SI 02305.071: Completing Redeterminations (RZs) in MSSICS or on Paper Forms SSA-8202-BK and SSA-8203-BK

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Effective Dates: 01/12/2016 - Present
TN 60 (12-15)
SI 02305.071 Completing Redeterminations (RZs) in MSSICS or on Paper Forms SSA-8202-BK and SSA-8203-BK
A. Policy for required use of redetermination wizard (RZwiz) for all redeterminations (RZ) and limited issues (LI)
1. Background on using RZwiz
RZwiz improves the RZ interview by providing claims representatives with an easy-to-use tool that automatically retrieves, consolidates, and interprets queries used during the RZ interview. It also provides a plain-English worksheet with data from multiple databases arranged side-by-side, and mathematical computations such as adding earnings to quarterly and yearly sums.
You MUST use the RZwiz worksheet during all RZ, LI and wage-related diary interviews. You do not need to retain the worksheet in the file after the interview, but you may scan the worksheet into the Claims File Records Management System (CFRMS), if necessary.
2. RZwiz features
The RZwiz:
* reviews the Supplemental Security Record (SSR) and identifies all associated social security numbers (SSNs) automatically; and
* obtains the Supplemental Security Income Display (SSID), Detailed Earnings Query (DEQY), Summary Earnings Query (SEQY), and National Directory New Hire (NDNH) data for all SSNs, and provides a plain-English worksheet for scheduled RZs.
3. User options
Use the RZwiz to request queries by adding SSNs to the SSN list box, and clicking the Generate Report(s) button.
4. Accessing RZwiz
To access RZwiz, click here. The website includes user guide, sample output, user tips, and general information.
a. Opening RZwiz
Follow these steps:
* Open the OQP toolbar;
* Log onto the Personal Communications (PCOM) program if you are requesting queries;
* Click on the Menu button on the toolbar;
* Select Programs on the Menu; and
* Select RZwiz on the list of programs and the RZwiz tool will open.
b. Obtaining an RZwiz review sheet
RZwiz retrieves queries and creates electronic review sheets.
Follow these steps:
* Select the desired PCOM session from the menu in the right upper corner.
* Enter the SSN(s) or open a saved list of SSNs.
In the SSN List Box, located along the left edge of the interface, you can:
* type one or more SSNs;
* save a list of SSNs; and
* retrieve a saved list of SSNs.
* Select the Generate Reports button to obtain the queries and create the review sheets(s).
5. Viewing RZwiz data
RZwiz presents the user with a tabbed interface that includes the Review Sheet tab and the PCOM Queries tab.
The SSN(s) will appear in the dropdown box in the upper-left corner. The interface allows users to:
* switch between SSNs when multiple numbers are required;
* use the navigation arrows next to the SSN dropdown box;
* review full queries by selecting the PCOM Queries tab, and selecting the query name in the left navigation pane; and
* access SSN Listings and Analyzer Reports by selecting the RZwiz AR menu item in the Tools>QMTs menu, or by selecting the RZ AR button in the tool strip above the tab.
6. Printing RZwiz worksheets
On the desired tab, select the Print menu item from the File menu, or select the Print icon from the tool strip above the tabs. The options available are:
* Print for selected SSN;
* Print for selected SSN and all queries;
* Print for all SSNs; and
* Print for all SSNs and all queries.
B. Procedure when using Form SSA-8202-BK (Statement for Determining Continuing Eligibility for SSI Payments)
1. Preparing the form
* As you prepare for the personal contact interview or mail-out RZ, obtain a SSID and review it carefully to determine what type of interview is appropriate.
For additional information about the SSID, see SM 01601.265 and SM 01601.280. When reviewing the SSID, determine if:
* The recipient is a qualified alien with a 7-year eligibility limit (see SI 00502.106 and SI 02305.082);
* A personal contact for dedicated account monitoring is required (see GN 00605.200 through GN 00605.235);
* An age18-disability redetermination is required (see DI 23570.001 through DI 23570.025);
* Anyone else in the household is turning age 18 (this event may affect living arrangements);
* Rep payee suitability development is necessary (see SI 02305.123);
* If the recipient is insured for Title II benefits; and
* Additional evidence is required.
