[Title 20 CFR G] [Code of Federal Regulations (annual edition) - April 1, 1996 Edition] [Title 20 - EMPLOYEES' BENEFITS] [Chapter III - SOCIAL SECURITY ADMINISTRATION] [Part 404 - FEDERAL OLD-AGE, SURVIVORS AND DISABILITY INSURANCE (1950- )] [Subpart G - Filing of Applications and Other Forms] [From the U.S. Government Publishing Office]20 EMPLOYEES' BENEFITS 2 1996-04-01 1996-04-01 false Filing of Applications and Other Forms G Subpart G EMPLOYEES' BENEFITS SOCIAL SECURITY ADMINISTRATION FEDERAL OLD-AGE, SURVIVORS AND DISABILITY INSURANCE (1950- ) Subpart G--Filing of Applications and Other Forms Sec. 404.601 Introduction. This subpart contains the Social Security Administration's rules for filing a claim for old-age, disability, dependents', and survivors' insurance benefits as described in subpart D of part 404. It tells what an application is, who may sign it, where and when it must be signed and filed, the period of time it is in effect and how it may be withdrawn. This subpart also explains when a written statement, request, or notice will be considered filed. Since the application form and procedures for filing a claim under this subpart are the same as those used to establish entitlement to Medicare benefits under 42 CFR part 405, persons who wish to become entitled to Medicare benefits should refer to the provisions of this subpart. Requirements concerning applications for the black lung benefits program are contained in part 410. Requirements concerning applications for the supplemental security income program are contained in part 416. Part 422 contains the requirements for applying for a social security number. Sec. 404.602 Definitions. For the purpose of this subpart-- Applicant means the person who files an application for benefits for himself or herself or for someone else. A person who files for himself or herself is both the applicant and the claimant. Application refers only to an application on a form described in Sec. 404.611. Benefits means any old-age, disability, dependents', and survivors' insurance benefits described in subpart D, including a period of disability. Claimant means the person who files an application for benefits for himself or herself or the person for whom an application is filed. We, us, or our means the Social Security Administration (SSA). You or your means, as appropriate, the person who applies for benefits, the person for whom an application is filed, or the person who may consider applying for benefits. Sec. 404.603 You must file an application to receive benefits. In addition to meeting other requirements, you must file an application to become entitled to benefits. If you believe you may be entitled to benefits, you should file an application. Filing an application will-- (a) Permit a formal decision to be made on your entitlement to benefits; (b) Protect your entitlement to any benefits that may be payable for as many as 6 months or 12 months (depending on the type of benefit, as explained in Sec. 404.621) before the application was filed; and (c) Give you the right to appeal if you are dissatisfied with the decision. [44 FR 37209, June 26, 1979, as amended at 46 FR 47444, Sept. 28, 1981] Applications Sec. 404.610 What makes an application a claim for benefits. To be considered a claim for benefits, an application must generally meet all of the following conditions: (a) It must be on an application form as described in Sec. 404.611. (b) It must be completed and filed with SSA as described in Sec. 404.611. (c) It must be signed by the claimant or someone described in Sec. 404.612. who may sign an application for the claimant. (d) The claimant, with the limited exceptions in Sec. 404.615, must be alive at the time it is filed. [[Page 172]] Sec. 404.611 Filing of application with Social Security Administration. (a) General rule. You must apply for benefits on an applications we prescribe. See Sec. 404.614 for places where an application for benefits may be filed. (b) Effect of claims filed with the Railroad Retirement Board. Pursuant to section 5(b) of the Railroad Retirement Act of 1974, as amended, 45 U.S.C. 231d(b), if you file an application with the Railroad Retirement Board on one of its forms for an annuity under section 2 of the Railroad Retirement Act of 1974, as amended, 45 U.S.C. 231a, unless you specify otherwise, this application also will be an application for any benefit to which you may be entitled under title II of the Social Security Act. (c) Effect of claims filed with the Veterans Administration. An application filed with the Veterans Administration on one of its forms for survivors' dependency and indemnity compensation (see section 3005 of title 38 U.S.C.) is also considered an application for social security dependents' and survivors' benefits except the lump-sum death payment. [44 FR 37209, June 26, 1979, as amended at 51 FR 41951, Nov. 20, 1986; 58 FR 60381, Nov. 16, 1993] Sec. 404.612 Who may sign an application. We will determine who may sign an application according to the