SI 02301: Posteligibility Changes
TN 18 (10-98)
A. Introduction
In most cases, the system will continue to pay the PPL on a record when the recipient appeals in the 10-day period after rceiving an advance notice and the FO promptly inputs rquired DPD entries including a GK status code of P. However, there are situations which require FOs to change the PPL on a record and issue a manual notice.
CAUTION: This section explains in general how to pay the PPL in the most common appeal situations where the system has processed an adverse action to a record. Detailed systems instructions on providing payment continuation in various appeal situations are in SM 01305.555.
B. Procedure
When a recipient appeals an adverse action processed to his or her record and qualifies for payment continuation, use the chart below to decide:
when to pay the PPL on the record,
when to manually recompute the PPL and input to pay a new PPL, and
when and how to issue a manual notice.
REMINDER: The PPL and other DPD entries displayed in the DUPR segment enable the system to pay continuing benefits at the PPL. The system posts the PPL when it processes an adverse action and issues an automated GK notice. FOs input the PPL with an adverse action that requires a manual GK notice.
| If... | then... | and send... |
|---|---|---|
|
the adverse action is due to a single change the adverse action is due to multiple changesandrecipient does not request payment based on changes not under appeal* the recipient requests payment continuation after waiving it |
pay the PPL on the record including any past benefits due based on the PPL NOTE: For eligible couples, pay the PPL couples, pay the PPL to both or reduced benefits only to a member who requests it. |
|
|
the adverse action is due to multiple changesandrecipient requests payment based on changes not under appeal* |
recompute the PPL using only changes not under appeal, input those changes with the new PPL. Pay the new PPL including any past benefits due based on the new PPL |
no manual notice (the system will issue an SSA-L8165 with no appeal rights). |
|
the recipient requests a reduced payment and disagrees with the amount or reconsiders and requests unreduced benefits based on the original PPL |
input and pay the original PPL including any past benefits due based on the original PPL (subject to subsequent changes, see SI 02301.325) |
|
*REMINDER: A recipient must on his or her own initiative request a reduction in the PPL based on changes that are not under appeal. See instructions in SI 02301.310B, on explaining payment continuation.
C. Process
FOs input the required DPD entries explained in SM 01305.555 to pay continuing benefits at the PPL. To pay past benefits due based on the PPL, FOs must use OTP procedures explained in SM 01901.001. This chart describes the process based on systems cutoffs:
| When inputting the GK data... | then the system will pay the PPL starting... | and the FO must pay... |
|---|---|---|
| the first day of the month through the recurring cutoff | the following month in a first-of-the month payment (recurring payment) | by A-OTP any benefits due for past months based on the PPL. |
| after the recurring cutoff through the supplemental tape (or A-OTP) cutoff * | the following month in a supplemental payment |
|
| REMINDER: Supplemental payments are dated the first-of-the month. | ||
| after the supplemental tape (or A-OTP) cutoff* | the month after the following month | by M-OTP any increase due for the following month |
|
PLUS any benefits due for past months based on the PPL. NOTE: FOs may use an A-OTP when it might pay faster than an M-OTP because of a reject, nonreceipt, returned check or input at the end of the month to pay the PPL. |
*The supplemental tape cutoff and the A-OTP cutoff usually occur on the same day around the 22nd of each month. After this day, the system processes an A-OTP input, but the payment is not issued until the beginning of the following month. An M-OTP occurs “outside” the system and is the only way to issue a payment after the supplemental cutoff and by the next regular monthly payment.
D. References
Computation of Payments, SI 02005.001
Processing Returned Checks during Payment Continuation, SM 01305.650
OTP Procedures, SM 01901.001