GN 03106.060: Effectuating Component Responsibility

changes
←	*	→

Effective Dates: 06/08/2012 - Present
TN 9 (05-02)
GN 03106.060 Effectuating Component Responsibility
A. INTRODUCTION
The effectuating component after receiving an order from the OGC is responsible for assuring that payments to individuals based on court orders are accurate and timely. All actions should be expedited, and, where necessary, the claims folder should be “walked” through the processing steps. If the computer system rejects the initial systems input to pay benefits in a court case, a special payment should be made outside of the system (i.e., one check only or automated one-time payment).
NOTE: In title II claims, payment to any beneficiary on the earnings record should not be delayed while development is undertaken for other beneficiaries on the record. See http://kcnet.kc.ssa.gov/mi/mampsc/TOELDeskChart.xls . for PCACS TOEL codes to be used in a case with court involvement.
NOTE: In title II claims, payment to any beneficiary on the earnings record should not be delayed while development is undertaken for other beneficiaries on the record. See http://kcnet.kc.ssa.gov/mi/mampsc/TOELDeskChart.xls. for PCACS TOEL codes to be used in a case with court involvement.
B. DESCRIPTION - COMPONENT RESPONSIBILITY
This chart indicates the component(s) having effectuation responsibility for the various types of benefits.
BENEFIT PROGRAM
EFFECTUATING COMPONENT
RSI
PSC
Title II
* Disability
* under age 54
* age 54 and over, or deceased
OCO
PSC
Concurrent
* Title II
* Title XVI
PC (see Title II Disability above)
RO/FO
Title XVI
RO/FO
C. PROCEDURE - PAYMENT IS DELAYED AND NO NOTICE OF APPEAL IS FILED
If payment of a reversal decision is delayed beyond 95 days from the date of the final court order and no notice of appeal has been filed (see GN 03106.055), the effectuating component must notify the claimant(s), in writing, that payment will be delayed. The delayed payment notice should indicate the reason for the delay. If there is a choice between sending the 95-day delayed payment notice and taking payment action, the 95-day delayed payment notice need not be sent and action should be taken to make payment. Effectuating components have the option of sending the 95-day delayed payment notice concurrently with taking action. Informational copies of the delayed payment notice must be sent to
* The claimant's attorney, and
* OGC (see GN 03106.020B. for a hyperlink to OGC's web page for telephone numbers and addresses).
NOTE: In concurrent title II/title XVI cases a notice should be sent if payment under either title or under both titles will be delayed.
D. EXAMPLE - NOTICE LANGUAGE ( DELAYED PAYMENT NOTICE)
See GN 03106.099, Exhibit E for an example of language to be included in the 95-day notice:
NOTE: Be sure to send a copy to the claimant's attorney.
E. PROCEDURE - HOW TO OBTAIN THE CLAIMS FOLDER
In order to effectuate the court order, the claims folder should be obtained.
IF benefits are...
THEN the file should be in...
AND THEN...
Title II only
the PC,
—
Title XVI only
the FO
If for any reason the FO does not have the file, request the file but do not delay effectuation. Effectuate the court order using MSSICS data pending receipt of the claim file.
Concurrent Title II/Title XVI
the PC
The PC will retain the title II folder and send the title XVI material to the effectuating FO on receipt of court order.
NOTE: If, for any reason, the folder is in any PC other than the PC that received the court order, then
* The PC receiving the court order will call the PC having possession of the claims folder; and
* The PC having possession of the folder is responsible for effectuating the first payment, then shipping the folder to the servicing PC.
Also, if reasonable efforts to locate the claim folder fail, contact OGC/OPL or the OGC Regional Chief Counsel that has responsibility for defending the claim. Ask the OGC component to provide a copy of the administrative record that was prepared for filing with the court. The administrative record contains a copy of the claimant's application, medical evidence and the final decision of the Commissioner before the court action was filed. The effectuating component can use this information to effectuate the court's order.
F. PROCEDURE - COURT ORDER IS RECEIVED FROM OUTSIDE OF SSA
If a FO/PC receives a reversal decision from a source outside of SSA (e.g., claimant, and/or claimant's attorney):
* Notify the OGC office that has responsibility for the case (OGC/OPL or the Regional Chief Counsel, as appropriate) by telephone (See GN 03106.020B. for a hyperlink to OGC's web page for telephone numbers and addresses);
* Forward a copy of the order to OGC if requested;
* Do not effectuate the court order unless advised to do so by the OGC.
G. PROCEDURE - WHO TO NOTIFY WHEN COURT ORDER CANNOT BE EFFECTUATED
The effectuating component must promptly notify the OGC office that has responsibility for the case, (OGC/OPL or the Regional Chief Counsel, as appropriate) via telephone (see GN 03106.020B. for a hyperlink to OGC's web page for telephone numbers) if for any reason the court order cannot be effectuated as written or if any other difficulty arises that causes an unreasonable implementation delay.
NOTE: FOs should contact OGC through ARC-MOS.
H. PROCEDURE - PREPARATION OF SSA-1129-U3 IN TITLE II CASES
In title II cases where the claimant is represented by an attorney and there are past-due benefits, send an SSA-1129-U3, Statement of Past Due Benefits, to notify OGC of the amount of benefits payable and the amount withheld for possible payment of attorney fees.
I. Reference
SSI Court Reversals, SI 04050.040.

POMS Reference

GN 03106.060: Effectuating Component Responsibility