POMS Reference

DI 60075: Promoting Opportunity Demonstration (POD)

BASIC (02-18)

The POD operations units are located within PC1 through PC7. The PITAG unit is responsible for POD operational work in PC1 through PC6. The Inquiries & Expedited Unit (I&E) is responsible for the POD operational workload in PC7.

A. Contact information for POD units within Processing Centers (PCs)

Each PC has a dedicated POD-specific email account used to handle all POD inquires. The email accounts will replace the Modernized Development Worksheet (MDW) process for communication between Field Offices (FO), PC, and the POD work units within the PC. The following is a list of POD email addresses for each PC:

B. Request for assistance

1. FO process

When a FO has a question about a POD case, the FO technician should:

  • send a request for assistance to the PC of jurisdiction via the established POD mailbox;

  • input “POD – Request for Assistance” in the subject field;

  • include the beneficiary’s name, social security number, and a detailed description of the request.

NOTE: The FO technician should only contact the PCs for information pertaining to POD waiver requests or personal conference inquiries. If the beneficiary brings in any information pertaining to the POD, the FO technician should refer the beneficiary to the POD Call Center (1-888-771-9188).

2. PC process

When responding to a FOs request for assistance, the PC technician should:

  • send the response directly to the field office of jurisdiction mailbox (do not reply to the sender of the request); and

  • input “POD – Request for Assistance” in the subject field.

NOTE: The PC technician should only contact the FO when responding to requests for assistance related to POD waiver requests or personal conference inquiries.

3. How to locate FO mailbox

  • Obtain a MBR;

  • Locate the office code (DOC) on the PAYMENT line;

  • Access IMAIN;

  • Select DOORS Online;

  • Enter office code and click search; and

  • The email address is located under the contact information.

C. Impairment related work expenses (IRWE) evaluation

POD participants can have their monthly offset threshold raised to the amount of their itemized and approved IRWE if that amount exceeds the standard trial work period (TWP) threshold. If a POD participant reports IRWE for a month in excess of the TWP threshold, Abt will add the report to a review queue in the Information Data System (IDS). Abt will email the central POD PC email account (see DI 60075.050A) in the PC of jurisdiction alerting the POD unit that there is an IRWE allegation that needs review.

The POD contact person in the servicing PC receives the email alert from Abt that an IRWE case needs review and creates an ACR in Paperless with the generic comment, “POD IRWE review needed.” The type-of-event-level (TOEL) used for POD IRWE is:

TOEL1 TOEL2 TOEL3 TOEL4 FILE ID

DISAB BENOFF POD ALERT PODALRT

A POD unit technician then accesses the IDS and reviews the record associated with the IRWE submission. All supporting documentation is stored in the IDS. For IRWE approval instructions, follow DI 10520.001.

After review of the IRWE record, the POD unit technician will update the record in IDS with the total approved IRWE amount. Abt will submit the complete earnings file with approved IRWE via IDS. The POD Automated System (PAS) receives the file and adjusts the threshold for offset to the approved IRWE amount, if above the standard threshold.

D. Undeliverable POD notices

For undeliverable POD notices, follow normal procedures per GN 02605.055.

E. Processing limitation alert through the Processing Center Action Control System (PCACS)

PAS creates a PCACS alert when it cannot adjust a beneficiary’s benefit for the POD. An Action Control Record (ACR) created in Paperless shows the TOEL of the work involved. The TOEL created for the POD is:

TOEL 1 TOEL 2 TOEL 3 TOEL 4 FILE ID

DISAB BENOFF POD ALERT PODALRT

The following table lists the processing limitations, exceptions, and alerts of the PAS. The output in the POD ACR will contain a three-digit code that identifies the type of action needed. The ID’s from 100-199 are processing edits that also require a manual database update, 200-899 are processing edits that do not require a database update, and 900-999 are processing alerts:

ID

Description

101

Code error - manual processing required, update database

102

Code error - manual processing required, update database

201

Current Suspense, EE coding required

202

No ABN field

203

MACADE/MADCAP action pending

204

Missing match - manual processing required

205

MACADE transaction failed

206

MACADE/MADCAP action pending

301

Termination or Suspension – need manual action

302

PAR REC – recovery amount greater than MBA

303

Triple entitlement

304

Dual entitlement

305

No ABN field

306

Missing match - manual processing required

307

MACADE transaction failed

308

MACADE/MADCAP action pending

309

More than six rows in MACADE - manual action required

310

PIA increase - Verification needed

311

Worker's Comp calculation - Verification needed

902

Special message limit exceeded

903

LESSDO suspense – DBS make whole, check AURORA for notice

904

Aux - missing DOEC date

905

Aux - RFD does not match LAF

906

Aux – Suspense, EE coding required

907

Aux limit exceeded – suspend benefits according to BIC A

908

ENB limit exceeded, see incomplete notice in AURORA

909

Aux limit exceeded – pay benefits according to BIC A

910

Aux suspense – pay benefits according to BIC A

911

Withdrawal notice needed – no POD coding on MBR

912

ENB limit exceeded, see incomplete notice in AURORA

913

Aux – payment does not match

914

Aux – overpayment, no SIC

F. Processing manual MACADE action for POD cases

Benefit Authorizers (BAs) in specialized workgroups within the PC will:

  • review why the POD case is a processing limitation;

  • take corrective action to complete the processing limitation;

  • calculate monthly offset amount from Paperless output;

  • refer to a Disability Examiner (DE) to update the POD data input screen on the DCF with any changes for each manually processed transaction;

  • key in POD data for initial POD cases;

  • adjust the monthly benefit taking into consideration POD offset;

  • select proper notice language; and

  • post special messages to the master beneficiary record (MBR).