* Enter the recipient's SSN and, if applicable, the spouse's SSN and name in the space provided.
* Enter the reference date in the space provided (see SI 02305.034C).
* If an exception to the criteria in SI 01730.045C.4. applies, line through Question 12, which requests information about third-party liability.
2. Conducting the RZ personal contact interview by mail
Take the following actions:
* Mail Form SSA-8202-BK (Statement for Determining continuing Eligibility for SSI Payments) to the recipient or representative, if applicable, for completion and return.
* Date stamp Form SSA-8202-F4-INST (Important Facts About Your Supplemental Security Income Payments) and mail it with a self-addressed postage-paid return envelope.
NOTE: You must date and retain a copy of Form SSA-8202-F4-INST in the file to document the 30-day timeframe for closeout purposes. For an explanation of the N20 failure to provide information closeout procedure, see SI 02301.235.
* Upon receipt of the signed Form SSA-8202-BK, destroy the copy of Form SSA-8202-F4-INST. Use alternative signature methods for cases processed through The Modernized SSI Claims System (MSSICS) (see SI 02305.003).
* Be sure to obtain the following on the form:
* the recipient’s or representative payee’s signature using alternative signature methods for cases processed through MSSICS; and
* signature from witness(es), when necessary.
* Mail a copy of Form SSA-4122-FO (Your Supplemental Security Income Folder) as described in SI 02305.038 and SI 02305.117C.3.
* Mail a copy of Form SSA-4122-FO (Your Supplemental Security Income Folder) as described in SI 02305.038 and SI 02305.117C.3.
3. Conducting the RZ personal contact interview by telephone
When conducting the RZ by telephone:
* Use Form SSA-8202-BK.
* Review and discuss the following with the recipient during the interview:
* Privacy Act/Paperwork Act Notice;
* Computer Matching and Privacy Protection Act provisions; and
* Transfer of resources provisions relating to both Medicaid and SSI eligibility.
NOTE: If a copy of Form SSA-3073 (Important Messages from Your Social Security Office) was not enclosed with Forms SSA-L3074-U2 (SSI Notice of Appointment) or SSA-L3075-U2 (SSI Notice of Appointment 1619(b)), mail a copy to the recipient.
* Read the Affirmation of Statements item to the recipient or representative payee, if applicable.
* Review the reporting responsibilities on the tear-off sheet with the recipient or representative payee, if applicable.
For more information about reporting responsibilities, see SI 02305.117.
* Confirm the following:
* the recipient’s or representative payee’s intent to provide the requested information that will enable the agency to determine continuing SSI eligibility;
* under penalty of perjury, the supplied information is correct; and
* the recipient’s or representative payee’s agreement to sign the RZ form necessary.
* Furnish a copy of Form SSA-4122-FO (Your Supplemental Security Income Folder) as described in SI 02305.038 and SI 02305.117C.3.
* Furnish a copy of Form SSA-4122-FO (Your Supplemental Security Income Folder) as described in SI 02305.038 and SI 02305.117C.3.
4. Entering responses
Take the following steps to enter responses on Form SSA-8202-BK:
* Complete any necessary development according to SI 02305.082 through SI 02305.124.
NOTE: You may need to complete additional forms such as Form SSA-8010-BK (Statement of Income and Resources) or SSA-8006-F4 (Statement of Living Arrangements, In-Kind Support and Maintenance) or both when you complete the RZ on a paper form.
* Compare responses on all forms with prior office files, the SSR, and manual or computer listings. For examples of prior files and listings, see SI 02305.070F.3.
* Resolve any discrepancies following appropriate instructions, unless a tolerance applies.
Information on the SSR or prior files that is not present or alleged on paper forms completed during the RZ does not constitute as a discrepancy. The information does not require development unless it indicates a question of eligibility.
EXAMPLE: A SSID reflects ownership of a non-excluded automobile. We do not develop the current value and continued ownership of this item when properly completing Form SSA-8202-BK. However, if this information plus other allegations on the form cause ineligibility, development is necessary.
5. Transmitting data necessary to complete the RZ
Complete Form SSA-1719B (Supplemental Security Income Post-eligibility Input) and transmit the data to the SSR. If necessary, complete a summary report of contact (RC).
For instructions on completing Form SSA-1719B and an RC, see SI 02305.059.
