements in RM 00207.015 when the claimant does not have an SSN or requests a replacement card.
  • 4. Other Names and SSN's - Questions 2(b) and (c)
  • This information is needed for NUMIDENT verification of the SSN (See SSR/NUMIDENT Interface - SM 02001.400)
  • * If 2(b) is answered "yes," complete (c) and list any other names and SSN's used by the claimant. Otherwise, go to question 3.
  • * If the claimant has more than one SSN, obtain Master Beneficiary Record (MBR) and SSR queries under the other SSN's. Retain the queries in the file.
  • When it appears that an individual uses multiple SSN's, consider fraud development in GN 04110.000.
  • 5. Prior Application for SSI - Question 4
  • a. Claim Filed in the United States
  • If claimant answers both 4(a) and 4(b) "No", develop an SSI claim as explained in SI 00601.000 if the claimant is not currently on the SSI rolls (i.e., has never been eligible for SSI or is in terminated status).
  • Be sure to explain to SSI recipients the effect on SSI benefits if he or she leaves the United States and establishes a residence outside the United States, as shown in SI 00501.400 - SI 00501.410 and SI 02301.225.
  • b. Claim Filed Outside of the United States
  • If claimant answers both 4(a) and 4(b) "No," do not develop an SSI claim. However, if the individual insists on filing an application for SSI, see SI 00604.000 for completing the Form SSA-8000-BK (Application For Supplemental Security Income) and forward to Central Processing Site in VB 00901.025.
  • (See VB 00101.001B.1. for definition of United States for SVB purposes.)
  • 6. World War II Military Service Information - Questions 5 and 6
  • If both questions 5 and 6 are answered "No", go directly to the signature block on page 4.
  • 7. Other Benefit Income - Question 7
  • If claimant answers "Yes" to any of the income sources shown on the form, indicating he or she is receiving benefit income from other sources, enter the beginning and ending dates (month/year) of that benefit. Also enter the monthly amount of each type of benefit.
  • If the claimant receives recurring payments that are not paid monthly, use the "Remarks" section to indicate the frequency and amount of each recurring payment. (See VB 00205.100B.2. for definition of recurring payment and VB 00205.115 for how to determine the monthly income amount of a recurring payment.)
  • 8. Deportation - Question 8
  • If claimant answers "Yes" to question 8(a), enter the date he or she was deported in question 8(b) and if he or she was lawfully admitted to the United States after the date shown in 8(b).
  • 9. Unsatisfied Arrest Warrant - Question 9
  • If claimant answers "Yes," use the "Remarks" section to explain the circumstances.
  • 10. Violation of Probation or Parole - Question 10
  • If claimant answers "Yes," use the "Remarks" section to explain the circumstances.
  • 11. Residence Outside the United States - Question 11
  • Since title VIII provides for payment of SVB benefits for individuals who reside outside the United States, question 11 asks if the claimant has established a residence outside of the United States or intends to establish a residence outside of the United States. If the claimant knows when he or she will be establishing a residence outside of the United States, a date should be entered in 11(c). If the claimant has established a residence outside the United States, block print the foreign address in 11(d).
  • 12. Signature Space
  • The proper applicant or third party should sign and date the application. Enter the telephone number where the applicant can be reached during the day.
  • Enter the mailing address of the individual who signed the application in the spaces provided. If a third party signed the application, enter the claimant's residence address in the "Remarks" section.
  • See GN 00205.115 when the applicant signs by mark.
  • 13. "Changes to Report" and "Receipt for Claim" Tear-off Page
  • Complete the "Receipt for Claim" for each application. Detach the "Changes to Report" and the "Receipt for Claim" page from the SSA-2000-F6 and give it to the claimant at the conclusion of the interview or mail it to the claimant when FO/FSP receives the signed application.
  • Complete the "Receipt for Claim" for each application. Detach the "Changes to Report" and the "Receipt for Claim" page from the SSA-2000-F6 and give it to the claimant at the conclusion of the interview or mail it to the claimant when FO/FBU receives the signed application.
  • D. Procedure – Face-To-Face Interview
  • When conducting a face-to-face interview, take the following steps:
  • * Enter the name(s) and SSN(s) of the claimant in the space provided on the form.
  • EXCEPTION: When a third party or proper applicant files the application, enter their name followed by the word "for" and the name(s) of the claimant.
  • * Enter the date the claim is filed.
  • * Enter the telephone number and address of the servicing office.
  • * Enter (in the narrative) the estimated number of days it will take to hear from us. (An estimate of the number of days required for processing may be based on regional or local guidelines.)
  • If verification of military service is necessary, an additional 30 days (4 weeks) should be included if a manual alpha search has to be done at the National Personal Record Center (NPRC) in St. Louis. (See VB 00205.055B. for the procedure to follow when requesting verification from NPRC.)
  • * Explain the Paperwork/Privacy Act Notice and computer matching statements as well as the burden estimate.