following rules: (a) A claimant who is 18 years old or over, mentally competent, and physically able to do so, must sign his or her own application. If the claim is for child's benefits for a person who is not yet 22 years old, the application may be signed by a parent or a person standing in place of the parent. (b) A claimant who is between 16 and 18 years old may sign his or her own application if he or she is mentally competent, has no court appointed representative, and is not in the care of any person. (c) If the claimant is under age 18, or mentally incompetent, or physically unable to sign, the application may be signed by a court appointed representative or a person who is responsible for the care of the claimant, including a relative. If the claimant is in the care of an institution, the manager or principal officer of the institution may sign the application. (d) If a person who could receive disability benefits or who could have a period of disability established dies before filing, an application for disability benefits or for a period of disability may be signed by a person who would be qualified to receive any benefits due the deceased. (e) If a person who paid burial expenses for which a lump-sum death payment may be made dies before filing an application for the payment, the application may be signed by a person who could receive the payment for the deceased's estate. (f) If a written statement showing an intent to claim benefits is filed with us, but the person for whom the benefits are claimed dies before an application is filed, an application may be filed as explained in Sec. 404.630(d). (g) If a person who could receive benefits on the basis of a ``deemed'' filing date of an application under Sec. 404.633(b)(1)(i) or (b)(2)(i) dies before an application for the benefits is filed, the application may be signed by a person who would be qualified to receive any benefits due the deceased person as explained in Sec. 404.633(b)(1)(ii) and (b)(2)(ii). (h) If it is necessary to protect a claimant from losing benefits and there is good cause for the claimant not signing the application, we may accept an application signed by some one other than a person described in this section. Example: Mr. Smith comes to a social security office a few days before the end of a month to file an application for old-age benefits for his neighbor, Mr. Jones. Mr. Jones, a 63 year old widower, just suffered a heart attack and is in the hospital. He asked Mr. Smith to file the application for him. We will accept an application signed by Mr. Smith since it would not be possible to have Mr. Jones sign and file the application until the next calendar month and a loss of one month's benefits would result. [44 FR 37209, June 26, 1979, as amended at 59 FR 44923, Aug. 31, 1994] Sec. 404.613 Evidence of authority to sign an application for another. (a) A person who signs an application for someone else will be required to [[Page 173]] provide evidence of his or her authority to sign the application for the person claiming benefits under the following rules: (1) If the person who signs is a court appointed representative, he or she must submit a certificate issued by the court showing authority to act for the claimant. (2) If the person who signs is not a court appointed representative, he or she must submit a statement describing his or her relationship to the claimant. The statement must also describe the extent to which the person is responsible for the care of the claimant. This latter information will not be requested if the application is signed by a parent for a child with whom he or she is living. (3) If the person who signs is the manager or principal officer of an institution which is responsible for the care of the claimant, he or she must submit a statement indicating the person's position of responsibility at the institution. (b) We may, at any time, require additional evidence to establish the authority of a person to sign an application for someone else. Sec. 404.614 When an application or other form is considered filed. (a) General rule. Except as otherwise provided in paragraph (b) of this section and in Secs. 404.630 through 404.633 which relate to the filing date of an application, an application for benefits, or a written statement, request, or notice is filed on the day it is received by an SSA employee at one of our offices or by an SSA employee who is authorized to receive it at a place other than one of our offices. (b) Other places and dates of filing. We will also accept as the date of filing-- (1) The date an application for benefits, or a written statement, request or notice is received by any office of the U.S. Foreign Service or by the Veterans Administration Regional Office in the Philippines; (2) The date an application for benefits or a written statement, request or notice is mailed to us by the U.S. mail, if using the date we receive it would result in the loss or lessening of rights. The date shown by a U.S. postmark will be