BASIC (01-02)

A. Process

SSA must make every reasonable effort to obtain evidence needed to determine an individual's continuing SVB qualification and entitlement, and/or to verify that SVB is being paid in the correct amount. The process is:

• Provide an initial written request for information/evidence;

• Provide a follow-up request;

• Exhaust all reasonable efforts to obtain the information when an individual fails to comply with the above requests;

• Document all efforts undertaken; and

• Suspend benefits.

Apply the claims development guidelines in VB 00210.001C. to determine the servicing office for SVB development purposes. Generally, the CPS will be the servicing office if development is undertaken via direct mail with an individual who is outside the United States. When a CPS requests assistance from another SSA office in obtaining evidence/information, the assisting office is the servicing office. For example, when the CPS requests the FBU to obtain evidence from an SVB recipient in the Philippines, the servicing office is the FBU.

SVB can be suspended for failure to provide information only after all development efforts have been exhausted (as discussed in VB 01503.210) and documented (as discussed in VB 01503.215). Only the CPS having SVB jurisdiction will input N20 suspensions. If the servicing office is not the CPS having SVB jurisdiction, all development efforts and documentation are to be faxed and then mailed to the CPS.

B. Procedure — Initial Written Request by Servicing Office

1. General

Prepare a notice to the recipient to:

• Advise him or her of the evidence/information being requested and his or her responsibility to provide it;

• Provide the date by which SSA must receive a response to the request in order to avoid SVB suspension;

• Offer assistance in obtaining the evidence/information; and

• Encourage him or her to contact SSA if he or she needs more time to comply with the request.

Date the notice the date it is mailed or handed to the individual.

2. Addressee In the United States

• Provide the individual with 30 calendar days from the date of the request to comply; and

• Prepare an MDW diary to follow-up in 15 calendar days.

3. Addressee Outside the United States

• Provide 45 calendar days from the date of the request to comply (to allow for foreign mail delivery in addition to the 30 calendar days to comply with the request); and

• Prepare an MDW diary to follow-up in 30 calendar days.

C. Procedure — Follow-Up Request by Servicing Office

If no response is received to the initial written request by the close of the MDW diary period, send a follow-up request. The follow-up request will duplicate the information provided in the initial request. Tickle an additional 15 calendar days (whether the addressee is in or outside the United States).

NOTE: If the servicing office is not the CPS having SVB jurisdiction, fax and then mail documentation of all efforts undertaken to obtain the information/evidence (i.e., the statement described in VB 01503.215B.) to the CPS having SVB jurisdiction.

D. Procedure — CPS

If a response is not received from the addressee by the close of the 15-day MDW extension, and all reasonable efforts to obtain the evidence/information have been undertaken per VB 01503.210 and documented per VB 01503.215, input the N20 suspension. Prepare and send a manual Notice of Planned Action explaining:

• The basis for the adverse action;

• How the failure to comply with requests to provide evidence/information will affect SVB payments and/or entitlement;

• The individual has 60 days to appeal the action taken;

• How to file an appeal; and

• SVB will continue uninterrupted and at the same amount until a decision is made at the first appeal level if the individual files an appeal within 10 days after receiving the Notice of Planned Action.

NOTE: Presumption of receipt of the above notice within 5 days of the date on the notice, as explained in SI 02301.300E.5., will NOT apply when the notice is being sent to an individual outside the United States. Allow 2 weeks for foreign mail delivery PLUS the 10-day Goldberg/Kelly due process period. If necessary, adjust the DPD accordingly to avoid the system suspending SVB prematurely. (If the notice is handed to the individual or mailed to a U.S. address, use the timeframes in SI 02301.310C.2. and SI 02301.310C.3. for determining when the Goldberg/Kelly due process period ends.)

Update the following information to the SVB Intranet site:

• The effective date of the suspension;

• The reason for the suspension;

• The date the Notice of Planned Action is mailed or given to the beneficiary; and

• The Goldberg/Kelly due process expiration date.

If an appeal is filed, follow VB 02501.045. (NOTE: If the appeal is filed in an SSA office not having SVB jurisdiction, fax and then mail the written appeal request to the CPS having jurisdiction of the SVB claim.)