Form SSA-1724 | Claim For Amounts Due In The Case Of Deceased Beneficiary

A deceased beneficiary may have been due a Social Security payment and/or a Medicare Premium refund prior to or at the time of death.

A Social Security payment due a deceased beneficiary may be paid to a family member or a legal representative of the estate in the following order:

  1. The surviving spouse who was either living in the same household as the deceased at the time of death or who, for the month of death, was entitled to a monthly benefit on the same record as the deceased;
  2. Children who, for the month of death, were entitled to a monthly benefit on the same record as the deceased;
  3. Parents who, for the month of death, were entitled to a monthly benefit on the same record as the deceased;
  4. A surviving spouse not qualified under 1. above;
  5. Children not qualified under 2. above;
  6. Parents not qualified under 3. above; or
  7. The legal representative of the deceased person's estate.

A Medicare Premium refund may be issued to the person or organization that paid the beneficiary's premiums. If the beneficiary paid the premiums, refunds may be issued to a family member or the legal representative of the estate in the following order:

  1. The legal representative of the deceased person's estate.
  2. The surviving spouse who was either living in the same household as the deceased at the time of death or who, for the month of death, was entitled to a monthly benefit on the same record as the deceased;
  3. Children who, for the month of death, were entitled to a monthly benefit on the same record as the deceased;
  4. Parents who, for the month of death, were entitled to a monthly benefit on the same record as the deceased;
  5. A surviving spouse not qualified under 1. above;
  6. Children not qualified under 2. above; or
  7. Parents not qualified under 3. above.

SSA-1724 | Claim For Amounts Due In The Case Of Deceased Beneficiary

Please complete this form to help us decide who should receive any payment due.

Where to send this form

Send the completed form to your local Social Security office. If you have any questions, you may call us toll-free at 1-800-772-1213 Monday through Friday from 7 a.m. to 7 p.m. If you are deaf or hard of hearing, you may call our TTY number, 1-800-325-0778.