POMS Reference

RM 03803: General Instructions

TN 11 (09-87)

A. General

When preparing closeout letters in completed cases the response should always include:

  1. All information requested.

    Exceptions:

    When a request for an earnings statement is received, apply the instructions in P.2. below. If a letter is to be addressed to another agency, apply the instructions in C. below. If the EIN appears on the Employer Report Listings, apply the instructions in O. below.

  2. Information regarding any action taken to correct an individual's earnings record. Inform the individual that it may take up to 9 months for any adjusted items to be included in a summary statement of earnings. Also, assure the individual that these items are immediately available if a claim is filed.

  3. An explanation of why the previous statement did not include the alleged earnings (if applicable).

  4. Specific information per the instructions in C-W below.

  5. An appropriate lag paragraph (if applicable).

  6. A reconsideration paragraph.

    Exception:

    Request for withdrawal of an allegation. In this case, apply the instructions in RM 03849.001.

  7. An explanation of the statute of limitations for periods which cannot be corrected because the time limitations have expired (if applicable). Refer to the instructions in M. below.

B. No Letter Necessary

It is not necessary to prepare a letter to an individual if both of the following conditions are applicable:

  1. Individual has had no contact with SSA and is unaware that his/her record is incorrect, and

  2. MEF printout for the individual's record does not reflect that an earnings statement was sent which includes earnings being transferred from the record.

    Exception:

    If a scrambled wage case is involved apply the instructions in Q.1. below.

    If a letter is not prepared per the above instructions, annotate the related MEF printout “No letter sent”.

C. Another Government Agency Involved

If another government agency called the discrepancy to SSA's attention, apply the following instructions:

  1. Prepare a letter to the agency only if the file indicates a reply is expected.

  2. Include confidential information only if disclosure is authorized by the confidential information procedure in GN 03300ff.

  3. Supply information per applicable instructions in P. or Q. below. However, restrict the information to the minimum required to satisfy the expressed needs of the agency.

D. No Investigation Of An Allegation Is Initiated

If an investigation of the allegation is not initiated, take the following actions:

NOTE: This situation generally occurs when an allegation is in substantial agreement with the earnings record (per RM 03803.013.B.2.) and the time limitations have not expired.

  1. Furnish earnings information per P. below.

  2. Inform the individual that we have not conducted an investigation because of the small amount of earnings involved.

  3. Ask NH to submit evidence to substantiate the allegation if he/she is not satisfied with the status of his/her earnings record.

    Exception:

    Do not request evidence where the difference is less than the amount required for a quarter of coverage for the period in question.

  4. Where evidence has been requested, explain that it may be in the form of pay envelopes , copies of W-2's, receipts, personal records or signed statements of co-workers.

E. Allegation Exceeds The Maximum And Earnings Record Shows Maximum Or Over Maximum Earnings

Furnish the following applicable information:

  1. Adjustments made to the earnings record on the basis of the allegation:

    1. Furnish earnings information per P. below.

    2. Explain the maximum for the years involved.

  2. No adjustments made on the basis of the allegation:

    1. Explain the maximum for the years involved.

    2. Do not provide itemization per P. below.

    3. Enclose any SSA-7014 C1 returned to SSA or request and forward a current one per.

      NOTE: Do not return mutilated forms. Obtain a typed copy.

F. SSN Is Unknown Or An Incorrect SSN Was Used

The following information should be provided in those cases where earnings are in suspense and/or adjustments are necessary to correct the record(s):

  1. Provide any information and/or itemization possible per the applicable instructions in this section.

  2. If an incorrect SSN was used, advise the individual of this fact.

  3. Prepare an extra copy of the closeout letter and forward it and a Form SS-5 to the individual along with the original of the closeout letter.

  4. Request the individual to take the following action:

    1. Write his/her social security number on the enclosed copy of the closeout letter, or

    2. If he/she does not have a social security number, complete the Form SS-5 and take it with a copy of the closeout letter to any field office to request that an SSN be issued.

  5. If SEI is involved, enter the taxable year and the master block unit and sequence number of the SE item or the IRS document locator number (whichever is applicable) of the SE item on the copy of the letter being sent to the individual.

