POMS Reference

Table of contents Recent changes
Contact
Back
This change was made on Feb 22, 2018. See latest version.
Text removed
Text added

SI 02309.010: Processing the Insured Status (KZ) Diary - Supplemental Security Income (SSI)

changes
← * →
  • Effective Dates: 10/02/2015 - Present
  • Effective Dates: 02/22/2018 - Present
  • TN 8 (10-15)
  • TN 10 (02-18)
  • SI 02309.010 Processing the Insured Status (KZ) Diary - Supplemental Security Income (SSI)
  • A. Introduction to the KZ diary selection process
  • The KZ diary sets for eligible recipients and eligible spouses who may qualify for a Title II benefit. The process to determine insured status occurs quarterly. Beginning October 1, 2015, the KZ diary selection process will occur annually.
  • The Supplemental Security Record (SSR) sets the KZ diary for eligible recipients and eligible spouses who may qualify for a Title II benefit. The process to determine insured status occurs annually.
  • The KZ diary sets only on Supplemental Security Records (SSRs) that are in current pay, force pay, or 1619(b). For more information on 1619 Policy Principles, see SI 02302.010.
  • Beginning December 2017, the KZ diary selection process expanded to include statutory blind insured status. Statutory blindness under both Title II and Title XVI:
  • * means a central visual acuity of 20/200 or less in the better eye with the use of a correcting lens; and
  • * considers an eye that has a limitation in the field of vision where the widest diameter of the visual field extends to an angle no greater than 20 degrees as having a central visual acuity of 20/200 or less.
  • For more information about statutory blindness for Title II and Title XVI, see DI 26001.001 and DI 10105.070.
  • The KZ diary sets only on an SSR in current pay, force due, or 1619(b). For more information on 1619 Policy Principles, see SI 02302.010.
  • The KZ diary indicates the recipient may:
  • * be fully insured for Title II retirement benefits (see RS 00301.105);
  • * be fully insured for Title II disability benefits and meet the 20/40 requirement for Title II disability benefits (see RS 00301.120); or
  • * meet the special insured status requirement for recipients disabled prior to age 31 (see RS 00301.140).
  • * meet the special insured status requirement for recipients disabled prior to age 31 (see RS 00301.140); or
  • * meet the statutory blind insured status when the SSR contains a primary or secondary diagnosis code of 3694 indicating statutory blindness, or an ID code of BI, BC, or BS.
  • The SSR does not set a KZ diary if the recipient receives, or has received, Title II benefits on his or her own record. However, the SSR sets the diary for a recipient who receives Title II auxiliary or survivor's benefits. For retirement insured status, the recipient must be age 61 years and 9 months, or older, at the time of the redetermination run that sets the KZ diary.
  • For more information about the SSR criteria for the KZ diary selection, see SM 01501.250B.
  • NOTE: The system tests all periods from the Supplemental Security Income (SSI) date of onset (DOO) and reviews the period beyond the DOO with the exception of statutory blindness cases (see EXCEPTION in SI 02309.010A in this section).
  • The system does not set a KZ diary if the recipient receives, or has received, Title II benefits on his or her own record. The system can set the diary for a recipient who receives Title II auxiliary or survivor's benefits. For retirement insured status, the individual must be age 61 years and 9 months, or older, at the time of the redetermination run that sets the KZ diary. For Systems criteria for the KZ diary selection, see SM 01501.250B.
  • The SSR uses all quarters of coverage earned through the test quarter. If an alleged earlier disability onset arises again. consider an alleged earlier disability onset when you process the KZ diary. Consider if collateral estoppel applies, see DI 11011.001.
  • NOTE: The system tests all periods from the SSI date of onset (DOO) and uses any quarters of coverage earned through the test quarter. The issue of an alleged earlier disability onset may arise again. If so, you must consider an alleged earlier disability onset when processing the KZ diary.