used as the date of mailing. If the postmark is unreadable, or there is no postmark, we will consider other evidence of when you mailed it to us; or (3) The date an application for benefits is filed with the Railroad Retirement Board or the Veterans Administration. See Sec. 404.611 (b) and (c) for an explanation of when an application for benefits filed with the Railroad Retirement Board or the Veterans Administration is considered an application for social security benefits. [44 FR 37209, June 26, 1979, as amended at 59 FR 44923, Aug. 31, 1994] Sec. 404.615 Claimant must be alive when an application is filed. A claimant must be alive at the time an application is filed. There are the following exceptions to this general rule: (a) If a disabled person dies before filing an application for disability benefits or a period of disability, a person who would be qualified to receive any benefits due the deceased may file an application. The application must be filed within 3 months after the month in which the disabled person died. (b) If a person who paid burial expenses for which a lump-sum death payment may be made dies before filing an application for the payment, the application may be signed by a person who could receive the payment for the deceased's estate. (c) If a written statement showing an intent to claim benefits is filed with us, but the person for whom the benefits are claimed dies before an application is filed, an application may be filed as explained in Sec. 404.630(d). (d) If a person who could receive benefits on the basis of a ``deemed'' filing date of an application under Sec. 404.633(b)(1)(i) or (b)(2)(i) dies before an application for the benefits is filed, the application may be signed by a person who would be qualified to receive any benefits due the deceased person as explained in Sec. 404.633(b)(1)(ii) and (b)(2)(ii). [44 FR 37209, June 26, 1979, as amended at 59 FR 44923, Aug. 31, 1994] [[Page 174]] Effective Filing Period of Application Sec. 404.620 Filing before the first month you meet the requirements for benefits. (a) General rule. If you file an application for benefits (except special age 72 payments) before the first month you meet all the other requirements for entitlement, the application will remain in effect until we make a final determination on your application unless there is an administrative law judge hearing decision on your application. If there is an administrative law judge hearing decision, your application will remain in effect until the administrative law judge hearing decision is issued. (1) If you meet all the requirements for entitlement while your application is in effect, we may pay you benefits from the first month that you meet all the requirements. (2) If you first meet all the requirements for entitlement after the period for which your application was in effect, you must file a new application for benefits. In this case, we may pay you benefits only from the first month that you meet all the requirements based on the new application. (b) Filing for special age 72 payments. The requirements for entitlement to special age 72 payments must be met no later than 3 months after the month an application is filed. [44 FR 37209, June 26, 1979, as amended at 52 FR 4003, Feb. 9, 1987] Sec. 404.621 Filing after the first month you meet the requirements for benefits. (a) Filing for disability benefits and for old-age, survivors', or dependents' benefits. (1)(i) If you file an application for disability benefits, widow's or widower's benefits based on disability, or wife's, husband's, or child's benefits based on the earnings record of a person entitled to disability benefits, after the first month you could have been entitled to them, you may receive benefits for up to 12 months immediately before the month in which your application is filed. Your benefits may begin with the first month in this 12-month period in which you meet all the requirements for entitlement. However, entitlement to wife's or husband's benefits under this rule is limited by paragraph (a)(1)(iii) of this section. (ii) If you file an application for old-age benefits, widow's or widower's benefits not based on disability, wife's, husband's, or child's benefits based on the earnings record of a person not entitled to disability benefits, or mother's, father's, or parent's benefits, after the first month you could have been entitled to them, you may receive benefits for up to 6 months immediately before the month in which your application is filed. Your benefits may begin with the first month in this 6-month period in which you meet all the requirements for entitlement. However, entitlement to old-age, wife's, husband's, widow's, or widower's benefits under this rule is limited by paragraph (a)(1)(iii) of this section. (iii) If the effect of the payment of benefits for a month before the month you file would be to reduce your benefits because of your age, you cannot be entitled to old-age, wife's, husband's, widow's, or widower's benefits