The road to Social Security Disability benefits can be a lengthy process. Sadly, several applicants pass away while their case is still pending. Families are consequently left wondering if the disability claim dies with the claimant. Fortunately, the answer is often no. If a Social Security Disability Insurance (SSDI) claim is approved, the decision may be issued after the individual's death. If the claimant passed away, a surviving family member, for example, a spouse or child, may step in as a substitute party to receive back pay owed to the deceased up to the date of death. This process, as described below, ensures that the benefits earned by the deceased are rightfully paid to their surviving family.
Differences Between Accrued and Survivor Benefits
The process involved in a Social Security disability case changes significantly when an applicant dies. The type of claim, Social Security Disability Insurance (SSDI) or Supplemental Security Income (SSI), is significant because it determines the benefits that may still be available. This distinction determines the type of financial relief available to the survivor upon the applicant's death.
The law distinguishes between accrued benefits and survivor benefits under Social Security Disability Insurance, Title II. SSDI eligibility is based on the deceased worker’s employment record. Because of this, the Social Security Administration (SSA) often keeps the claim open to issue a posthumous decision, effective as of the date of death. If approved, back pay benefits are paid to eligible survivors. The important thing is that the death of an SSDI-insured worker means that qualified family members can apply for separate, ongoing survivor benefits. Furthermore, this can provide people with substantial monthly support.
By contrast, SSI (Supplemental Security Income, Title XVI) is a needs-based benefit, and the claim generally expires immediately at the death of the applicant. According to the SSA, an SSI payment cannot be made for any month during which a claimant dies. The result is restricted to just accrued benefits, which represent the unpaid sum that the applicant was owed at the time of death. The payment of these limited underpayments is restricted to a narrow group, usually a surviving spouse or parent living in the deceased's home, with little relief thereafter.
Claiming Payments Owed to the Deceased
A claimant’s lump sum payment of past-due disability benefits (“back pay”). That is, the monthly payment the claimant would have received if they had been found disabled from the date their disability began (or application) to the date of death. The SSA calculates the cut-off point differently for SSDI and SSI.
- SSDI (Title II) — Amounts accumulated for accrued benefits are payable through the whole month of death. For example, if the applicant passed away on October 25, they should receive benefits for the entire month of October.
- SSI (Title XVI) — The financial rules of the needs-based program are so strict that SSI (Title XVI) benefits are generally not payable for the month of death. Therefore, payment will only be calculated up to September for the October death, that is, only liability up to the month before death.
When the SSA makes a favorable (posthumous) disability determination, it must pay these accrued benefits to an eligible survivor. The law creates a strict order of priority for who collects this lump-sum underpayment, and the SSA must make an effort to locate and pay the highest available person on the list.
- The surviving spouse of a deceased individual, one who lived in the same home at the time of the death, or one who qualified for a monthly check on the same earnings record
- A child or children of the deceased are entitled to a monthly benefit on the same earnings record, which will be shared equally among all
- If both of the deceased parent's parents are entitled to a benefit based on the same earnings record, the benefit shall be divided equally between the parents
- A surviving spouse, child, or parent who does not meet the criteria described in Steps 1 through 3
- The estate’s legal representative of the deceased, which is usually the last resort
If the highest-priority category has more than one person, the payment is split equally among them. This strict legal hierarchy means that accrued benefits, which often bypass the probate system, are distributed directly to immediate family members.
Continuing a Claim or Applying for New Family Benefits
If a disability claimant dies while the case is pending, a qualified relative can become a substitute claimant to pursue the claim. This change enables the SSA to finalize its review and issue a posthumous ruling, which is necessary to release the accrued benefits mentioned in the previous section. The surviving party must give prompt notice to the SSA, along with Form HA-539, Notice Regarding Substitution of Party Upon Death of Claimant, and a death certificate. The substitute claimant assumes the deceased's place without assuming any responsibility for the claim. This includes presenting evidence and going to court if necessary. Their purpose is to prove that the deceased was disabled right up to death.
The type of claim determines who may serve as a substitute claimant. The substitute claimant for SSDI is usually a qualified spouse or child. The back pay will ultimately go to the claimant. However, this substitute is only intended to pursue the claim that secures the lump sum. The substitute claimant does not receive ongoing monthly payments from that disability claim. The rules for continuing an SSI claim are stricter, with eligibility limited to those authorized by SSA payment priority. The SSA's payment priority determines eligibility to be the substitute party. Furthermore, only a surviving spouse or parent who qualifies to receive the accrued payment, like having lived with the deceased SSI applicant, may generally act as the representative.
The death of a wage-earner opens avenues beyond a payout of the deceased’s disability claim for continued coverage for the family. People in your family cannot start a new disability claim for the dead person after the fact. The rare exception is if the dead person had a protective filing date. This date indicates they had the intention to file, which was followed closely by their death. The benefactors may then have a short window (up to 3 to 6 months for SSDI, generally 60 days for SSI) to finish the new application.
Conversely, the SSA advocates for eligible family members to file a new claim for Survivor Benefits (if the deceased paid into the SSDI) or a brand-new SSI claim on their own behalf, if they meet the program’s low-income and resource requirements after a loss of household income. When you have suffered a loss, a family-initiated claim can help you maintain your stability.