  • EXCEPTION:In statutory blindness cases, the KZ diary process uses the date of birth rather than the SSI date of onset. If you find blind insured status, the recipient requires a Title II medical determination. Do not adopt Title XVI statutory blindness determinations because duration, onset, and substantial gainful activity requirements differ in Title II and Title XVI statutory blindness cases.
  • B. Requirement to take a Title II application
  • B. Exceptions to taking a Title II application
  • Technicians are required to take a Title II application to process the KZ diary, with the following exceptions:
  • You are required to take a Title II application to process the KZ diary, except when:
  • * The recipient receives a higher Title II benefit than the potential retirement insurance benefits (RIB) or disability insurance benefits (DIB) computation, and filing for a lesser RIB or DIB amount is not advantageous to the recipient (see SI 00510.001C);
  • * The current payment status has a non-pay code, including payment status code E01, suspense, or terminated status code (unless the case is in 1619(b) status; or
  • * The current payment status has a non-pay code, including payment status code E01, suspense, or terminated status code (unless the case is in 1619(b) status); or
  • * A Title II application for the recipient’s only potential Title II eligibility is pending at the reconsideration, hearing, or Appeals Council Review level of appeal.
  • * The SSR indicates a technician correctly developed and documented a KZ diary, and the diary resets based on the monthly selection process. (Do not redevelop the KZ diary. Confirm the file is documented properly using Step 5 in SI 02309.010D in this section.).
  • C. Recipients receiving higher Title II benefits than potential RIB or DIB
  • When you take a new Title II application, follow the instructions in subsection GN 00201.005C.
  • * Explain to the recipient the advantages and disadvantages of filing an application.
  • * Allow the recipient to decide whether to file. If the recipient does file an application, document the KZ diary development and completion using the Development Documentation (DDKZ) screen in Modernized Supplemental Security Income Claims System (MSSICS).
  • * Document the action taken about the potential entitlement using the appropriate screen shown here:
  • * Retirement and Disability Entitlement (BSRD), see MSOM MSSICS 019.016;
  • * Spouse, Widow, or Widower Entitlement (BSSW), see MSOM MSSICS 019.017;
  • * Child’s Entitlement from Father (BSCF), see MSOM MSSICS 019.018; and
  • * Child’s Entitlement from Mother (BSCM), see MSOM MSSICS 019.019.
  • For non-MSSICS cases, use the SSR Remarks Data line to document this development.
  • In addition, document and fax into the Non-Disability Repository for Evidentiary Documents (NDRED) Form SSA-5002 (Report of Contact), or document the SSR Remarks data line for non-MSSICS cases.
  • Indicate that:
  • * The RIB/DIB will probably never exceed the current Title II amount; or
  • * If known, the month and year that the RIB will be higher than the Widow(er)’s (WIB) in RIB/WIB cases. The system reselects the KZ diary each year if no application is taken. The remark provides guidance on when to take a RIB application, if applicable. Filing a RIB application would fulfill the Filing for Other Benefits Requirement (i.e., once the RIB exceeds the WIB).
  • When you take a new Title II application, follow the instructions in GN 00201.005C.
  • * Explain the advantages and disadvantages of filing an application to the recipient.
  • * Allow the recipient to decide whether to file. If the recipient files an application, use the Development Documentation (DDKZ) screen in Modernized Supplemental Security Income Claims System (MSSICS) to document the KZ diary development and completion.
  • * Document the action taken about the potential entitlement using the appropriate page:
  • * Retirement (BRIB) and disability entitlement (BDIB), see MS INTRANETSSI 019.022;
  • * Spouse, widow, or widower entitlement (BSSW), see MS INTRANETSSI 019.024; and
  • * Child’s entitlement from parents (BSCP), see MS INTRANETSSI 019.026.
  • Use the SSR Remarks Data line to document the potential entitlement development. In addition, use Form SSA-5002 (Report of Contact) to document this development and fax into the Non-Disability Repository for Evidentiary Documents (NDRED).
