GN 02406.175: Exclusions to the Nonreceipt Process
Effective Dates: 07/27/2012 - Present TN 26 (08-11) GN 02406.175 Exclusions for Nonreceipt Process A. Introduction The nonreceipt of payment process cannot handle certain types of payments. These exclusions require a timely process to ensure the SSA Trust Fund and the Treasury General Fund receive credit for the money that is due. Many Title II exclusions require the servicing processing center (PC) to process nonreceipt claims. These situations require the field office (FO) and teleservice center (TSC) to notify the PC via the Modernized Development Worksheet (MDW). To complete a MDW electronic document see the modernized systems operations manual (MSOM) MSOM MDW 001.003. B. Exclusions for Title II and Title XVI nonreceipt 1. Current representative payee (RP) reports nonreceipt of check issued to former RP New RP reports of nonreceipt may occur when the change of payee action processed too late to affect payment. To investigate and resolve current and former RP nonreceipt report locate information from the payee query or the query response selection list (QRSL), choice 1 (Historical Payee/Addressee). For handling RP nonreceipt reports take the following actions: a. FO and TSC actions * Review the Master Beneficiary Record (MBR) and Supplemental Security Record (SSR) to determine when the payee change was processed.
- * Determine the latest date a change could be made to the record (systems processing cutoff date; consider payment cycling window period);
- * If the change of representative payee input missed the cutoff date, explain that payment was sent to the former payee and why;
* TSC forward the case to the FO to contact the former RP. * FO contacts the former payee to determine if the check was received and used to benefit the beneficiary. If so, explain to the current payee that, since the beneficiary received benefit of the check, this does not constitute nonreceipt. If the RP received the check but it was not used for the beneficiary or if the former representative reports that the check was received and used for the beneficiary but the beneficiary does not agree, refer to Misuse of Benefits – Investigation, Determination & Restitution GN 00604.000. * For Title II, if the former RP alleges nonreceipt, request via MDW the PC input stop payment action (F-Stop). For Title XVI cases, the FO/TSC can input the F-Stop. b. PC Actions Input an F-stop payment action so that any returned funds or credits can be reissued to the new payee, as appropriate. Follow the instructions in: * MSOM RSDHI 002.005 Stop Payment Request (PESP) * SM 00609.200 Processing Center Direct Input of Nonreceipt, Photocopy and Stop Payment Process * SM 00609.200 Stop Payment Actions 2. Former RP reports nonreceipt If a former payee alleges nonreceipt of a payment certified before the change of payee action was processed: * FO and TSC for Title II send a MDW request to the servicing PC to complete an SF-1184 stop payment action; for Title XVI, input the F-Stop. * PC process the request per MSOM RSDHI 002.005B (PESP screen), and * reissue any replacement payments to the current payee when credit is received.
- 3. Payment issued under an incorrect account number
Alleged nonreceipt situations may occur when a payment that was issued under an incorrect account number and SSA/SSR records were corrected after the payment was made. * FO and TSC forward via MDW to the PC and FO of jurisdiction. Alert the PC and FO, “Payment Issued Under SSN--XXX-XX-XXXX--Stop Payment Action Required.” * PC and FO process against the incorrect SSN according to PESP screen MSOM RSDHI 002.005.
- 4. Partial payment received when total payment expected
* FO, TSC, and PC obtain a Payment History Update System (PHUS), MBR and Supplemental Security Record (SSR) and attempt to reconcile the discrepancy. * FO and TSC if the payment is due, refer to the servicing FO and PC, as appropriate for action via MDW. * PC if payment is due, issue payment according to current Manual Adjustment, Credit, and Award Process (MADCAP) and Manual Adjustment, Credit, and Award Data Entry (MACADE) procedures SM 00810.000A through SM 00810.800D. * Tell claimant that a replacement should be received in 5 - 7 mail delivery days.
- 5. Miscellaneous overpayment situations
- Do not use the nonreceipt of payment process for the following miscellaneous overpayment situations:
* Partial monthly benefit cases involving overpayments (that are being recovered through partial adjustment) * When the recipient is requesting resumption of full benefits * Conversion cases for beneficiaries who receive payments at the old rate rather than at the converted rate.
- Refer these cases to the PC and FO of jurisdiction for action.
6. Nonreceipt report received more than 1 year after the date of the check Process according to the instructions for Limited Payability Cases for Title II and Title XVI GN 02401.901. 7. Check is not due and check date is 12 months or less from date of the report Request the PC via MDW to input a SF-1184 stop payment (F-stop) action for Title II checks. FO's can input Title XVI F-stops.
- 8. Settlement check
Follow the instructions Nonreceipt of a Settlement Check for Title II and Title XVI GN 02406.202.
