SI 02006: Windfall Offset and Effect on Title XVI Payments
TN 14 (03-98)
See GN 03940.001 for a description of the fee agreement process. Note that:
An agreement must be submitted before the date SSA makes a favorable determination or decision.
Special procedures apply to calculating past-due benefits in concurrent title II/XVI claims. See GN 03940.001 for instructions when a concurrent titleII/title XVI is involved.
The fee specified in the agreement may not exceed the lesser of 25% of the past-due benefit or the specified dollar amount of the fee cap shown in GN 03940.003A.3.
NOTE: When the title XVI claim has been paid first, the field office must compute a fictitious title XVI past-due benefits amount in order to determine the title XVI portion of the total fee. This computation is done using the full unreduced title II amounts. The SSI eComputations (eComps) application can be used to perform this fictitious computation if it is not already shown on the SSR. Once the total fee is determined, the software can also be used in many cases to compute the adjustment.
Calculating a Title XVI representative's fee amount. (Procedures differ depending on whether Title XVI paid first or second), GN 03940.050.
Title II income for representative's fees using form SSA-2894, SI 02006.210.
Title XVI past-due benefits, GN 03940.001B.6.
URL for eComps site: http://ecomp.sspf.ssa.gov/eComp/startEComp.action.
Use the procedure below for determining title XVI past due benefits and title XVI fee when title XVI paid first:
When you reach step 3.c., call up the eComps application to help you compute the “fictitious” title XVI past-due amounts.
Enter the required data for the SSI computation beginning with the first month of SSI eligibility. Be sure to enter proration data and all income received. Include title II that is actually received. Continue the computation through the month of effectuation of the Title XVI benefits.
After all data are entered, trigger the RMA computation.
Next, select choice 5., “Windfall Offset Computation” from the RMA main menu. Then from the Windfall Offset Menu, select choice 1., “Enter a Windfall Offset Computation.” Follow the software instructions to indicate the beginning and ending dates of the windfall period.
CAUTION: DO NOT enter any attorney fee amount when computing the “fictitious” past due benefits. Use the full amount of title II retroactive benefits for each month of type W income (except for the last two months of the windfall period which are always zero). After all data are entered, trigger the windfall offset computation.
Print the SSA-4346 SSI Offset Summary. Using the SSA-4346, total up the new FAM and new SAM amounts for all months in the computation. Include all the months paid in the title XVI retroactive payment in your total.
NOTE: If any months in the SSI retro are not part of the windfall period, the amount paid for those months should be added to this total. Remember that you must reduce your total by any payments that are not past due benefits for representation fee purposes per GN 03940.001B.7. Once you have completed this step, you will have determined the correct amount of title XVI past due benefits to be used in computing the title XVI fee.
Proceed to determine the title XVI fee by following step 5 of GN 03940.050C.5.e.
Add the title XVI fee to the title II fee to determine the total representative fee.
When you reach step 7 of GN 03940.050C.7., adjust the title II income per SI 02006.210 and adjust the retroactive title II benefits for the total representative fee. The eComps application can be used in many cases to complete an SSA-2894 for you. Follow the third and fourth bulleted items above until you reach the screen which asks for the attorney fee. Type in the total attorney fee and indicate that it is a title II offset. Complete additional screens that give information on the representative fee and the title II benefit rate changes that occurred in the windfall period. Then the software will compute the adjusted “W” amounts for you. After all data is entered, trigger the windfall offset computation.
Print the SSA-2894 and the SSA-4346 for use in computing any underpayment due the recipient. If the title II retroactive benefits have not been released, trigger an automated windfall offset computation, unless a posteligibility change has occurred on the SSR. Print the SSA-1719B input information on the eComps application.
Adjust only the title II income of those SSI recipients who are obligated for the representative's fee. In fee agreement cases, only the person or persons who sign the fee agreement are obligated for the fee. See SI 02006.202B.5. for additional information on determining who is obligated when auxiliary title II benefits are involved and for instructions on windfall offset computations involving an auxiliary who is not obligated.