G. Potential Claims Case

Furnish the following applicable information only for those cases which do not require referral to the DO per RM 03812.012 A and B:

  1. Furnish earnings information per P. or Q. below.

  2. Include in the letter a statement regarding the individual's insured status. If the individual is:

    1. Insured, also include a statement advising the individual that he/she is eligible to apply for social security benefits and may wish to contact the nearest social security office to discuss his/her eligibility.

    2. Not insured, also include a statement advising the individual that even though he/she does not yet have enough quarters of coverage to be eligible for benefits, his/her nearest social security office will be glad to discuss the requirement with him/her.

      NOTE: It will be necessary to request an SSA-7014C.1 before the information in G.2 above can be provided. Refer to H.2.a. below for a detailed explanation of this requirement.

H. Benefit Estimate Requested

If a benefit estimate is requested, take the following appropriate action:

  1. If FO has furnished the benefit estimate, disregard the request and prepare the letter per applicable instructions in this section.

  2. If FO has not furnished the benefit estimate, apply the following instructions:

    1. Request an updated SSA-7014 C1, Social Security Summary Statement of Earnings (if not previously associated with the case).

      NOTE: Accurate QC information must be provided to the FO for all benefit estimate cases. At the present time, the QC information displayed on the MEF or SSA-1826 printout is incomplete. Since the QC totals on an SSA-7014 C1 are accurate, the form must be requested to ensure that correct information is provided.

    2. Prepare an undated closeout letter disregarding the request for a benefit estimate.

    3. Furnish information per the applicable instructions in this section.

    4. Note the file copy of the closeout letter to show that the FO has been requested to furnish a benefit estimate and to give our letter to the individual.

    5. Prepare a copy of the incoming correspondence and the MEF or SSA-1826 printout.

    6. Correct the annual earnings totals and QC information on the summary earnings record portion of the MEF or SSA-1826 printout based on any additional amounts established based on evidence submitted, transferred, or reinstated.

    7. Place the summary earnings record portion in the front of the MEF or SSA-1826 printout.

    8. Forward the closeout letter, copy of the incoming correspondence, and the MEF or SSA-1826 printout to the servicing FO under cover of an OF-41 requesting that a benefit estimate be furnished, and that our letter be dated and given to the NH.

    9. Send the original of the incoming and the copy of the MEF or SSA-1826 printout together with the official file copy of our letter, to the files for 4-year filing.

I. Downward Adjustment

If a downward adjustment is being made and the closeout letter is being prepared during the year in which the time limitation for refund will expire, advise the individual that it is possible that the time limitation for refund may expire before the employer can take credit for the overpayment of FICA on a subsequent report. Therefore, the following action should be taken:

  1. Contact your employer for a refund.

  2. If your employer indicates that you will not be reimbursed before the time limitation expires, you should file a claim for refund directly with the Internal Revenue Service. (Enclose a Form 843, Claim-Internal Revenue Service.)

J. Individual Denies Employment And No Wages Are Posted For The ER Involved Take the following action:

NOTE: Usually the individual has received a notice of employment from a source other than SSA.

  1. Itemize and identify all amounts for the periods involved per P. or Q. below.

  2. Inform the individual that our records do not include wages from the employer.

  3. Return any W-2 or other evidence submitted.

  4. Refer the individual to IRS where he/she is concerned with income tax liability.

K. QC Data Questioned

If an individual questions the accuracy of QC data previously furnished, take the following appropriate action:

NOTE: Only the OAR-7014 C1 can be relied upon to reflect an accurate QC total. For 1951 through 1977, the MEF printout will not reflect gift QC's. Also, SE QC's and AG QC's will not be included in the total QC field for years prior to 1978.

  1. If not fully insured and the:

    1. Data previously furnished were incorrect, include a paragraph giving the correct QC data.

    2. Data previously furnished were correct, include breakdown of the earnings and QC's credited for each year.

  2. If fully insured, explain fully insured status.

L. Employer Report In Process

If the employer report is in process but we are unable to determine if alleged earnings were reported correctly, furnish the individual with the following information:

  1. We are processing his/her employer's report.

  2. Give the date our records should reflect his/her correct earnings.

  3. Ask the individual to request a statement of earnings after the report should be posted.

M. Time Limitations Have Expired

If no exception to the statute of limitations exists and the individual's allegation is not in exact agreement with SSA's records, it will be necessary to provide an explanation of the statute of limitations. In the closeout letter, refer the individual to the employer and suggest the possibility of a correctional report.

N. Court Action Pending Or Possible Fraud Is Present

Refer the case to the module manager for a decision on action to be taken.

O. Employer Reporting Problem Case Involved

If the case involves a problem employer, take the following action:

  1. Prepare a special “Due To” closeout letter when one or more of the following conditions are present:

    1. The EIN of the employer involved in an allegation appears on Part I or Part III of the three-part Employer Reports Listings received from DEEA and the “Post Run” column contains either no entry or a date which has not been updated to the record, or,

    2. Correspondence is received with the case which indicates an employer reporting problem exists, or,

    3. Evidence for other employees of the same employer is received with the case.

  2. Complete the alleged discrepant year and name of employer blank spaces with the appropriate information.

  3. Complete the remaining blank spaces as follows:

    1. If the EIN appears on Part I or Part III of the Employer Reports Listings and the “Post Run” column is blank or not updated , enter “twelve months.”

    2. If the EIN appears on Part I or Part III of the Employer Reports Listings and the “Post Run” column contains a month and year, enter the month and year (shown on the listing).

    3. If the EIN does not appear on Part I or Part III of the listings but correspondence indicates an employer reporting problem or contains evidence for other employees of the same employer, enter “twelve months.”

P. Furnishing Earnings Information - No Scramble Involved

Furnish the following information:

  1. Furnish itemization of earnings for all discrepant employers and/or periods for which any of the following conditions apply.

    1. The individual alleged that earnings were discrepant.

    2. Earnings that were in the lag period at the time a prior statement of earnings (on which the allegation is based) was released but have subsequently been posted.

    3. Earnings have been established on the basis of evidence.

    4. Earnings have been transferred to or from the record.

    5. Earnings have been reinstated to the record.

  2. A statement of earnings will be provided to an individual upon request only if the information associated with the case indicates that the individual had not received a statement on which the current allegation of discrepancy is based. If a prior statement was furnished under this condition and a request for a revised statement is received from the individual, include the total(s) for the year(s) in question plus the grand total for all years combined in the closeout letter.

    NOTE: When corrections are made to an individual's record, subsequent closeout letters advise him/her to request a revised statement of earnings when the corrections have been processed. Conversely, if no corrections are made to the record, the prior statement would be correct except for any earnings subsequently posted in the lag period. Therefore, a new statement would not be provided under the above condition.

  3. If primary evidence is submitted, furnish earnings information per P.1. above. If any of the following conditions exist, take the additional action noted:

    1. If evidence is for the exact amount claimed and the earnings information is to be used in connection with a claim for unemployment benefits, itemize all the earnings that are available for the last 2 pre-lag years . Also, advise the individual that the amounts may not agree with the amounts recorded with the State Unemployment Agency. Explain that some State unemployment compensation requirements for reporting earnings differ from those provided by the Social Security Act.

    2. If evidence is not in substantial or exact agreement and the individual accepted the amount shown on the evidence, include in the letter a reference to the individual's acceptance.

    3. If evidence is for an amount in excess of maximum for the years involved, include an appropriate paragraph informing the individual of the maximum provisions.

  4. If secondary evidence is submitted, furnish earnings information per P.1. and P.2. above. If any of the following conditions exist, furnish the additional information noted:

    1. If earnings are established for an amount smaller than the amount claimed, inform the individual that the additional earnings claimed cannot be credited because the evidence is insufficient.

    2. If earnings cannot be established on the basis of the evidence submitted, itemize the employment investigated and inform the individual that the evidence is insufficient to substantiate his/her claim of earnings from (employer) during (year).

Q. Furnishing Earnings Information - Scrambled Wages Are Involved

Apply the instructions in A-O and R-W of this section with the following exceptions:

  1. If the MEF printout, for the wrong number used, shows an earnings statement was sent that included earnings being transferred from the record, prepare a letter to both individuals. Furnish itemized earnings to both individuals per Q.2. below.

    NOTE: It is necessary to write to both individuals because they both used the SSN and there is no way of knowing which one received the erroneous earnings statement.

  2. Furnish itemized earnings for all employers and total yearly earnings for each year beginning with the earliest year investigated through the lag year.

  3. A statement of earnings will be provided to an individual upon request only if the information associated with the case indicates that the individual had not received a statement on which the current allegation of discrepancy is based. If a statement is to be provided, include total earnings for all years up to the first year investigated. Beginning with the first year investigated through the current year, furnish earnings information per P.2. above.

  4. Apply the rules for primary, secondary or no evidence submitted per P.2.-4. above with the exception that earnings information will always be provided per Q.2. above.

  5. If an individual disclaimed earnings that are not being removed from the record (conditions in RM 03816.016 B.6.a-d are not met), inform the individual that SSA cannot remove earnings reported with his/her name and SSN without evidence. Explain that the evidence can be a tax return with W-2's for the year(s) in question showing that the disclaimed earnings were not reported.

R. Self-Employment Case

Provide information per the applicable instructions in this section with the following exceptions:

  1. Where necessary, explain the changes in the law regarding non-coverage for some years, and coverage for other years for the same type of self-employment.

  2. Where earnings have been adjusted:

    1. Explain that IRS is being informed of the determination we have made.

    2. Indicate that IRS will make any appropriate tax adjustment.

  3. When the individual is being informed that he/she has 6 months in which to file an amended or original self-employment report:

    1. Prepare an extra copy of the letter.

    2. Retain such extra copies in a special file for further processing per RM 03846.013.

  4. If SEI has been rounded to the next higher dollar:

    1. Inform the individual of the exact amount SSA has determined his/her SEI to be (i.e., the amount shown in item 9(b) of the form SSA-7000 U5).

    2. Make no mention that SEI is raised to the next higher dollar unless the individual questions the difference between the amount reported and the amount on his/her record, or there is some particular reason why it is necessary to mention the change in SSA's accounting system eliminating the cents and raising the reported amount.

    3. If the conditions in 4.b above are applicable, include an explanation of the difference in the letter.

    4. Explain the reason for any adjustment.

      Caution: The letter must be carefully worded so that the individual is not told that he/she reported the amount of SEI that had been posted to his/her earnings record before SSA made the adjustment (i.e., the amount in item 9(c) of the Form SSA-7000 U5).

S. Informational Copies

If informational copies are necessary, take the following appropriate action:

  1. Where VARO, Philippines conducted part or all of the investigation, prepare a copy of the closeout letter for the Manager, VA Regional Office, SSA Section, San Francisco, California APO 96528.

  2. Where the file reflects attorney involvement, be sure to send the attorney a copy of any notice sent to his/her client.

T. Form SSA-L573

Since a recon paragraph is required in all replies to individuals disagreeing with their earnings record, except for stall letters, status replies, and notices about lag earnings, the SSA-L573 can be utilized for replies in lieu of a dictated letter. The SSA-L573 contains the following information:

  1. Reconsideration paragraph (RM 03803.071.A6)

  2. Lag paragraph (RM 03803.071A.5)

  3. Nine-month adjustment paragraph (RM 03803.071A.2)

  4. Maximum paragraph (RM 03803.071E), and

  5. Time limit paragraph (RM 03803.071A.7)

U. Form SSA-L1094, Letter Enclosing Form SSA-1826

Use this form letter when no earnings are being adjusted and all alleged earnings are included on an SSA-1826.

V. Dictated Letter

Prepare a dictated letter when there is no appropriate form letter to use. Be sure the letter includes all necessary information.

W. Returning Evidence To The Individual

The following types of evidence should be returned to the individual:

  1. Any employee records which appear to be of value, such as account books, time books, or piecework books.

  2. Any evidence specially requested by the individual.

    NOTE: When evidence is returned to the individual, be sure to obtain photocopies of the evidence or the pertinent portions of such evidence for retention in the folder.