for any month before the month in which your application is filed, unless you meet one of the conditions in paragraph (a)(2) of this section. (An explanation of the reduction that occurs because of age if you are entitled to these benefits for a month before you reach the retirement age of 65, is in Sec. 404.410.) An example follows that assumes you do not meet any of the conditions in paragraph (a)(2) of this section. Example: You become 65 years old in April 1981. If you apply for old-age benefits in April, you cannot be entitled to benefits for months in the 6-month period before April because the payment of benefits for any of these months would result in your benefits being reduced for age. If you do not file your application until July 1981, you may be entitled to benefits for the months of April, May, and June 1981 because the payment of benefits for these months would not result in your benefits being reduced for age. You will not, however, receive benefits for the 3 months before April. (2) The limitation in paragraph (a)(1)(iii) of this section on your entitlement to old-age, wife's, husband's, widow's, or widower's benefits for months before you file an application does not apply if-- [[Page 175]] (i) You are a widow, widower, surviving divorced wife, or surviving divorced husband who is disabled and could be entitled to retroactive benefits for any month before age 60. If you could not be entitled before age 60, the limitation will prevent payment of benefits to you for past months, but it will not affect the month you become entitled to hospital insurance benefits. (ii) You are a widow, widower, or surviving divorced spouse of the insured person who died in the month before you applied and you were at least age 60 in the month of death of the insured person on whose earnings record you are claiming benefits. In this case, you can be entitled beginning with the month the insured person died if you choose and if you file your application on or after July 1, 1983. (b) Filing for lump-sum death payment. An application for a lump-sum death payment must be filed within 2 years after the death of the person on whose earnings record the claim is filed. There are two exceptions to the 2-year filing requirement: (1) If there is a good cause for failure to file within the 2-year period, we will consider your application as though it were filed within the 2-year period. Good cause does not exist if you were informed of the need to file an application within the 2-year period and you neglected to do so or did not desire to make a claim. Good cause will be found to exist if you did not file within the time limit due to-- (i) Circumstances beyond your control, such as extended illness, mental or physical incapacity, or a language barrier; (ii) Incorrect or incomplete information we furnished you; (iii) Your efforts to get evidence to support your claim without realizing that you could submit the evidence after filing an application; or (iv) Unusual or unavoidable circumstances which show that you could not reasonably be expected to know of the time limit. (2) The Soldiers' and Sailors' Civil Relief Act of 1940 provides for extending the filing time. (c) Filing for special age 72 payments. An application for special age 72 payments is not effective as a claim for benefits for any month before you actually file. (d) Filing for a period of disability. You must file an application for a period of disability while you are disabled or no later than 12 months after the month in which your period of disability ended. If you were unable to apply within the 12-month time period because of a physical or mental condition, you may apply not more than 36 months after your disability ended. The general rule we use to decide whether your failure to file was due to a physical or mental condition is stated in subpart D. (e) Filing after death of person eligible for disability benefits or period of disability. If you file for disability benefits or a period of disability for another person who died before filing an application and you would qualify under Sec. 404.503(b) to receive any benefits due the deceased, you must file an application no later than the end of the third month following the month in which the disabled person died. [44 FR 37209, June 26, 1979, as amended at 46 FR 47444, Sept. 28, 1981; 51 FR 4482, Feb. 5, 1986; 56 FR 58846, Nov. 22, 1991] Sec. 404.622 Limiting an application. Your application may entitle you to benefits for up to 6 months or 12 months (depending on the type of benefit, as explained in Sec. 404.621) before the month in which it is filed. You may limit the number of months of your entitlement in the 6-month or 12-month period. You may state this choice any time before a decision is made on your claim by indicating, in writing, the month you want your benefits to begin. You may change the first month of entitlement in this 6-month or 12-month period after a decision has been made on your claim under the following conditions: (a) You