  • * Review the reporting responsibilities and answer any questions the claimant may have about the requirements. Remind the claimant about the penalty provision for failure to make a timely report.
  • * Tell the claimant that, if he or she is awarded SVB payments, the first few months' checks may still contain the legend for SSI benefits.
  • This will only apply to the first checks issued under title VIII. Once Treasury has made the change any future beneficiaries will receive the appropriate legend on the title VIII checks. This doesn't apply to beneficiaries using direct deposit.
  • * Tell the claimant that he or she should retain the "Changes to Report" page for later reference because it provides written acknowledgement of filing an SVB claim and explains how to contact us, and the reverse side provides the changes to report.
  • E. Procedure -- Telephone Interview
  • When conducting a telephone interview, take the following actions:
  • * Follow the instructions in VB 00201.045C.13.b.
  • * Before mailing the application form to applicant/claimant for signature, detach the "Changes to Report" and "Receipt for Benefits" tear-off page and retain it in the claims folder.
  • * Upon receipt of the signed application form, mail the "Changes to Report" tear-off page to the claimant with a brief cover note explaining the following:
  • * The "Receipt for Claim" is enclosed; and
  • * Purpose and importance of the "Changes to Report;" and
  • * He or she must report changes because changes can affect payment. Call or write to the office identified on the "Receipt."
  • * If awarded SVB payments, first few months' checks may still contain the title XVI (SSI) legend if claimant is receiving monthly checks instead of direct deposit.
  • F. Procedure - Application Mailed Directly to Applicant/Claimant for Completion
  • If mailing the application, take the following actions:
  • * As shown in VB 00201.045C.13.c., before mailing the application form to applicant/claimant for completion, detach the "Changes to Report" and the "Receipt for Claim" page from the SSA-2000-F6.
  • * Use optional paragraph space in notice to advise applicant/claimant to answer all questions with complete information. If information is not known or available, applicant/claimant should enter "unknown." (See VB 05001.012 - VB 05001.013 for appropriate notices.)
  • * Retain a copy of the notice as well as the detached "Changes to Report" tear-off page in a claims folder.
  • * Upon receipt of the signed application form, mail the "Changes to Report" tear-off page to the claimant with a brief cover note explaining the following:
  • * The "Receipt for Claim" is enclosed; and
  • * Purpose and importance of the "Changes to Report;" and
  • * He or she must report changes because changes can affect payment. Call or write to the office identified on the "Receipt."
  • * If awarded SVB payments, mention that the first few months' checks may still contain the title XVI (SSI) legend if claimant is receiving monthly checks instead of direct deposit.
  • G. Procedure - Obtaining Queries
  • Take the following actions when obtaining queries for SVB benefits:
  • * Obtain the following query(ies) for all SVB claimants to determine if an application has been previously filed.
  • * SVB information from the San Francisco Intranet Site . See Intranet site instructions.
  • * Modernized Development Worksheet (MDW) - for date of protective filing, if any.
  • * Numident (NUMI) - for verification of the claimant's SSN.
  • * Master Beneficiary Record (MBR) - if claimant alleges receipt of title II benefit under his or her own SSN or another SSN used by the claimant.
  • * Supplemental Security Record (SSR) - for verification of claimant's eligibility for SSI in December 1999, the date the law went into effect, as well as eligibility for SSI in the month the application was filed. The SSR may also contain information about any prior application for title VIII benefits.
  • Rely on SSA data base since experience has proven that claimants often cannot recall accurately the month or year of filing.
  • * Associate the queries with the file.
  • * Retain queries in the file through adjudication.
  • H. Procedure - Use of Queries
  • 1. Title VIII Application Previously Filed
  • If a title VIII application was ever filed by, or on behalf, of the claimant, consider whether the:
  • Claimant established residence outside of the United States within the 4-month period after he or she was notified about meeting the requirements for qualification for SVB (see VB 00101.001B.1. for definition of United States for SVB purposes and VB 00101.001 for extending the 4-month period);
  • * Claimant is still in an appeals period (See GN 03101.050);
  • * Prior application for SVB can be reopened under the rules of administrative finality (See VB 02507.000); and
  • * Prior period of entitlement was suspended or terminated (See VB 01501.001).
  • 2. Title XVI Application Previously Filed
  • If a title XVI application was ever filed by, or on behalf, of the claimant, consider whether the:
  • * Claimant was eligible for SSI for December 1999, the month when title VIII was enacted (See VB 00205.020);
  • * Claimant was eligible for SSI for the month when he or she filed the application for SVB (See VB 00205.020);
  • * Claimant is still in an appeals period (See GN 03101.050);
  • * Prior application for SSI can be reopened under the rules of administrative finality (See SI 04070.001);
  • * Prior period of SSI eligibility was suspended or terminated (See SI 02301.001).
  • I. References
  • Definition of United States, VB 00101.001B.1. SSI Eligibility for SVB Benefits, VB 00205.020