From Follow-up on Claims Denied Because Claimants Were Not Insured for Benefits, a report by Social Security’s Office of Inspector General:
… This audit is a follow up to our 2016
review of Retirement Claim Denials
Because of Lack of Insured Status.
Generally, to be insured for retirement
benefits, a claimant must have
40 quarters of covered earnings and
have attained age 62. SSA
employees should not deny a
retirement claim if the claimant is not
insured for benefits at the time of filing
but will become insured within
4 months and evidence of the earnings
is available.
We obtained the records of 450,209
retirement claims filed between
May 2014 and June 2023 that SSA
employees determined the claimants
lacked insured status. From this,
we identified 4,077 claimants who may
have been insured because they had
40 or more quarters of coverage in the year of filing. Of the 100 claimants in our sample, SSA employees denied retirement claims for 43 who alleged lag earnings when they filed their claims, were fully insured, and entitled to retirement benefits but employees did not consider their lag earnings. Despite reminders issued to employees after our prior review, employees denied the retirement claims because they determined the claimants lacked insured status; however, the claimants had lag earnings when they filed their claims.
Based on sample results, we estimate, from May 2014 to June 2023, employees denied retirement benefits to 1,753 claimants who were insured for benefits. Of these, 1,347 claimants were entitled to over $3 million in retirement benefits.
Without controls and processes to ensure employees identify, review, and document lag earnings, SSA will continue denying millions of dollars in retirement benefits to claimants who should be receiving them. Depriving retired individuals of the benefits to which they are entitled could have a significant and harmful effect on beneficiaries, including financial hardship and emotional distress. …
This problem is not limited to retirement claims. I’d say it’s more common in disability claims.