POMS Reference

RS 00615: Computation of Monthly Benefits Amounts

TN 24 (09-02)

A. INTRODUCTION

A person may be entitled to reduced RIB after DIB has ended, reduced RIB and DIB with the DIB starting first, or reduced RIB and DIB with the RIB starting first. The benefit amount depends on the sequence of entitlement and the choice of the beneficiary.

B. POLICY

1. Reduced RIB after DIB Ends

  • The prior DIB does not affect the RIB reduction. The RIB is reduced by the number of months remaining until FRA.

  • Computation of the RIB PIA is affected by the normal rules on exclusion and non-exclusion computations.

  • The SUB DIB Guarantee PIA can be used to determine the RIB PIA. The SUB DIB Guarantee applies because the prior DIB has terminated.

2. Simultaneous Entitlement to Reduced RIB after DIB has Started

  • An individual who at the time of filing for RIB is simultaneously entitled to a DIB will receive the higher benefit unless he/she elects to receive the lower benefit. An election is not necessary to receive the higher benefit. The “higher benefit” refers to the amount of the claimant's MBA rather than the PIA. It also refers to the benefit amount prior to any deductions or offsets that may apply.

  • A signed election is necessary to receive the lower benefit, or to make a subsequent change after the first election.

  • The DIB does not affect the RIB reduction. The RIB is reduced by the number of months remaining until FRA.

  • Computation of the RIB PIA is affected by the normal rules on exclusion and non-exclusion computations. The disability period may be excluded when figuring the RIB PIA computation even though the disability period has not ended.

  • The SUB DIB Guarantee PIA cannot be used to determine the RIB PIA. The SUB DIB Guarantee only applies when the prior DIB has actually terminated. When the DIB ends at FRA we may then consider the SUB DIB Guarantee as the RIB PIA.

  • Whenever the claimant elects to receive the lower benefit instead of the other, the reason for requesting that particular benefit must be documented. There are several reasons for choosing a benefit option. If WC/PDB offset or the disability family maximum apply, the reduced RIB may yield larger total family benefits. If the WC/PDB ends or auxiliaries are no longer entitled, the NH may elect to receive DIB to maximize his/her personal benefits.

  • After the claimant has received either the reduced RIB or the DIB if he/she wishes to receive the other benefit, he/she may change the election. The reason for the change must be documented.

    In cases where the NH dies before adjudication of a DIB application, or before the option of electing a lower RIB to maximize total family benefits is explained, the proper applicant may complete an SSA-795 to elect the lower RIB.

  • Entitlement to either DIB or RIB does not terminate entitlement to the other.

  • The DIB will end when the disability ends or upon attainment of FRA.

  • If the claimant is also entitled to another benefit, the calculation of that benefit is based on the benefit that the claimant has elected to receive.

3. Simultaneous Entitlement to DIB after Reduced RIB has Started

  • Entitlement to DIB does not cause entitlement to RIB to terminate.

  • The DIB is reduced by the number of months of reduced RIB that was paid.

  • If the DIB terminates before FRA, the RIB which again becomes payable is reduced by the original reduction factor (i.e., without considering the intervening DIB). The ARF to eliminate months of DIB entitlement will occur at FRA.

  • The RIB must be recalculated if the PIA based upon the disability freeze period used in the previous RIB computation is affected by termination of the DIB entitlement.

  • Months of DIB entitlement will be excluded from the RIB reduction factor at FRA.

NOTE: It is possible that a person may elect to switch back and forth several times before FRA. Because neither the RIB nor the DIB causes the other benefit to terminate, once the RIB and the DIB amounts are established they do not change merely because the claimant elects to receive one or the other. Each time the RIB is elected it will be reduced by the total number of reduction months used in the original reduced RIB computation. Each time the DIB is elected the reduction in DIB will be the total number of months that reduced RIB was paid up to first month of DIB entitlement.

EXAMPLE: A beneficiary elects reduced RIB at age 62. His FRA is 66 so his RIB reduction factor (RF) is 48. After 6 months he becomes entitled to DIB. His DIB is reduced for 6 RF because RIB was paid for 6 months. After 6 months he becomes entitled to a workers' compensation benefit that will offset his DIB, so he elects to receive reduced RIB again. Even though he is now age 63, the RIB will still be reduced by the original 48 RF. After 6 more months the worker's compensation ends so he elects DIB again. The DIB this time will still be reduced for 6 RF because a total of 6 months of reduced RIB were paid prior to the first DIB month of entitlement..