file the request in writing. (b) If you are filing for the claimant, he or she is alive when the request is filed. (c) If any other person who is entitled to benefits would lose some or all of those benefits because of the change, that person, or the person who filed for him or her, consents in writing. (d) Any benefit payments that would become improper as a result of the [[Page 176]] change in entitlement month are repaid, or we are satisfied that they will be repaid. [44 FR 37209, June 26, 1979, as amended at 46 FR 47445, Sept. 28, 1981] Sec. 404.623 Filing by person eligible for old-age and husband's or wife's benefits. (a) Presumed filing for husband's or wife's benefits. If you file an application for old-age benefits, you are presumed to have filed an application for husband's or wife's benefits in the first month of your entitlement to old-age benefits, if-- (1) Your old-age benefits are reduced for age because you choose to receive them before you become 65 years old; and (2) You are eligible for either a husband's or a wife's benefit for the first month of your entitlement to old-age benefits. (b) Presumed filing for old-age benefits. (1) If you file an application for a husband's or a wife's benefits, you are presumed to have filed an application for old-age benefits in the first month of your entitlement to husband's or wife's benefits if-- (i) Your husband's or wife's benefits are reduced for age because you choose to receive them before you become 65 years old; and (ii) You are eligible for old-age benefits for the first month of your entitlement to husband's or wife's benefits. (2) The rule in paragraph (b)(1) of this section is not used if you are also entitled to disability benefits in the first month of your entitlement to husband's or wife's benefits. In this event, you are presumed to have filed for old-age benefits only if your disability benefits end before you become 65 years old. Filing Date Based on Written Statement Sec. 404.630 Use of date of written statement as filing date. If a written statement, such as a letter, indicating your intent to claim benefits either for yourself or for another person is filed with us under the rules stated in Sec. 404.614, we will use the filing date of the written statement as the filing date of the application, if all of the following requirements are met: (a) The statement indicates an intent to claim benefits. (b) The statement is signed by the claimant, the claimant's spouse, or a person described in Sec. 404.612. If you telephone us and advise us that you intend to file a claim but cannot file an application before the end of the month, we will prepare and sign a written statement if it is necessary to prevent the loss of benefits. (c) The claimant files an application with us on an application form as described in Sec. 404.611, or one is filed for the claimant by a person described in Sec. 404.612, within 6 months after the date of a notice we will send advising of the need to file an application. We will send the notice to the claimant. However, if it is clear from the information we receive that the claimant is a minor or is mentally incompetent, we will send the notice to the person who submitted the written statement. (d) The claimant is alive when the application is filed; or if the claimant has died after the written statement was filed, an application is filed-- (1) By or for a person who would be eligible to receive benefits on the deceased's earnings record; (2) By a person acting for the deceased's estate; or (3) If the statement was filed with a hospital under Sec. 404.632, by the hospital if-- (i) No person described in paragraph (d) (1) or (2) of this section can be located; or (ii) A person described in paragraphs (d) (1) or (2) of this section is located but refuses or fails to file the application unless the refusal or failure to file is because it would be harmful to the deceased person or the deceased's estate. Sec. 404.631 Statements filed with the Railroad Retirement Board. A written statement filed with the Railroad Retirement Board will be considered a written statement filed with us under the rules in Sec. 404.630 if-- (a) The statement indicates an intent to claim any payments under the Railroad Retirement Act; [[Page 177]] (b) It bears the signature of the person filing the statement; (c) No application is filed with the Railroad Retirement Board on one of its forms. If an application has been filed, we will use the date of filing of that application as determined by the Railroad Retirement Board (see Sec. 404.614(b)(3)); and (d) The statement is sent to us by the Railroad Retirement Board. Sec. 404.632 Statements filed with a hospital. A statement (generally a hospital admission form) filed with a hospital may serve as a written statement under Sec. 404.630 if the requirements of this section are met. The statement will be considered filed with us as of the date it was filed with the hospital and will serve to protect entitlement to benefits. A statement