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GN 01010.205: Modernized Claims System (MCS) Earnings Computation (EC) Processing

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  • Effective Dates: 01/28/2015 - Present
  • Effective Dates: 05/17/2018 - Present
  • TN 13 (11-11)
  • TN 22 (05-18)
  • GN 01010.205 Modernized Claims System (MCS) Earnings Computation (EC) Processing
  • A. Importance of EC processing
  • Processing claims fully through MCS (i.e., using the EC screens) has many advantages. Therefore, process claims to payment, denial, disallowance, abatement or pre-effectuated withdrawal using EC screens whenever possible. Some of the advantages of using the EC process are:
  • 1. Process claims through MCS EC whenever possible. Processing claims fully through MCS EC has many advantages. Some of the advantages of using the EC process are:
  • * Higher payment accuracy levels;
  • * Generation of MCS online edits;
  • * Immediate availability of entitlement data to claimant;
  • * Shorter processing time to issue payments; and
  • * No duplication of claims control information (e.g., Workload Management System (WMS)).
  • NOTE: The Pre-adjudicative EC Request is a useful claim development tool and can help to identify and develop potential issues within a claim before making an Adjudicative EC Request, see MS MCSEC 001.004.
  • 2. If an EC processing limitation (PROCLIM) or exception occurs:
  • * Attempt to resolve limitations and exceptions using the guide here before starting an Automated 101 (A101).
  • * Separate cases involving multiple claimants on the same MCS segment to process claims through EC, when appropriate.
  • * Verify EC benefit computations and consider the accuracy of rates subject to the family maximum before separating cases in MCS involving multiple claimants on the same MCS segment.
  • * Prepare a manual award via an A101 or Electronic Form 101 (EF101) if you cannot process an award via MCS EC or if separating claims on the same MCS segment will incorrectly pay the beneficiary.
  • * Prepare a manual denial via the Manual Adjustment Credit and Award Data Entry (MACADE) if you are not able to process a denial via MCS EC.
  • B. MCS EC processing claim types
  • Refer to MSOM MCSEC 001.005 for a complete list of the types of claims that you can be fully process to payment, denial, disallowance, abatement or pre-effectuated withdrawal using MCS EC screens.
  • Refer to MS MCSEC 001.001C. for a complete list of the types of claims that can be fully processed to payment, denial, disallowance, abatement or pre-effectuated withdrawal using MCS EC screens.
  • For a list of EC processing limitations and messages, see MSOM MCSEC 001.036 and MSOM MCSEC 001.001.
  • For a list of EC processing limitations and messages, see MS MCSEC 001.036 and MS MCSEC 001.001.
  • C. Procedure for adjudicating District Office Final Authorization (DOFA) and non-DOFA claims
  • The section below describes the required screens for a title II DOFA and non-DOFA claim processing.
  • The section below describes the required screens for Title II DOFA and non-DOFA claim processing.
  • 1. DOFA Claim
  • You must complete the Earnings Computation Approval (DAPP) screen when adjudicating and effectuating a DOFA claim in the Field Office (FO) via MCS EC, see MSOM MCSEC 001.034 DAPP.
  • Complete the Earnings Computation Approval (DAPP) screen when adjudicating and effectuating a DOFA claim in the Field Office (FO) via MCS EC, see MS MCSEC 001.034.
  • 2. Non-DOFA Claim
  • When processing a non-DOFA claim in the FO, you must annotate the appropriate non-DOFA reason on the decision (DECI) screen in MCS and transfer the claim to the Processing Center (PC) of jurisdiction by entering a processing (PROC) code of “N” on the interface (INTE) screen. This action creates a record request for the PC to review and process the claim. See GN 01010.027 for more information on Non-DOFA cases and processing.
  • When processing a non-DOFA claim in the FO, annotate the appropriate non-DOFA reason on the decision (DECI) screen in MCS and transfer the claim to the Processing Center (PC) of jurisdiction by entering a processing (PROC) code of “N” on the interface (INTE) screen. This action creates a “record request” for the PC to review and process the claim. For more information on Non-DOFA cases and processing, see GN 01010.027.
  • D. References
  • * GN 01010.010 MCS – Earnings Computation (EC) screens
  • * GN 01010.205 MCS – Earnings Computation (EC) processing
  • * MSOM MCS 012.003 Interface (INTE)
  • * MSOM MCS 014.001 Automated SSA-101 Process
  • * GN 01010.010 Modernized Claims System (MCS) Earnings Computation (EC) screens
  • * GN 01010.220 Manually Processed Awards
  • * MS MCS 011.002 Introduction to Edits
  • * MS MCS 012.003 Interface (INTE)
  • * MS MCS 014.001 Automated SSA-101 Process
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