DI 55030: Earnings Verification for Ticket Users
TN 3 (02-14)
A. Determining status of benefits
When the PM receives evidence of a beneficiary/recipient's work or earnings, the PM queries its system, which is linked to SSA's systems, to determine the status of benefits and whether earnings data have already been posted to the disability control file (DCF).
B. Evaluating the document(s) the employment network (EN) submits
The PM will evaluate the document(s) the EN or State VR agency submits using the guidelines for preferred evidence in GN 00301.030.
1. Evaluation process
The PM's process involves:
evaluating the documents for authenticity;
preparing a copy of the document;
returning the original document to the beneficiary/recipient when original documents are sent;
maintaining a photocopy of the document in its evidence files; and
recording the evidence of gross earnings, including any net earnings from self-employment (NESE) on the evidence screens of the shared process menu. (See DI 55030.010D.)
2. Exceptions to retaining a photocopy
There are two instances in which the PM will retain the original document instead of a photocopy in its evidence files. The PM will retain the original if:
the original document is not legible when photocopied, or
the original document is a statement (for example, not a paystub, but a letter from the employer or other knowledgeable third party.)
C. Evaluating the evidence
The PM will determine whether the evidence meets SSA's standards of priority of evidence, using the guidelines in RS 01403.005 and SI 00820.130. If the evidence initially submitted is secondary evidence of earnings, the PM will work with the EN or State VR agency to determine if primary evidence of earnings is available and obtain it whenever possible. If the PM, EN, or State VR agency cannot obtain additional evidence of earnings, they will request that the FO obtain it.
D. Recording the evidence electronically
1. PM posted earnings
The PM records the evidence it evaluated on the evidence (EVID) screen of the shared process menu (SPMN), using the guidelines in GN 00301.286.
2. Special comments
The following chart displays two special comments that the PM may record on the EVID screen and indicates when these comments will appear.
Special comments the PM records on the EVID screen
|
PM Comment |
Comment Will Appear |
|
“Posted by the PM” |
In all cases |
|
“No primary evidence of earnings available” |
When the PM was unable to obtain primary evidence, and the FO must obtain evidence |
E. Batching earnings information
The PM uses a nightly batch process to pass the reported earnings information to SSA's Office of Systems (OS).
1. Earnings posted to the DCF
The OS processes the batch file and posts the gross earnings or net earnings from self-employment (NESE) to the DCF as alleged earnings. The earnings are posted as alleged earnings because they come from a third-party source, that is, the EN or State VR agency. If we determine that the evidence is preferred evidence, we can accept it.
NOTE: The PM will create a manual issue for the FO if the earnings the PM receives differ from earnings already posted to the DCF, and the difference could affect a TWP, SGA, or title XVI payment determination.
(See DI 55030.010F for instruction on manually posting earnings to the DCF.)
2. Actions that create a systems-generated CDR development worksheet (CDRW) issue
The OS automatically passes a systems-generated verify earnings (VY) CDRW issue to the servicing FO when:
the amount of alleged gross earnings the PM posts exceeds certain tolerance levels that could be material to a TWP, SGA, or title XVI payment determination; and
the beneficiary/recipient's entitlement or eligibility has not ended or terminated.
The following chart summarizes the earnings tolerance levels by indicating what systems-generated issue is passed automatically to the DCF and when it is created.
Earnings tolerance levels for a systems-generated “VY” CDRW Issue on the DCF. (Earnings can be gross earnings or net earnings from self- employment (NESE).)
|
VY Issue |
Passed to CDRW |
|---|---|
|
T2VY + MMYY |
There is title II involvement and
OR |
|
16VY + MMYY |
There is title XVI involvement and the alleged earnings exceed $65. |
F. Manually posting earnings (ERNGS) issues to the CDRW
1. Reasons the PM will post a manual ERNGS issue and related comments
There are three situations in which the PM will post a manual ERNGS issue to the CDRW. The following chart summarizes the reasons for a manual posting and provides the corresponding comment that the PM will enter on the CDRW.
Reasons the PM may post a manual ERNGS issue to the CDRW
|
Reason for a Manual ERNGS Issue |
Comment on CDRW |
|
|---|---|---|
|
The PM reported alleged gross earnings to the DCF based on when they were paid, not earned. There is title II involvement and the gross earnings may affect the TWP or SGA determination for the prior month. |
Earnings for MM/CCYY include wages earned in prior month—see EVID screen. MAXIMUS |
|
The PM received and recorded to the EVID screen differs from those already posted to the VERN screen in the DCF. The difference may change a TWP, SGA, or title XVI benefit payment determination. |
Earnings based on evidence differ from posted earnings for MM/CCYY—see EVID screen. MAXIMUS |
|
The PM reported alleged NESE were below TWP or SGA-level earnings, and the individual worked for more than 80 hours in the month or performed significant services. |
Self-employed beneficiary/recipient worked 80 hours or performed significant services for MM/CCYY. MAXIMUS |
2. Manual issue the PM could enter
When the PM creates ERNGS issues, it will enter one of the following issues on the CDRW to identify the type of claim involved:
T2EARN;
T16EARN; or
CONCEARN.