POMS Reference

HI 01120: New Initial Determinations Using Beneficiary Information

TN 3 (02-09)

A. Policy

B. Procedure

A. Policy

  1. Beneficiaries may update their estimates as often as necessary.

  2. Beneficiaries who provide estimates are requested to bring in their signed copy of their tax return once it has been filed with the IRS.

  3. SSA will not accept an updated estimate of MAGI that could result in a higher IRMAA than SSA originally imposed using IRS tax data for the year. (“Estimates” do not include amended returns or corrected tax information.)

NOTE: If a tax year is being used for more than one premium year, only one input is necessary.

B. Procedure

If

Then

The beneficiary states he wants to change the estimate that he provided previously for an LCE or provides the filed tax return for a previously made estimate.

  • Access the IRMAA screens (See MSOM T2PE 008.001 through MSOM T2PE 008.019)

  • On the IRMN screen

    • Enter the Beneficiary's Own SSN.

    • In the “Select the Desired Option” field select “1” Establish

    • Input the premium year that the new initial determination request is for.

    • In the “Select the Desired Function” field select “2” Tax Information

    • Input the Tax Year the beneficiary is updating

    • Press Enter

  • The PYTY screen will appear because there is data on file for the tax year requested and it is displayed under the Highest Probative Value Data Field. (For an explanation of Highest Probative see MSOM T2PE 008.019.)

    • Select “2” New Tax Data. The system will process the determination using the updated tax information provided as long as the value of the data is of equal or higher value than the information on file.

  • Press Enter.

    • On the IRMA screen

  • Input the beneficiary's adjusted gross income and tax exempt interest for the updated tax year.

  • On the “Select Type” field select the appropriate tax source based on the information provided by the beneficiary. See MSOM T2PE 008.005.

  • On the “Select Filing Status” field enter the appropriate filing status for the beneficiary.

  • Show Proof as “1” Proven

  • Press Enter.

The IRRE Screen will display the current and recalculated IRMAA data. The “New Determination Results” field will provide the determination based on the information entered.

NOTE: If an updated estimate would result in IRMAA higher than what was or would have been imposed using the original IRS data, the system will process a dismissal and use the original IRS data

  • Record the evidence provided, if any, on the EVID screen in Shared Processes (See GN 00301.286 through GN 00301.300 and MSOM EVID 001.003).

NOTE: The IRMN Screen will display an alert to go to the EVID screen to document proofs submitted for the event reported. Pressing any “PF” key or the “Enter” key from the IRMN screen, will take you to the Shared Processes Menu.