- 9. Attorney fees
Request assistance from the PC via MDW; PC should process according to instructions in Nonreceipt of Paper Check Payments Made to Non-Beneficiaries GN 02406.127.
- 10. Nonreceipt of payments made to non-beneficiaries
Follow the instructions for Nonreceipt of Paper Check Payments Made to Non-Beneficiaries GN 02406.127. 11. Nonreceipt of IA payments made to State agencies When a state Agency notifies a FO of nonreceipt of an IA payment, refer the Agency to the Regional Office’s Interim Assistance Reimbursement Coordinator per GN 02406.170 12. Suspensions a. Individual suspended pending receipt of a better address
- * S6 for Title II, see How the Returned Check Action (REACT) Program Processes Returned Checks and SF-1184 (“00”) Credits SM 00624.010;
* S06 for Title XVI, see Issuing SSI Checks SM 01315.001A.
- b. Individual suspended pending development of a representative payee
- * S8 for Title II, see FO Processing of S8/S08 Alerts GN 00504.150
- * S08 for Title XVI
13. Due payment after a beneficiary's or recipient's death Individuals reporting non-receipt for deceased beneficiary/recipient’s requires stop payment processing is required as follows:
- a. Title II
* FO and TSC send an MDW to the servicing PSC for SF-1184 stop payment action requests. The FO completes underpayment development (SSA-1724, Claim for Amounts Due in the Case of a Deceased) if applicable (see GN 02301.500, GN 02301.030A). * PC processes via the PESP screen MSOM RSDHI 002.005.
- b. Title XVI
* FO and TSC input the F-stop. The FO should complete underpayment development (SSA-1724, Claim for Amounts Due in the Case of a Deceased) if applicable (see GN 02301.500)
- 14. “Not due” payments for reasons other than death
Generally, this situation occurs when there is an overpayment on the record, there has been a change of payee or the payee, or beneficiary is declared legally incompetent. This situation requires stop payment processing. a. Title II * FO and TSC request the PC of jurisdiction to request SF-1184 stop payment action. * PC process via PESP Screen MSOM RSDHI 002.005 b. Title XVI FO and TSC input the F-stop. Use the sign screen per Transmitting Reports of Nonreceipt, Loss, Theft, or Destruction for Title II and Title XVI – Recurring Checks and PMA Checks – Normal and Dire Need Situation GN 02406.125 15. Returned payments Returned Title II and Title XVI payments posted on the PHUS and SSR do not require an input of nonreceipt. Identify the reasons for returned payments and if payments are due to the beneficiary/recipient. For returned check reason codes see SM 00530.020B. If the payment is still due, take necessary action to reissue the payment for reason code = MS (Miscellaneous): * Check the Special Message Field on the MBR/SSR for prior development or for a reason to explain the check return code MS. * Review the appropriate fields to determine if there has been a recent change (i.e., direct deposit, address, or other action that could explain the returned payment). If any of these conditions exist and the record has not been updated, take appropriate action to resolve the issue. * If you determine that payment is due, explain to the claimant that we will reissue the payment and allow 15 days for receipt of the payment. C. Procedure for Title XVI exclusion 1. Surviving eligible or ineligible spouse or parent If the surviving eligible or ineligible spouse or parent reports non-receipt of A-OTP or M-OTP nonreceipt and the SSR reflects an underpayment, manual processing as described in SM 01315.168 is required. 2. Other For other Title XVI nonreceipt and stop payment actions transmit the nonreceipt via 719N (Nonreceipt/SF-1184 Request) screen as described in GN 02406.125F. D. Procedure for Title II exclusions
- 1. Black Lung payments involving Department of Labor (DOL) jurisdiction
FOs, TSCs and Office of Disability and International Operations (ODIO) must redirect reports of nonreceipt to DOL at the address provided below:U.S. Department of LaborEmployment Standards Administration Division of Coal Mine Workers’ Compensation200 Constitution Ave. N.W.Washington DC 20210
- 2. Railroad Retirement Board (RRB) certification payments
* FOs and TSCs redirect the claims to RRB as outlined in GN 02406.805B. * PCs redirect the claims to RRB as outlined in GN 02406.810A.
- 3. Initial claims not established on the MBR and delayed payment
This is NOT a nonreceipt issue that appears as such until you determine a reason for the check not being issued. For related information and references see also * RS 02805.030 Calls from Beneficiaries * SM 00609.500B Systems Alerts Received in the Field Office (FO) and Teleservice Center (TSC) * TC 25001.000 Handling Non-Critical Delayed Claims/Payments.
- 4. Initial Critical Payment System (CPS) payment or one-time (SAC-P) CPS payment
Process initial CPS or one-time special action code-P (SAC-P) following the instructions in GN 02406.201C.
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