C. Procedure when using Form SSA-8203-BK (Statement for Determining Continuing Eligibility for SSI Payments)
1. Preparing the form
Prepare for the interview as follows:
* follow the instructions in SI 02305.071B.1. in this section; and
* if an exception to the criteria in SI 01730.045E applies, line through Question 24 requesting information about third-party liability.
2. Transmitting data necessary to complete the RZ
Follow the instructions in SI 02305.071B.5 in this section.
D. Procedure when using MSSICS
1. Preparing for a MSSICS RZ
Follow the instructions in SI 02305.071A in this section.
2. Conducting the MSSICS interview
Take these steps:
* Open an RZ event.
* Complete the RZ on the chosen path.
* Review the Privacy Act/Paperwork Act Notice, Computer Matching and Privacy Protection Act provisions, and transfer of resources provisions with the recipient or representative payee, if applicable.
* Review the affirmation of statement requirement with the recipient or representative payee, if applicable.
* Review recipient reporting responsibilities with the recipient or representative payee, if applicable.
* Obtain the following on the printout of the RZ form:
* the recipient’s signature using alternative signature methods for cases processed through MSSICS (see SI 02305.003); and
* signatures of witness(es), if necessary.
* Furnish a copy of Form SSA-4122-FO (Your Supplemental Security Income Folder) as instructed in SI 02305.038.
E. Entering the responses
Use the following steps to enter responses on the MSSICS screens:
* Review the information on the MSSICS screens with the recipient;
* Complete any necessary development (see SI 02305.082 through SI 02305.124); and
* Resolve any discrepancies following appropriate instructions, unless a tolerance applies.
F. Transmitting the data
Verify all documentation (wages, resources, or living arrangements). Upon completion of all necessary development, close the RZ event and build the transaction SSR. Retain all documentation obtained during the RZ in a locked Report of Contact (DROC) and fax into the non-disability repository for evidentiary documents (NDRED).
G. Procedure for additional issues to consider during the RZ interview
1. Recipient is a non-citizen
If the recipient is a non-citizen, follow instructions in SI 02305.082.
2. Dedicated account monitoring is required
If dedicated account monitoring is required on the case and a personal contact is desirable, coordinate the interview.
For more information about dedicated account monitoring, see GN 00605.200 through GN 00605.235 and SI 02305.011.
3. Age 18-disability redetermination is required
If a disability redetermination is required on the case, coordinate the interview (see DI 23570.001 through DI 23570.025).
4. Representative payee suitability development required
Develop representative payee suitability if the Type of Payee (T) code is “OTH” and the Custody (CU) code is “SEL” in the Representative Payee (REPY) segment of the pre-RZ SSID.
For more information about developing representative payee suitability, see SI 02305.123.
5. Title II entitlement
a. Protective filing leads to entitlement for other benefits
SSI recipients must file for all other benefits for which they are entitled, including Title II benefits. If the recipient does not wish to file and does not comply with filing for other benefits, we must suspend the SSI payments using payment status code N06.
For more information about filing for other benefits, see SI 00510.001 through SI 00510.030.
Remain alert about information you receive that indicates possible eligibility for Title II benefits on a recipient's own record or on the another record. If the recipient is entitled to Title II benefits, the RZ serves to protect the Title II filing date. Protective filing remains open until properly closed out.
For information about determining the protective filing date, see GN 00204.015.
When one member of an eligible couple attains age 62 to 64 and does not receive Title II benefits, pursue entitlement to Title II spouse's benefits (see SI 02309.007). You must close out protective filings.
For instructions on closing out protective filings, see GN 00204.012.
b. Concurrent cases
In concurrent cases, review all Title II aspects of the case to ensure recipients are receive the highest Title II benefit to which they are entitled. Use only a certified earnings record to document an individual’s insured status for Title II benefits.
For information on certified earnings records, see GN 00204.004, GN 01010.009, and SI 00601.035B.
EXAMPLE: A recipient is receiving Title II widow's insurance benefits (WIB). During the interview, she meets all factors of entitlement on her own record, except for insured status that she will meet within four months of the RZ. Because, her retirement insurance benefit (RIB) is determined to be higher than her WIB, the RZ serves as protective filing for RIB.
