DI 40525: Other Processing Issues
TN 1 (10-02)
A. Introduction
Under CFR 404.1596, when a CDR is underway, title II benefit payments to an individual are occasionally suspended to reduce the possibility of an overpayment when disability cessation may result.
B. Policy
1. When alert is generated
Each month, the Regular Transcript Attainment and Selection Pass system generates an S-0 alert (see SM 00619.050).
2. Who is identified
The alert identifies disabled individuals who have been in suspense status for at least 6 months.
3. Contents of alert
Social Security Number,
Age of suspense action, and
Month account was selected by the system for review.
4. Who processes alerts
Disability examiners (DE) in the PCs process the alerts.
NOTE: S-0 alert code will remain on the MBR until final action is effectuated.
C. Procedure
1. Alert received with temporary folder
If the alert is received with a temporary folder, determine the location of the folder and proceed as follows:
a. Permanent folder in FO, DDS, or Office of Disability Adjudication and Review (ODAR)
If the permanent folder is in the FO, DDS, or ODAR:
Use systems query to determine the status of the CDR;
If status of CDR is not apparent from query, call component holding permanent folder to determine status of CDR;
Annotate S-0 alert with reported status;
Sign and date alert;
Return alert and temporary folder to files.
b. Permanent folder in another PC
If the permanent folder is in another PC:
Determine which component has proper jurisdiction of the folder;
Forward S-0 alert to the component holding permanent folder; or
Request transfer of permanent folder, as necessary. When received, process per DI 40525.005C.2.
Delete temporary folder, if appropriate.
c. Folder not in recorded location
If the folder is not in the recorded location, undertake a complete folder search.
2. Alert received with permanent folder
Review the folder to determine correctness of suspension and proceed as follows:
If determination as to continuance of disability | And | Then |
---|---|---|
Is not prepared |
Work issue is involved |
Check eWork for location of work review. If work review is pending within eWork, forward the alert to component which has jurisdiction of work review. If no pending action found in eWork, forward to servicing FO for necessary development and subsequent action, or DPBs are to undertake development and subsequent action. |
Is not prepared |
A medical issue is involved |
Forward to FO for personal contact interview per DI 13005.030. |
Is prepared |
Not effectuated |
Forward to benefit authorizer (BA) for expeditious handling for termination or reinstatement action. |
Is prepared |
Effectuated |
Review folder to ensure action has been taken to effectuate a determination and refer to BA if there is any doubt as to current status. |
NOTE: Effectuation of termination or reinstatement action is evidenced by Form SSA-3925-EP (Determination of Benefit Adjustment) in file.