  • Make sure the SSR Remarks data line and Form SSA-5002 indicate that:
  • * The RIB/DIB will probably never exceed the current Title II amount; or
  • * If known, the month and year that the RIB is higher than the widow(er)’s (WIB) in RIB/WIB cases. The SSR reselects the KZ diary each year if a technician does not take an application. The remark provides guidance on when to take a RIB application, if applicable. Filing a RIB application fulfills the “filing for other benefits” requirement (i.e., once the RIB exceeds the WIB).
  • For more information on documentation requirements with the application policy, see SI 00601.035.
  • D. Processing the KZ diary
  • Coordinate the processing of a scheduled redetermination and KZ diary. Develop the diary when you initiate any development to reinstate the recipient's benefits. If an exception applies, development may not be necessary as described in SI 02309.010B in this section. However, you must not remove the diary. Follow these steps for processing the KZ diary:
  • Coordinate the processing of a scheduled redetermination and KZ diary. Develop the diary when you initiate development to reinstate the recipient's benefits. If an exception applies, you may need to develop as described in SI 02309.010B in this section.
  • Do not remove the diary. Follow the steps in the chart to process the KZ diary:
  • STEP
  • Step
  • ACTION
  • Action
  • 1
  • Review a current SSR to see if you must take other post eligibility actions.
  • 2
  • Take a Title II application even if it appears that the recipient is not insured. If the Title II application is for disability benefits but the claimant does not meet insured status, you may be able to take an abbreviated application (see GN 00204.009).
  • Reminder: Consider a possible earlier date of onset when processing the KZ diary as advised in SI 02309.010A in this section.
  • If the SSR contains a primary or secondary diagnosis code of “3694” or an ID code of “BI,” “BC,” or “BS,” run a blind insured status computation using the recipient’s date of birth (see SI 02309.010A in this section).
  • Review the certified earnings record (CER) with the recipient to develop incomplete earnings, gaps in postings, or lag earnings.
  • Consider when the recipient can file and adjudicate the application. For more information about an applicant filing a claim before entitlement, see GN 00204.007C;
  • For more information on CERs, see GN 01010.009.
  • Check for possible entitlement to auxiliary or survivor benefits (see GN 00204.022);
  • For more information on the Wage Development policy, see RS 01404.003B.
  • For disability claims, consider an earlier disability onset date than established for SSI. Also consider whether the evidence in file suggests disability insured status;
  • Follow these actions:
  • * Adjudicate the application after considering when the recipient can file. For more information about an applicant filing a claim before entitlement, see GN 00204.007C;
  • * Check for possible entitlement to auxiliary or survivor benefits (see GN 00204.022);
  • * For disability claims, consider an earlier disability onset date than that established for SSI. Also consider whether the evidence in file would suggest disability insured status at any time in the future;
  • * Make sure there is no open Title II application based on the SSI application that the recipient filed previously, or an earlier date that you could use to establish the Title II application filing date;
  • Make sure there is no open Title II application based on the SSI application that the recipient filed previously, or an earlier date for you to establish the Title II application filing date;
  • For more information, see GN 00204.027; and
  • For more information on the scope of the application, see GN 00204.027; and
  • For protective filings, see GN 00204.010.
  • * A redetermination may serve as a protective filing for Title II benefits (see GN 00204.015).
  • A redetermination may serve as a protective filing for Title II benefits (see GN 00204.015).
  • REMINDER: Consider a possible earlier date of onset when processing the KZ diary, as advised in SI 02309.010A in this section.
  • Review the certified earnings record (CER) with the recipient to develop incomplete earnings, gaps in postings, or lag earnings.
  • For more information on CERs, see GN 01010.009.
  • For more information on the wage development policy, see RS 01404.003B.
  • If an earlier application filing date does not exist, the protective filing date is the date we contact the claimant (or proper applicant) and determine that the claimant wishes to file for Title II benefits. Do not use the date the KZ diary set as a protective filing date.
  • For more information on the Application Filing Date policy, see GN 00204.007.
  • For more information on the application filing date policy, see GN 00204.007.