filed with a hospital by you or some other person for you requesting or indicating an intent to claim benefits will be considered a written statement filed with us and Sec. 404.630 will apply to it if-- (a) You are a patient in the hospital; (b) The hospital provides services covered by hospital insurance under the Medicare program; (c) An application has not already been filed; and (d) The statement is sent to us. Deemed Filing Date Based on Misinformation Sec. 404.633 Deemed filing date in a case of misinformation. (a) General. You may have considered applying for monthly benefits for yourself or for another person, and you may have contacted us in writing, by telephone or in person to inquire about filing an application for these benefits. It is possible that in responding to your inquiry, we may have given you misinformation about your eligibility for such benefits, or the eligibility of the person on whose behalf you were considering applying for benefits, which caused you not to file an application at that time. If this happened, and later an application for such benefits is filed with us, we may establish an earlier filing date under this section. Example 1: Mrs. Smith, a widow of an insured individual, contacts a Social Security office when she reaches age 60 to inquire about applying for widow's insurance benefits. She is told by an SSA employee that she must be age 62 to be eligible for these benefits. This information, which was incorrect, causes Mrs. Smith not to file an application for benefits. When Mrs. Smith reaches age 62, she again contacts a Social Security office to ask about filing for widow's insurance benefits and learns that she could have received the benefits at age 60. She files an application for these benefits, provides the information required under paragraph (f) of this section to show that an SSA employee provided misinformation, and requests a deemed filing date based on the misinformation which she received from an SSA employee when she was age 60. Example 2: Ms. Hill, a 22-year-old, is forced to stop work because of illness. When she contacts a Social Security office to inquire about applying for disability insurance benefits, she is told by an SSA employee that she must have 20 quarters of coverage out of the last 40 calendar quarters to be insured for disability insurance benefits. The employee fails to consider the special rules for insured status for persons who become disabled before age 31 and, consequently, tells Ms. Hill that she is not insured because she only has 16 quarters of coverage. The misinformation causes Ms. Hill not to file an application for disability insurance benefits. Because of her illness, she is unable to return to work. A year later, Ms. Hill reads an article that indicates that there are special rules for insured status for young workers who become disabled. She again contacts a Social Security office to inquire about benefits based on disability and learns that she was misinformed earlier about her insured status. She files an application for disability insurance benefits, provides the information required under paragraph (f) of this section to show that an SSA employee provided misinformation, and requests a deemed filing date based on the misinformation provided to her earlier. (b) Deemed filing date of an application based on misinformation. Subject to the requirements and conditions in paragraphs (c) through (g) of this section, we may establish a deemed filing date of an application for monthly benefits under the following provisions. (1)(i) If we determine that you failed to apply for monthly benefits for yourself because we gave you misinformation about your eligibility for such benefits, we will deem an application for such benefits to have been filed with us on the later of-- (A) The date on which the misinformation was provided to you; or [[Page 178]] (B) The date on which you met all of the requirements for entitlement to such benefits, other than the requirement of filing an application. (ii) Before we may establish a deemed filing date of an application for benefits for you under paragraph (b)(1)(i) of this section, you or a person described in Sec. 404.612 must file an application for such benefits. If you die before an application for the benefits is filed with us, we will consider establishing a deemed filing date of an application for such benefits only if an application for the benefits is filed with us by a person who would be qualified to receive any benefits due you. (2)(i) If you had authority under Sec. 404.612 to sign an application for benefits for another person, and we determine that you failed to apply for monthly benefits for that person because we gave you misinformation about that person's eligibility for such benefits, we will deem an application for such benefits to have been filed with us on the later of-- (A) The date on which the misinformation was provided to you; or (B) The date on which the person met all of the requirements for entitlement to such benefits, other than the requirement of filing an application. (ii) Before we may establish a deemed filing date of an application for benefits for the person under paragraph (b)(2)(i) of this section, you, such person, or another person described in Sec. 404.612 must file an application for such benefits. If the person referred to in paragraph (b)(2)(i) of this section dies before an application for the benefits is filed with us, we will consider establishing a deemed filing date of an application for such benefits only if an application for the benefits is filed with us by a person who would be qualified to receive any benefits due the deceased person. (c) Requirements concerning the misinformation. We apply the following requirements for purposes of paragraph (b) of this section. (1) The misinformation must have been provided to you by one of our employees while he or she was acting in his or her official capacity as our employee. For purposes of this section, an employee includes an officer of SSA. (2) Misinformation is information which we consider to be incorrect, misleading, or incomplete in view of the facts which you gave to the employee, or of which the employee was aware or should have been aware, regarding your particular circumstances, or the particular circumstances of the person referred to in paragraph (b)(2)(i) of this section. In addition, for us to find that the information you received was incomplete, the employee must have failed to provide you with the appropriate, additional information which he or she would be required to provide in carrying out his or her official duties. (3) The misinformation may have been provided to you orally or in writing. (4) The misinformation must have been provided to you in response to a specific request by you to us for information about your eligibility for benefits or the eligibility for benefits of the person referred to in paragraph (b)(2)(i) of this section for which you were considering filing an application. (d) Evidence that misinformation was provided. We will consider the following evidence in making a determination under paragraph (b) of this section. (1) Preferred evidence. Preferred evidence is written evidence which relates directly to your inquiry about your eligibility for benefits or the eligibility of another person and which shows that we gave you misinformation which caused you not to file an application. Preferred evidence includes, but is not limited to, the following-- (i) A notice, letter or other document which was issued by us and addressed to you; or (ii) Our record of your telephone call, letter or in-person contact. (2) Other evidence. In the absence of preferred evidence, we will consider other evidence, including your statements about the alleged misinformation, to determine whether we gave you misinformation which caused you not to file an application. We will not find that we gave you misinformation, however, based solely on your statements. Other evidence which you provide or which we obtain must support your statements. Evidence which we will consider includes, but is not limited to, the following-- [[Page 179]] (i) Your statements about the alleged misinformation, including statements about-- (A) The date and time of the alleged contact(s); (B) How the contact was made, e.g., by telephone or in person; (C) The reason(s) the contact was made; (D) Who gave the misinformation; and (E) The questions you asked and the facts you gave us, and the questions we asked and the information we gave you, at the time of the contact; (ii) Statements from others who were present when you were given the alleged misinformation, e.g., a neighbor who accompanied you to our office; (iii) If you can identify the employee or the employee can recall your inquiry about benefits-- (A) Statements from the employee concerning the alleged contact, including statements about the questions you asked, the facts you gave, the questions the employee asked, and the information provided to you at the time of the alleged contact; and (B) Our assessment of the likelihood that the employee provided the alleged misinformation; (iv) An evaluation of the credibility and the validity of your allegations in conjunction with other relevant information; and (v) Any other information regarding your alleged contact. (e) Information which does not constitute satisfactory proof that misinformation was given. Certain kinds of information will not be considered satisfactory proof that we gave you misinformation which caused you not to file an application. Examples of such information include-- (1) General informational pamphlets that we issue to provide basic program information; (2) The Personal Earnings and Benefit Estimate Statement that is based on an individual's reported and projected earnings and is an estimate which can be requested at any time; (3) General information which we review or prepare but which is disseminated by the media, e.g., radio, television, magazines, and newspapers; and (4) Information provided by other governmental agencies, e.g., the Department of Veterans Affairs, the Department of Defense, State unemployment agencies, and State and local governments. (f) Claim for benefits based on misinformation. You may make a claim for benefits based on misinformation at any time. Your claim must contain information that will enable us to determine if we did provide misinformation to you about your eligibility for benefits, or the eligibility of a person on whose behalf you were considering applying for benefits, which caused you not to file an application for the benefits. Specifically, your claim must be in writing and it must explain what information was provided; how, when and where it was provided and by whom; and why the information caused you not to file an application. If you give us this information, we will make a determination on such a claim for benefits if all of the following conditions are also met. (1) An application for the benefits described in paragraph (b)(1)(i) or (b)(2)(i) of this section is filed with us by someone described in paragraph (b)(1)(ii) or (b)(2)(ii) of this section, as appropriate. The application must be filed after the alleged misinformation was provided. This application may be-- (i) An application on which we have made a previous final determination or decision awarding the benefits, but only if the claimant continues to be entitled to benefits based on that application; (ii) An application on which we have made a previous final determination or decision denying the benefits, but only if such determination or decision is reopened under Sec. 404.988; or (iii) A new application on which we have not made a final determination or decision. (2) The establishment of a deemed filing date of an application for benefits based on misinformation could result in the claimant becoming entitled to benefits or to additional benefits. (3) We have not made a previous final determination or decision to which you were a party on a claim for benefits [[Page 180]] based on alleged misinformation involving the same facts and issues. This provision does not apply, however, if the final determination or decision may be reopened under Sec. 404.988. (g) Effective date. This section applies only to misinformation which we provided after December 1982. In addition, this section is effective only for benefits payable for months after December 1982. [59 FR 44924, Aug. 31, 1994] Withdrawal of Application Sec. 404.640 Withdrawal of an application. (a) Request for withdrawal filed before a determination is made. An application may be withdrawn before we make a determination on it if-- (1) A written request for withdrawal is filed at a place described in Sec. 404.614 by the claimant or a person who may sign an application for the claimant under Sec. 404.612; and (2) The claimant is alive at the time the request is filed. (b) Request for withdrawal filed after a determination is made. An application may be withdrawn after we make a determination on it if-- (1) The conditions in paragraph (a) of this section are met; (2) Any other person whose entitlement would be rendered erroneous because of the withdrawal consents in writing to it. Written consent for the person may be given by someone who could sign an application for him or her under Sec. 404.612; and (3) All benefits already paid based on the application being withdrawn are repaid or we are satisfied that they will be repaid. (c) Request for withdrawal filed after the claimant's death. An application may be withdrawn after the claimant's death, regardless of whether we have made a determination on it, if-- (1) The claimant's application was for old-age benefits that would be reduced because of his or her age; (2) The claimant died before we certified his or her benefit entitlement to the Treasury Department for payment; (3) A written request for withdrawal is filed at a place described in Sec. 404.614 by or for the person eligible for widow's or widower's benefits based on the claimant's earnings; and (4) The conditions in paragraphs (b)(2) and (3) of this section are met. (d) Effect of withdrawal. If we approve a request to withdraw an application, the application will be considered as though it was never filed. If we disapprove a request for withdrawal, the application is treated as though the request was never filed. [44 FR 37209, June 26, 1979, as amended at 48 FR 21931, May 16, 1983; 51 FR 37720, Oct. 24, 1986] Sec. 404.641 Cancellation of a request to withdraw. A request to withdraw an application may be cancelled and the application reinstated if-- (a) A written request for cancellation is filed at a place described in Sec. 404.614 by the claimant or someone who may sign an application for the claimant under Sec. 404.612; (b) The claimant is alive at the time the request for cancellation is filed; and (c) For a cancellation request received after we have approved the withdrawal, the request is filed no later than 60 days after the date of the notice of approval.