[ Rescinded 8/8/96 -- See 61 Federal Register 41439 ]
PURPOSE: To revise the definition of "living in the same household."
CITATIONS (AUTHORITY): Sections 202(i) and 216(h)(1)(B) of the Social Security Act; Regulations No. 4, sections 404.346, 404.347, 404.390, and 404.760; Commissioner's Decision dated February 19, 1982.
PERTINENT HISTORY: To qualify for the lump-sum death payment (LSDP) as a spouse living in the same household, the widow(er) and the deceased must have been "customarily living together as husband and wife in the same residence," according to section 404.347 of the Social Security Regulations. Temporary separations do not necessarily preclude the Social Security Administration (SSA) from considering a couple to be living in the same household. However, SSA generally has considered extended separations (including most that last 6 months or more) to be indicative that the couple was not living in the same household. Therefore, in situations where medical reasons alone forced a husband and wife to live apart, SSA had considered the couple not to be living in the same household.
Prior to the passage of Public Law (P.L) 97-35, the widow(er) of the worker could qualify for the LSDP if he or she had been living in the same household as the deceased when the latter died or, under certain conditions, if he or she paid the burial expenses of the deceased worker. This provision ensured that a widow(er) who was not living in the same household as the deceased could still receive the LSDP if he or she performed in a manner which demonstrated strong concern for the worker. In the majority of cases where spouses lived apart solely due to medical reasons, the widow(er) qualified for the LSDP by paying the burial expenses without the necessity of establishing eligibility under the "living in the same household" test. P.L. 97-35 redefined who may qualify for the LSDP. Under the new law, a spouse can qualify for the LSDP only if (1) he or she was living in the same household as the deceased worker at the time of death, or (2) he or she was entitled to (or eligible for) benefits on the worker's record for the month in which the worker died. Payment of the worker's burial expenses no longer has any bearing on who may qualify for the LSDP.
With the changes made by P.L. 97-35, certain spouses separated solely due to medical reasons must satisfy the "living in the same household" definition to qualify for the LSDP. An example follows:
SSA believes that the living in the same household definition contained in section 404.347 of the regulations is broad enough to include widow(er)s situated like the one above. Accordingly, the Commissioner has expanded the operational definition of "living in the same household" to include extended separations due to the confinement of either spouse in a nursing home, hospital, or other curative institution; that is, as long as evidence indicates the husband and wife were initially separated, and continued to be separated, solely for medical reasons and would otherwise have resided together, they would be considered to be "living in the same household."
This revised definition arose in regard to the LSDP provision, but will also apply to deemed marital relationships under section 404.346. A spouse filing for benefits based on a deemed marriage must be living in the same household with the worker at the time the application is filed (if the worker is living) or at the time of the worker's death. The revised definition of "living in the same household" described in this policy statement applies in both life and death cases in which a deemed marital relationship is involved.
POLICY STATEMENT: If a husband and wife are (or were) separated and continue(d) to be separated, solely for medical reasons, SSA may consider them to be living in the same household even if the separation is (or was) likely to be permanent and there is (or was) little or no expectation of the parties again physically residing together. As long as the spouse who is now applying for the LSDP or spouse's benefits based on a deemed marriage has continued to demonstrate strong personal and/or financial concern for the worker, SSA will assume they would have lived together (absent evidence to the contrary) had the medical reasons not necessitated their separation, and will pay the LSDP or spouse's benefits to the spouse.
To establish that a spouse satisfies the above requirement, he or she will be asked to sign a statement (and in some cases to submit other evidence) that confirms the reason for the initial and continued separation from his or her spouse.
EFFECTIVE DATE: This revised definition is effective for all LSDP claims and deemed spouses' claims finally adjudicated on or after March 4, 1982 (the date the processing instructions implementing the Commissioner's decision were issued to field offices) except those claims where the LSDP has already been correctly paid to another person under previous instructions. Also, the definition applies to any disallowed LSDP claims that SSA identifies if the claim is based on a death after August 1981 (when P.L. 97-35 became effective) and the LSDP has not already been paid.
CROSS-REFERENCES: Claims Manual sections 706-712, A702; Program Operations Manual System section GN 00210.025-00210.045; GN 00305.170-00305.205.
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