1. Demonstration project DMO screen (HISTDEMO)

The DMO screen (on the MBR) for the POD beneficiary is coded with the demonstration project indicator (DPI) with DP and the START date that is equal to the month of random assignment and a STOP date of 06/30/2021.

DEMO

DEMO project indicator: DP

DST: start date of offset

DSP: stop date of offset

MDE 012218 DEMONSTRATION PROJECT (HISTDEMO) DM

SSN: 111-11-1111 BIC: A

[ DPI START STOP

[ (MMCCYY) (MMCCYY)

| DP 012018 062021

2. HST screen

When offset is applied, code the offset benefit amount with a Work Indication Code (WIC) of Z. If there is dual entitlement, apply any excess offset to the DWB or CDB record.

If the offset amount is higher than the full monthly benefit amount (MBA), place the HA in LAF SQ by coding a reason for deduction (RFD) of Q, a WIC of Z and Reason for Suspension Termination (RFST) of DMPRDP (Demonstration Project DP), then place any auxiliaries on the record in LAF SQ.

NOTE: We consider prior months’ work as a closed period or overpayment (OP).

3. Example of current operating month (COM) equals first month of offset

Action taken in 01/2018 to apply offset. The primary insurance amount (PIA) is 1018.60 for 12/2017. The offset amount is $522.00. The BA codes the HST, DEMO, and SMG screens with the following information:

HST

PIC: A (BIC for POD beneficiary)

MR: 496.60 (Offset MBA)

FROM: 01/2018 (Month of earnings submission)

TO: CON

COM: COM

RFD: Blank (POD beneficiary is not in full offset)

WIC: Z

RFST: Blank

ABS: (ABN field on MBR)

ARC: Blank

OCO: Blank

ENB: P* (see POD notice fill-ins in DI 60075.080).

MDE 011018 PAYMENT HISTORY HST

SSN: 111-11-1111

[ SLN PIC BIC MR FROM TO RFD WIC SIC RFST

| 001 A 0496.60 0118 con Z

| 002

| 003

| 004

| 005

| 006

COM (MM): 01 ABS: XYZ ARC: OCO:

XSSN: XBIC:

PRI: PDI: INT:

ENB: P*WDS024,840.00*ERN096,1884.00,01/2017*WDS025,522.00,02/2017*BEN139,496.00,01/2017.

DEMO

DEMO project indicator: DP

DST: 01/2018 (start date of participation)

DSP: 06/2021 (stop date of participation)

MDE 011018 DEMONSTRATION PROJECT (HISTDEMO) DM

SSN: 111-11-1111 BIC: A

[ DPI START STOP

[ (MMCCYY) (MMCCYY)

| DD 012018 062021

SMG

HA IN POD PROJECT, SPECIAL PROCESSING REQUIRED. SEE DI 60075.000.

MDE 011018 SPECIAL MESSAGE DATA (SP MSG) SMG

SSN: 111-11-1111

MSG1 : HA IN POD PROJECT, SPECIAL PROCESSING REQUIRED. SEE DI 60075.000.

TRAN DATE:

DEL(#): STANDARD MSG CODE (?, 01-51): DEL DATE (MMYY):

4. Example of MACADE action for POD participant

A BA takes action on 05/2018 to apply offset retroactive to 02/2018. PIA is $1370.50, effective 12/17. The offset amount is $522.00.

The BA codes the HST, DEMO, and SMG screens with the following information:

HST

PIC: A (BIC for POD beneficiary)

MR: 848.50 (Offset MBA)

FROM: 01/2018 (Month of earnings submission)

TO: CON

COM: COM

RFD: Blank (POD beneficiary is not in full offset)

WIC: Z

RFST: Blank

ABS: ABN field on MBR

ARC: Blank

OCO: Blank

ENB: P* (see POD notice fill-ins in DI 60075.080).

MDE 051018 PAYMENT HISTORY HST

SSN: 111-11-1111

[ SLN PIC BIC MR FROM TO RFD WIC SIC RFST

| 001 A 848.50 0118 0418 Z 80

| 002 A 848.50 0518 CON Z

| 003

| 004

| 005

| 006

COM (MM): 05 ABS: XYZ ARC: OCO:

XSSN: XBIC:

PRI: PDI: INT:

ENB: P*WDS024,840.00*ERN096,1884.00,02/2017*WDS025,522.00,02/2017*BEN139,848.00,02/2017*OPT179,4110.00,02/2017-THROUGH-01/2017,2544.00,02/2017-THROUGH-01/2017,1566.00

DEMO

DEMO project indicator: DP

DST: 01/2018 (start date of offset)

DSP: 06/2021 (stop date of offset)

MDE 051018 DEMONSTRATION PROJECT (HISTDEMO) DM

SSN: 111-11-1111 BIC: A

[ DPI START STOP

[ (MMCCYY) (MMCCYY)

| DD 012018 062021

SMG

HA IN POD PROJECT, SPECIAL PROCESSING REQUIRED. SEE DI 60075.000.

MDE 051018 SPECIAL MESSAGE DATA (SP MSG) SMG

SSN: 111-11-1111

MSG1 : HA IN POD PROJECT, SPECIAL PROCESSING REQUIRED. SEE DI 60075.000.

TRAN DATE:

DEL(#): STANDARD MSG CODE (?, 01-51): DEL DATE (MMYY):

NOTE: MADCAP calculates the overpayment automatically.