Notification and Documentation for SSA
A surviving family member should notify the SSA promptly as the first step to protect their right to accrued benefits. The Social Security Administration must be notified as soon as possible after the applicant dies. The fastest and best way to do this is to call the national SSA toll-free number or visit your local SSA field office in person. Do not just leave it to the funeral home to report the death. Always follow up with SSA yourself to ensure the pending disability claim is flagged correctly and can continue to be processed.
To officially change the claim for accrued benefits, specific paperwork is required:
- To verify the date and cause of death, the SSA needs either an original or certified copy of the death certificate.
- The substitute claimant must submit Form HA-539, Notice Regarding Substitution of Party Upon Death of Claimant, which defines his/her legal role
- The substitute claimant must provide proof of his/her relationship with the deceased, for example, a marriage certificate or birth certificate, to establish payment priority
Moreover, although not strictly necessary for notification, any medical records related to the time leading up to the death should be gathered. The records will help the substitute claimant submit the best possible evidence to obtain posthumous disability approval.
Who is Eligible for the Social Security Survivor Benefits?
Survivor benefits differ from accrued disability benefits in that they are guaranteed, ongoing monthly payments, as opposed to a lump sum payment. To receive these benefits, the deceased worker must have paid enough SSDI taxes to earn sufficient work credits to be fully insured. Unlike accrued benefits, which require the original claim to be awarded after the insured's death, survivor benefits are a separate insurance policy that is claimed directly by eligible family members.
Eligibility requirements vary depending on the survivor’s relationship to the deceased:
- A surviving spouse may be entitled to benefits if he/she is between the ages of 60 and 66. Eligibility can start as early as age 60 (or age 50 if disabled), or at any age, if caring for the deceased worker’s child who is under age 16 or disabled
- A divorced spouse is also eligible if the marriage was at least 10 years and meets the current spouse's age or disability requirements
- Unmarried children generally qualify for benefits if they are under the age of 18 (or 19 while going to school full-time), or if they became disabled before age 22
- Dependent parents (aged 62 or older) may qualify if they depended on the deceased worker for at least half of their support. Each person who qualifies collects their percentage of payment from the SSA. These sums do not go to the estate of the deceased nor through the substitute claimant.
Appealing a Denied Claim After Death
The appeals process for a denied disability claim may continue even if the claimant dies. If the applicant dies while the claim is pending reconsideration, an Administrative Law Judge hearing, or Appeals Council review, a qualified relative can serve as the substitute claimant to pursue accrued benefits. You must file Form HA-539, Notice Regarding Substitution of Party Upon Death of Claimant, to formalize this substitution.
The substitute claimant takes on the burden of proof that the deceased was disabled until the date of death. In this role at the hearing level, a substitute party represents the decedent’s case to the ALJ. The burden is on them to collect and submit additional medical or non-medical evidence, like hospital records, work history, testimony from coworkers, or testimony from family, that supports the claim. If there is a hearing, the claimant’s substitute may be asked to attend and testify before the ALJ about how the deceased’s condition impaired his/her ability to work and carry on daily activities.
By adequately representing the deceased, the stand-in claimant ensures that the SSA issues a final disability decision on behalf of the deceased. If approved, survivors will then be paid the back pay (accrued benefits) in the order required by law. The order is designed to ensure the deceased’s financial relief goes to his/her beneficiaries.
Understanding Timelines and Potential Delays
The length of time it takes to process a claim after a death is influenced by the stage the original disability application reached before the death.
For accrued benefits, the SSA must first issue a posthumous disability decision on the original SSDI claim if it was already far along, for example, at the hearing level or at the stage of awaiting a final decision. This process can take several months to over a year due to administrative backlogs and the time required for final review of medical evidence. Once eligibility is established, the back pay (accrued benefit) calculation and payment typically occur within a few months.
Applications for survivor benefits are processed separately and often take two to six months for an initial decision. Survivor benefits are typically processed more quickly than disability claims, as they do not require a lengthy medical review. The focus is instead on the dead person’s work record and the survivor’s relationship and age.
Common Delay Factors
It is common to experience delays in the process due to administrative issues and complexities in a case. The most common cause for holdups is incomplete or missing documentation. Most often, this is due to failure to sign the Form HA-539 (Notice Regarding Substitution). Alternatively, it may be due to a missing certified death certificate.
Moreover, backlogs caused by administrators at the SSA and state disability determination services (DDS) can delay the process. A complex case, like one that requires reviewing voluminous medical records, or multiple possible claimants for accrued benefits, adds to the delay. The quickest and most effective way to minimize wait times is through the punctual and accurate submission of all required forms and evidence.
Find a Social Security Disability Lawyer Near Me
When a disability applicant dies, it does not mean the battle is over. While SSI claims essentially cease, an SSDI worker's death opens two critical paths for the family: pursuing accrued benefits (back pay) and securing ongoing survivor benefits. Managing the legal payment structure and navigating bureaucratic delays during a challenging time is difficult.
The first and most vital step any surviving family member should take is to contact a qualified disability attorney in California. These attorneys become the substitute claimant to ensure the SSA issues a favorable posthumous decision and aggressively pursues every dollar that is owed. Contact experienced disability claims attorneys at Leland Law today at 866-449-6476 for guidance and to improve your chances of a successful claim outcome.
