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NL: Notices, Letters and Paragraphs

Effective Dates: 09/17/2012 - Present

TN 9 (08-95)

A. Background

Prior to mid-July 1992, the system was issuing a variety of PE notices from SD records going to first recurring payment. In fact, the system "suppression" meant only that the system would issue a PE notice, even if the SD record was an IC.

Beginning July 1992, the system was changed to correctly suppress these notices, up to and including the notice of first payment on a start date record.

B. Process — Notice Issuance

1. Systems Suppression of SD

The system suppresses notices in SD cases until after the system makes the first regular SD payment, or makes the decision of ineligibility for payment.

NOTE: Regular SD payment means a systems- generated payment which is not one of the following: an Immediate Payment (IP), Emergency Advance Payment (EAP), Manual or Automated One-Time Payment (MOTP or AOTP), or Presumptive Disability or Blindness (PD/PB) Payment.

2. List of Exceptions

  1. The system issues correct notices in three situations, as follows:

    • Presumptive disability/blindness payments (PD/PB) begin, change or end because the 6 months is over;

    • The Master Beneficiary Record (MBR) interface causes regular payments to begin, or causes the case to compute to ineligibility due to income (NO1); or,

    • An interim assistance reimbursement (IAR) notice is due to the State (on an SSA-L8l65-U2, SSI Notice of Decision, or SSA-L8125, SSI Notice of Interim Assistance).

  2. The system issues incorrect PE notices when the SD record changes from PD/PB payments to a decision of ineligibility for all months on the SD record (a medical or non-medical denial). The FO suppresses this notice per D.2. below.

RATIONALE: Automated PD/PB and IAR notices will continue to be generated since the system can send the correct notice. The system will also issue notices when payment is triggered by an MBR interface since the field does not get an alert and would not know that the case has been paid and that a notice is needed.

3. DDS Process

The DDS checks the Remarks field of the SSA-831-U3 for the FO annotation that a case is an SD record. (See DI 11055.130 concerning the FOs annotation.) When the DDS allows an SD case, it will alert the FO via route slip to send a manual notice.

When the DDS denies most SD cases, the DDS sends the disability denial notice, and no notice suppression is necessary. But when the DDS denies an SD case that has had PD/PB payments, it inputs notice suppression along with the final denial input.

C. Process — Notice History

Prior to July 1992, the system posted “0002” in the NOTC field of SD records to indicate notice suppression (see SM 01601.670C). However, the notice was not suppressed, and the system posted the form and paragraph numbers of the PE notice issued.

Effective July 1992, the system continues to post “0002” in the NOTC field from the time an SD record is created. In addition, each time the system suppresses a notice that would otherwise have been issued from the SD record, the system also posts “0004” in NOTC. There may be multiple entries of “0004” if the FO has made inputs that affect the record and would otherwise result in a PE notice before the first regular payment or final denial is made on the record. (See D.1.d. below).

D. Procedure

1. Manual Notice — No Suppression Needed

Issue a manual notice in the following SD record situations for which notice suppression is now automatic:

  1. SD record is going from no regular payment (on the SD record) to a regular systems-generated payment on the SD record.

    NOTE: The payment may be a payment for any retroactive month, and/or the current computational month. IP, EAP, ATOP, MOTP, and PD/PB payments may have already been made on the record. The system will still suppress the first notice about a regular systems payment.

    (The system will issue notices of PD/PB; see B.2. above. Issue manual notices for any IP, EAP, AOTP or MOTP payments.)

    Usually in SD cases you must send a notice even if there is no change in payment between the payments on the old and new records. For example, case composition changes require an SSA- L8166-U2, SSI Important Information, even if the change does not affect payment.

  2. An SD record with presumptive payments receives a final allowance decision and regular payments will begin.

  3. A non-medical denial (for all months) on the SD if no PD/PB payments have been made on this record.

  4. PE information is posted to an SD record on which no PD/PB or regular payment has been made, and the information will not cause the case to go to payment (but is information which in a non-SD record would cause the system to generate a PE notice).

    For example, send a manual notice in a PE case (before first payment on an SD record) if you are:

    • posting a waiver decision;

    • changing information such as the State of residence, representative payee data, or direct deposit data; or

    • making other changes which would otherwise result in a systems- generated Notice of Important Information.

    EXCEPTION: This is not necessary on an IC case. In IC, wait and include all the above facts on the manual award notice when the case finally goes to payment.

2. Mandatory Suppression of PD/PB Denials

Take the following steps to post a non-disability denial for a PD/PB SD case:

  1. Input notice suppression on the SSA-1719B the same time you make the denial input;

    OR,

    On an SSA-450, PR9 input, change the onset type to “X” at the same time you make the denial input.

    NOTE: If the onset type code is changed from “P” to “X” , the system will automatically suppress the notice.

  2. Send a manual nonmedical denial notice for technical denials. (The DDS will send the denial notice on medical denials.)

NOTE: Do not input notice suppression on a PR9 input. These inputs will reject in an SD case.

3. Optional Suppression of PD/PB Notices

To suppress a PD/PB notice in an SD case, input notice suppression on an SSA-1719B with the input which causes the PD/PB payments to begin or change.

NOTE: You cannot input notice suppression via a PR9 input on an SD record; it results in a reject.

4. Couples Records

If one member of a couple is in payment first and the other member of the couple becomes eligible, then:

  • Input notice suppression; and

  • Issue a manual award notice to the member of the couple becoming eligible, and issue a manual posteligibility notice to the other member of the couple.

(See SSA-L8151 notice suppression instructions in SM 01301.675A.1. or SSA- L8155 notice suppression via DPD fields in SM 01305.515C)

NOTE: The system will issue an incorrect PE notice to the couple if these steps are not taken.

E. References

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