  • 3
  • Follow these actions:
  • * Explain the effect of receiving Title II benefits on the individual's SSI payment;
  • * If the recipient does not file for Title II, follow the procedures in SI 00601.035C.4;
  • * If the recipient fails to file for other benefits, follow the procedures in SI 00510.001 through SI 00510.030;
  • * If the recipient files for Title II, but does not elect full retroactivity, see SI 00510.001 through SI 00510.030. Suspend SSI payments using payment status code N06 when the recipient does not comply with the requirement to file for other benefits;
  • * If the recipient does not comply with the general requirement to provide information, such as complete a redetermination, suspend SSI payments using payment status code N20 (see SI 02301.235). For a description of the suspension codes, see SM 10802.130; and
  • * Do not delete the KZ diary at this time.
  • Explain the effect of receiving Title II benefits on the recipient’s SSI payment;
  • If the recipient does not file for Title II, follow the procedures in SI 00601.035C.4.;
  • If the recipient fails to file for other benefits, follow the procedures in SI 00510.001 through SI 00510.030;
  • If the recipient files for Title II, but does not elect full retroactivity, see SI 00510.001 through SI 00510.030. Suspend SSI payments using payment status code N06 when the recipient does not comply with the requirement to file for other benefits;
  • If the recipient does not comply with the general requirement to provide information, such as complete a redetermination, suspend SSI payments using payment status code N20 (see SI 02301.235).
  • For a description of the suspension codes, see SM 10802.130; and
  • Do not delete the KZ diary.
  • 4
  • Once you have a signed Title II application, transmit type Title II entitlement ("A" unearned income) with recent filing code (code "R") to the SSR (see SM 01305.240).
  • Once you have a signed Title II application, transmit Title II entitlement ("A" unearned income) with recent filing code (code "R") to the SSR (see SM 01305.240).
  • For information about posting type “A” unearned income using MSSICS, see MSOM INTRANETSSI 014.044.
  • For information about posting type “A” unearned income using MSSICS, see MS INTRANETSSI 014.044.
  • 5
  • Follow these actions:
  • * Clear the KZ diary only after you have received a valid Title II application.
  • * If the exception in SI 02309.010B.1 in this section applies, update the DDKZ screen accordingly, and clear the KZ diary without further development.
  • * Do not clear the KZ diary if you suspended benefits for failure to file for other benefits or failure to cooperate or any other reason. Update the DROC screen accordingly. For non-MSSICS cases, document Form SSA-5002 and fax into NDRED.
  • Clear the KZ diary only after you have a valid Title II application.
  • Update the DDKZ screen accordingly, and clear the KZ diary without further development if the exception applies in SI 02309.010B.1 in this section.
  • Do not clear the KZ diary if you suspended benefits for failure to file for other benefits, failure to cooperate, or any other reason. Update the DROC screen accordingly.
  • For non-MSSICS cases, document Form SSA-5002 and fax into NDRED.
  • IMPORTANT: A KZ diary can reset when it appears we approved a recipient at a hearing while insured for Title II, but his or her record does not show a Title II payment. In these cases, review the hearing decision to see how we addressed Title II.
  • A common discovery is an administrative law judge issued a partially favorable decision and the onset date was later than the date last insured (DLI). Therefore, find no Title II eligibility for that period.
  • Another common finding is that the recipient agreed to a later onset date during the hearing resulting in the same situation even though the decision might show as a fully favorable rather than a partially favorable decision.
  • When a KZ diary resets, do not re-develop or clear the subsequent KZ diary if the case was correctly developed and documented in the claims path. Enter Remarks (RMKS) on the SSR and document MSSICS via a DROC to identify these cases. If the reset diary is associated with a pending RZ or limited issue (LI) profiled for a reason other than the reset KZ diary, clear the KZ diary to complete the pending RZ or LI.
  • Document the DDKZ screen with the file documentation remarks: “Reset KZ Diary Previously Developed and Documented.” To identify reset diaries, look for limited issues profiled solely on a KZ diary with following SSR characteristics:
  • CRZD profile of ‘X’;
  • CRZD selection indicator of ‘X’; and
  • KZ is the only RZ/LI priority diary in the DIAR field.
