POMS Reference

VB 00901: Adjudication Policy

TN 1 (10-00)

A. Policy -- Processing Responsibilities

1. Servicing Field Office (FO)

The servicing FO is responsible for maintaining and processing the SVB claim of an individual who files for SVB in the United States.

2. Central Processing Site (CPS)

The central processing site is responsible for all applications filed outside the United States, including Puerto Rico and the U.S. Virgin Islands. They are also responsible for all actions on the SVB claim once the claimant has left the United States and established foreign residency.

3. Federal Benefits Unit (FBU)

FBUs assist in the development of claims and the evaluation of evidence. The Regional Federal Benefits Officer (RFBO) in Manila, Philippines has the authority to issue formal denials of SVB claims.

B. Procedure

1. Servicing Field Office

If the claimant is in the U.S., the servicing FO has responsibility for actions on the claim. The FO:

  • Obtains the application and collects evidence in file to support the determination of qualification for SVB.

  • May take representative payee action, if necessary (see VB 00501.010)

  • Makes the determination of qualification for SVB.

  • Prepares the appropriate manual notices (see VB 05001.001).

  • Controls the SVB case for 4 months after the month the qualification notice is dated for receipt of evidence of foreign residency (see VB 00205.115).

  • Advises the claimant to tell the FO when he or she is leaving or plans to leave the United States.

  • Advises the claimant to contact the nearest Social Security office, or FBU as soon as the claimant establishes residency outside the U.S. and provide evidence of foreign residency. (VB 00101.001).

  • Posts to the SSR any necessary input to suspend benefits if the individual is receiving SSI and is leaving the United States (see SI 02301.225).

  • Posts SVB information to the Intranet site (see Intranet site instructions).

  • Maintains jurisdiction of the SVB claims file until the claimant establishes foreign residency and proof of foreign residency is sent to the FO from FBUs or SSA FOs in Puerto Rico and the U.S. Virgin Islands.

  • Transfers SVB file to the appropriate CPS after receipt of the proof of foreign residency (even if other development is outstanding).

If for some reason evidence of foreign residency is sent to a CPS instead of the servicing FO, the CPS should request the claims file from the FO for necessary action on the claim.

2. Central Processing Site

  • If the claimant is outside the United States, the CPS has responsibility for actions on the claim. The CPS:

  • Receives SVB claims file from the servicing field office once the FO receives evidence of foreign residency.

  • Evaluates evidence of foreign residency and takes appropriate action to award or deny the claim for SVB benefits. CPS is also responsible for making the necessary systems input (see VB 04001.001).

  • Obtains the application and collects evidence in file to support the determination of qualification to SVB.

  • Makes the determination for qualification for SVB.

  • Initiates foreign development when needed.

  • Prepares and issues the award or denial notice (see VB 05001.001).

  • Closes out protective filings and the title II and/or the title XVI aspects of the title VIII claim, as appropriate by issuing proper notice (VB 00201.035 and VB 05001.001) (if the FO has not already done so.)

  • Appoints payee and issues proper notices, if necessary (see VB 00501.010).

  • Computes and makes benefit payments for the title VIII claim.

  • Posts SVB information to the Intranet Site. (See Intranet site instructions.)

  • Maintains permanent jurisdiction of the SVB folder for subsequent actions, i.e., appeals, redeterminations, suspension, and termination.

3. Federal Benefits Unit (FBU) Responsibility

FBUs do not have the authority to make formal determinations nor can they adjudicate claims. However, they can perform the following services:

  • Take and develop applications including the necessary development and the investigation and send to FO or Central Processing Site.

  • Develop and report PE events affecting the suspense, reinstatement and termination of benefits.

  • Make payee recommendations.

  • Handle requests for assistance from SSA offices in the U.S.

The RFBO in Manila, Philippines, only, may issue formal denials of SVB claims, along with the appropriate notice.

C. References

Role of FSPs Process, GN 00307.005

Determining Servicing Office, GN 00904.010

FSPs Trained in Claims-Taking and Development, GN 00904.225

Requesting Assistance from FSP Personnel Abroad, GN 00904.230

Function of the SSA Division in FSP, Manila-Background, GN 00905.350

Previous:
Up:
VB 009: Adjudication
Next: