TN 24 (10-04)

A. Introduction

Correcting benefits on time requires an understanding of systems GK processing, system cutoffs dates and when the FO must suppress an automated GK notice and issue a manual or online GK notice to reduce or stop the following month's benefit.

B. Process - Systems GK Processing

This section gives an overview of how the system identifies and processes an adverse action. (See SI 02301.301E. for examples. See detailed systems instructions in SM 01305.500.)

1. System Identifies an Adverse Action

The system identifies an incoming change as an adverse action when the new monthly benefit amount due is less than the amount due in the last regular first-of-the-month payment(s). (See SM 01701.010 about payment tapes and systems computation periods.)

NOTE - SYSTEMS LIMITATION: The system is unable to consider certain underpayments (payment type codes 2 and 4) when comparing monthly benefit amounts. When the system cannot identify an adverse action due to an underpayment, FOs must input GK due process data (DPD) with the change, suppress the systems notice, and issue a manual GK notice. (See SM 01305.520B. on how to compute the monthly benefit amount.)

a. System Compares Benefit Amounts

The system compares benefit amounts for:

• incoming changes to records in C01, N01 for section 1619(b) eligibles, and

• records changing from S06, S07 and S08 to C01 or N01 through N54.

b. System Does Not Compare Benefits

The system does not compare benefit amounts for the following exceptions to GK procedures:

• records changing to S06, S07, S08, N19 and T01, and

• records changing from N19 to another payment status.

2. System Posts the Adverse Action Month

The system determines the month that it can actually reduce or stop a future month's benefit and posts it to the record.

3. System Issues the Automated GK Notice

For most adverse actions, the system issues an automated GK notice and:

• dates the notice 7 days after the notice run date, to allow for processing and mailing time and

• records the notice run date (not the notice date), the notice form, and the notice paragraph numbers or Universal Text Identifier (UTI) in the Notices Data (NOTC) segment on the SSR. For a description of the NOTC segment see SM 01601.670. and

• retains a copy of the notice on the online retrieval system (ORS).

4. System Issues an Online GK Notice during the GK Temporary Period

For most adverse actions processed through MSSICS during the GK temporary period, the system can issue an online GK notice when requested and:

• dates the notice the same day it is produced and puts the time (Eastern Standard) the notice was created in the upper right hand corner of the notice

• records the notice run date and time, the notice form (8155), and the notice paragraph numbers or UTIs in the Notices Data (NOTC) segment on the SSR

• records the notice indicator in the Notices Data (NOTC) segment of the SSR. OH indicates the notice was produced online and handed to the claimant. OM indicates the notice was produced online and mailed to the claimant.

• stores a copy of the notice on the online retrieval system (ORS).

For a more detailed description of the system’s process involved in the online GK notices, see SM 01305.510 through SM 01305.620.

5. System Posts GK Data (DPD Entries)

The system posts GK due process data (DPD) in the Due Process Data (DUPR) segment on the SSR when the Goldberg Kelly (DBGK) screen is completed in MSSICS and an online, manual, or overnight automated notice is selected. The DPD entries enable the system to pay future benefits at the PPL when a recipient appeals. The following are some of the DPD entries:

• The adverse action month (AVM)

• The new benefit amount (MBL) by separate Federal and State amounts

• The protected payment level (PPL) by separate Federal and State amounts

• The date the FO handed or mailed a manual GK notice

• The GK status code. For example, the FO inputs GK status code N for no appeal, P to place the record in protected payment status (pending appeal and payment continuation), and R for a rendered appeal decision and to remove protected payment status.

For a description of these data and other DPD entries displayed in the DUPR segment, see SM 01305.510.

6. Subsequent Incoming Change

When the system receives a subsequent incoming change and the DUPR segment shows:

a. No Appeal

The system compares the new benefit amount due with the MBL set by the last GK notice. If the new benefit is less than the MBL, the system recognizes the adverse action and issues an automated GK notice and posts the new MBL to the record. For adverse actions processed through MSSICS, the system will post the new MBL to the record and, if requested, produce an online GK notice.

b. Appeal and Payment Continuation

The system cannot identify the incoming change as an adverse action and reduce benefits. (The MBL entries change to 0s when a record goes into protected payment status.) For adverse actions, the FO must manually recompute the PPL, input the new PPL and issue a manual GK notice. See SI 02301.325 for instructions.

For a description of automated systems processing during payment continuation, see SM 01305.645.

C. Process - Systems Cutoffs

This section describes the monthly systems cutoffs to consider when inputting a change to reduce a future month's benefit. The cutoff dates vary each month and appear in a monthly systems processing schedule. See SM 01701.010 about payment tape cutoffs and computation periods for processing SSI records.

1. The GK Notice Cutoff

The GK notice cutoff occurs around the 7th to 9th day of each month. This is generally the last day that the FO can input a change to reduce the following month's benefit and have the system issue an automated GK notice. After this day, there is not enough time left to produce and mail an automated notice at least 15 days before the first day of the following month.

2. The GK Temporary Period

The GK temporary period begins the day after the GK cutoff and ends with the recurring tape cutoff. During this period, the system can reduce the following month's benefit only if a GK notice is issued timely and due process data (DPD) is entered. The system will build the required DPD entries for adverse actions processed through MSSICS. The advance GK notice can be produced online or manually. For adverse actions processed outside MSSICS, the FO inputs the GK status code and other DPD entries with the change and produces an online GK notice or issues a manual GK notice. If the DPD entries are not included with the 1719B transaction when issuing a manual notice, the system will issue an automated GK notice and reduce benefits for the month after the following month. See EXCEPTION.

EXCEPTION: When the FO inputs the changes to S06, S07, S08 or N19 on the SSI record, the system will stop the following month’s benefit and will issue the automated notice as long as the FO makes these inputs before the recurring payment tape (treasury) cutoff.

NOTE: The DPD entries are built automatically by the system when the adverse action is processed in MSSICS during the GK temporary period.

3. The Recurring Payment Tape (Treasury) Cutoff

The recurring cutoff date precedes the Treasury Check Generation Run which is processed on the third Saturday of each month. The Friday preceding the third Saturday of each month is the recurring payment tape (Treasury) cutoff date and occurs around the 15th to 21st day of the month. After this day, the system cannot reduce the following month's benefit.

For more information regarding the Recurring Payment Tape cutoff, see SM 01305.515A.

NOTE: In order for claimants to receive due process, notices must be mailed at least 15 days prior to the end of the month. Notices can be handed to claimants 10 days prior to the end of the month and still meet the due process requirements required by law.

D. Procedure

1. Before Inputting an Adverse Action

Before inputting an adverse action to the SSR:

• Determine the effect of the change.

  REMINDER: Use the retrospective monthly accounting (RMA) rules in SI 02005.001 to compute payments and determine when to reduce a future month's benefit. Use the SSI eligibility rules to determine the effective month of a suspension, stop payment or termination event.

• If the adverse action is not being processed in MSSICS, make sure to check the systems processing schedule to find out the first month the system can actually reduce or stop benefits when the following month could result in an overpayment or N05, N19, N20, S06 or S08. If these adverse actions can be processed in MSSICS, the system will select the earliest month possible for reduction based on the notice type selected.

2. When Inputting an Adverse Action

When inputting an adverse action, follow systems input instructions in SM 01305.500 and

• Issue an online or manual GK notice for an input during the GK temporary period to reduce the following month’s benefit unless the input will change the record to S06, S07, S08 or N19. For these payment status codes (PSCs), the system will stop next month’s payment and issue an automated notice as long as the inputs are completed by the recurring payment tape cutoff date.

• Prepare a manual GK notice if the system cannot identify the adverse action due to an underpayment or if the action is being processed outside of MSSICS or if the system cannot issue the correct notice for the situation. See SI 02301.307 for a list of manual GK notice situations.

Be sure to input DPD entries when required during the GK temporary period to reduce the following month's benefit. Otherwise, the system will not reduce benefits until 2 months later.

E. Examples

1. Incoming Change/Adverse Action - System Sets MBL

Evelyn English's monthly benefit amount is $100. An incoming change in July 2004 results in a new benefit amount of $50 for September. The system identifies the change as an adverse action because the new amount of $50 is less than the last amount of $100.

The system processes the adverse action, issues an automated GK notice and posts the MBL of $50 to the record. The notice explains that the benefits will be reduced to $50 beginning in September.

Later in July 2004, Ms. English reports a subsequent change that again affects the September benefit. See the examples in SI 02301.301E.2. and SI 02301.301E.3.

2. Subsequent Change/Increase in Payment

Same as Example 1 (SI 02301.301E.1.) except that the FO inputs the subsequent change to the system on August 2, 2004. Ms. English's monthly payment of $100 will change to $75 beginning September. The system processes the change as an increase because the new amount of $75 is greater than the MBL of $50 set by the last GK notice. The system issues Form SSA-L8151 (Notice of Change in Payment) which explains the increase to $75 beginning September 2004.

3. Subsequent Change/Adverse Action - System Sets New MBL

Same as Example 1(SI 02301.301E.1.), except the subsequent incoming change to the system on August 2, 2004 results in a new benefit amount of $25 for September instead of the MBL of $50 set by the last GK notice. The system processes the change as an adverse action, issues an automated GK notice to reduce the September 2004 payment to $25 and posts the new MBL of $25 to the record.

4. Inputting Adverse Action During GK Temporary Period

During the systems GK temporary period in October 2004, Alvin Carr provides evidence of his wages for past months. The FO computes the effect of the wages on the following month's benefit amount and determines that a reduction is necessary. If the changes are processed through MSSICS, an online GK notice can be issued and the system will post the required DPD entries. Otherwise, the FO inputs the required DPD entries with the wages and issues a manual GK notice to reduce the November 2004 payment on time.

NOTE: If the wages did not reduce the benefit amount until December due to RMA, the FO would have input the wage changes through MSSICS or on a 1719B without DPD entries and the system would issue an automated GK notice to reduce the December 2004 payment.

5. Inputting Adverse Action During GK Temporary Period After Period of S06, S07 or S08

Sam Yoo's monthly SSI benefit amount is $446. His record goes to non-pay effective April 2005 for whereabouts unknown (S06). Mr. Yoo requests reinstatement in May. The FO determines that the correct monthly payment beginning in June is $297.34 due to the value of food and shelter Mr. Yoo began receiving 2 months before in April. During the GK temporary period in May, the FO should process the change through MSSICS and select the online or manual GK notice option on the DBGK screen in order to reinstate benefits and reduce the June 2005 payment to $297.34.

NOTE: If the FO did not select the online or manual GK notice option on the DBGK screen or if the FO input the changes after the GK temporary period, Mr. Yoo would have been overpaid for June 2005. The system would have paid $446 for June and issued an automated GK notice to reduce the July payment to $297.34.

6. Inputting Adverse Action During GK Temporary Period – Underpayment on SSR (payment type codes 2 or 4) – Manual Notice Required

During the systems GK temporary period in January 2005, Brooklyn Bryant provides evidence of her wages for past months. Her SSR already shows that an underpayment is due (payment type code 2). The FO determines that her benefits should be reduced. If the case is in MSSICS, the FO inputs the wages, selects the manual notice handed or manual notice mailed option (depending on if the notice will be handed or mailed) on the Goldberg Kelly (DBGK) screen, sends the information to the SSR so the system can build the DPD entries, and prepares and issues the manual GK notice. For cases processed outside MSSICS, the FO inputs the required DPD entries with the wages and prepares and issues a manual GK notice to reduce the February 2005 payment on time.

F. References

• Computation of Payments, SI 02005.001

• Goldberg/Kelly Procedures, SM 01305.500

• Description of Fields on the SSR, SM 01601.000

• Systems Payment Tape Cutoffs and Computation Periods, SM 01701.010