  • AND
  • An RZ/LI completion in the same or previous fiscal year; or
  • IMPORTANT: When a KZ diary resets, do not re-develop or clear the subsequent KZ diary if it was correctly developed and documented in the claims path. Enter Remarks (RMKS) on the SSR and document MSSICS via a DROC to assist in identifying these cases. If the reset diary is associated with a pending RZ or LI profiled for a reason other than the reset KZ diary, clear the KZ diary to complete the pending RZ or LI. Document the DDKZ screen with the following file documentation remarks, “Reset KZ Diary Previously Developed and Documented.” To identify reset diaries, look for limited issues profiled solely on a KZ diary.
  • MSSICS DDKZ screen completed in the same or previous fiscal year.
  • 6
  • If the field office uses specialization, follow up with the Title II adjudicator using local procedures to determine that the recipient has filed and is pursuing the claim. For more information on monitoring the compliance for filing for other benefits, see SI 00510.025.
  • Follow up with the Title II adjudicator using local procedures to determine that the recipient filed and is pursuing the claim if the field office uses specialization.
  • E. References
  • * SI 02302.010 1619 Policy Principles
  • * RS 00301.105 Fully Insured Status
  • * RS 00301.120 DIB Insured Status
  • * RS 00301.140 Special Insured Status for Disability Before Age 31
  • * SM 01501.250B Procedure for clearing diaries and alerts
  • * SI 00510.001C General exception to filing requirements
  • * GN 00201.005C Policy-Filing an application
  • * MSOM MSSICS 019.016 Retirement and Disability Entitlement (BSRD)
  • * MSOM MSSICS 019.017 Spouse, Widow, or Widower Entitlement (BSSW)
  • * MSOM MSSICS 019.018 Child’s Entitlement from Father (BSCF)
  • * MSOM MSSICS 019.019 Child’s Entitlement from Mother (BSCM)
  • * SI 00601.035 Adjudicating Title II When A Title XVI Application is Filed
  • * SI 02309.010B Requirement to take a Title II application
  • * GN 00204.009 Abbreviated Applications-Title II
  • * SI 02309.010A Introduction to the KZ diary process
  • * GN 01010.009 Certified and uncertified earnings records (e/r)
  • * RS 01404.003B Policy on wage development
  • * GN 00204.007C Policy for filing before entitlement or eligibility
  • * GN 00204.022 Explore Entitlement on Another Earnings Record or to Another Class of Benefits
  • * GN 00204.027 Title II Application Open Because of Title XVI Filing
  • * GN 00204.010 Protective Filing
  • * GN 00204.015 Title XVI Redeterminations (RZs) as Protective Filings for Title II Benefits
  • * GN 00204.007 Application Filing Date
  • * SI 00601.035C.4 Title XVI Claimant or (Proper Applicant on the Claimant’s Behalf) Does Not File a Separate Title II Application
  • * SI 00510.001 Overview of the Filing for Other Program Benefits Requirement through SI 00510.030 Exhibit of the SSA-L-8050-U3 (SSI Claim Information Notice)
  • * SI 02301.235 Failure to Provide Information (N20)
  • * SM 10802.130 Description of Payment Status Codes (SSR)
  • * SM 01305.240 Frequency Code of R
  • * MSOM INTRANETSSI 014.044 Social Security Benefit
  • * SI 02309.010B.1 Requirement to take a Title II application
  • * SI 00510.025 Monitoring and Determinations of Compliance - Filing for Other Benefits
  • For more information on monitoring the compliance for filing for other benefits, see SI 00510.025.
The materials available at this web site are provided free of charge, for informational purposes only, and without warrant by True Link Financial, Inc., and are not legal advice or Social Security benefits advice. You should contact your attorney to obtain advice with respect to any particular issue or problem, or the Social Security Administration with any general inquiries. Click here to view this section of the POMS on the Social Security Administration website.