For development of potential Title II entitlement, see SI 02305.110.
6. Processing Medicare Part B applications
The State Buy-In Program pays Medicare Part B premiums for some Title XVI recipients. Process a Medicare Part B application for State buy-in if the SSI recipient:
* is age 64 years and 9 months, or older;
* is uninsured for Title II;
* does not have Medicare; and
* resides in a 1634 State (also known as an auto-accrete state).
For information on 1634 States and processing State buy-in, see SI 01730.060, HI 00815.000, and HI 00810.010.
NOTE: An aged individual may file for Part A hospital insurance (HI) benefits on the record of a 62- year old spouse (see HI 00801.008).
7. Information material to other SSI recipients in the household
In multi-recipient household situations when an RZ reveals information that may be material to payment amount or eligibility of other SSI recipients in the same household, consider the RZ a third-party report and develop. For information on third-party reports, see SI 02301.010A.
EXAMPLE: An RZ uncovers changes in the household composition or changes in earned income in deeming situations.
H. References
* SM 01601.265 Online Complete Record Request - SSID
* SM 01601.280 SSID Query Reply
* SI 02305.082 Developing Alien Status - RZs
* SI 00502.106 Time-Limited Eligibility for Certain Aliens
* GN 00605.200 Overview of Monitoring Representative Payees with Dedicated Accounts, through
* GN 00605.235 Payee Fails to Respond to SSA-6233-BK
* DI 23570.001 Public Law 104-193 – General, through
* DI 23570.025 Processing Childhood and Age 18 Disability Redeterminations
* SI 02305.123 Developing Rep Payee Suitability During RZs
* SI 02305.034 Period of Review – RZs and LIs, C Policy - Reference Date
* SI 01730.045C.4. Redeterminations
* SI 02301.235 Failure to Provide Information (N20)
* SI 02305.003 Alternative Signature Methods: Attestation and Witnessed Signature
* SI 02305.038 Use of the SSA-4122-FO (Your Supplemental Security Income Folder) – RZs
* SI 02305.038 Use of the SSA-4122-FO (Your Supplemental Security Income Folder) – RZs
* SI 02305.117C.3. Mail out RZs - SSA-8202-BK
* SI 02305.117 Informing Recipients of their Reporting Responsibilities – RZs
* SI 02305.082 Developing Alien Status – RZs, through
* SI 02305.124 Developing RZs With Multiple Rep Payees
* SI 02305.070F.3. Prior information
* SI 02305.059 Disposition of RZ and Limited Issue Case Development and Decision Data
* SI 02305.071B.1. Preparing the form
* SI 01730.045E Procedure-completing the SSA-8019-U2
* SI 02305.071B.5. Transmitting data necessary to complete the RZ
* SI 02305.071A Policy for required use of redetermination wizard (RZwiz) for all redeterminations (RZ) and limited issues (LI)
* SI 02305.011 Dedicated Account Monitoring RZs and LIs
* SI 00510.001 Overview of the Filing for Other Program Benefits Requirement, through
* SI 00510.030 Exhibit of the SSA-L8050-U3 (SSI Claim Information Notice)
* GN 00204.015 Title XVI Redeterminations (RZs) as Protective Filings for Title II Benefits
* SI 02309.007 Detecting Entitlement to Title II Spouse’s Benefits – KP Diary
* GN 00204.012 How to Close a Protective Writing
* GN 00204.004 Considering Possible Entitlement to Retirement Insurance Benefits (RIB) when a Spouse's Application is Filed
* GN 01010.009 Certified and uncertified earning records (e/r)
* SI 00601.035 Adjudicating Title II When a Title XVI Application is Filed, B. Policy - Applications
* SI 02305.110 Potential Eligibility for Title II Benefits – RZs
* SI 01730.060 Medicaid Information by Regions
* HI 00815.000 State Enrollment of Eligible Individuals
* HI 00810.010 How the Medicare Attainments and Leads Process Works
* HI 00801.008 HI Entitlement for Aged Spouse of Age 62 Worker
* SI 02301.010 How to Act on Reports

POMS Reference

SI 02305.071: Completing Redeterminations (RZs) in MSSICS or on Paper Forms SSA-8202-BK and SSA-8203-BK