TN 10 (09-21)

RM 03844.045 Processing Coverage Cases

1. A. 

   Determine if the FO development is complete.

2. B. 

   Refer to RM 03856. and RS 01901. for information concerning coverage issues.

3. C. 

   If further development of the coverage issue appears to be necessary, check the employer precedent card file and handle as follows:

   1. 1. 

      If the employer submitted the required information on the precedent case, do not request further development of the coverage issue.

   2. 2. 

      If there is no precedent case in file, or if a precedent case is in file but it does not resolve the problem in the current case, return the case to the FO for additional investigation of the coverage issue, and any required “wage” development.

   3. 3. 

      If the question involves an employer whose status may have been ruled on by the Railroad Retirement Board (RRB):

      1. a. 

         Consult the RRB Employer Status List (located in the “Reference Room” ) for employers whose status had been determined by RRB but the HHS General Counsel disagrees with or questions the ruling,

      2. b. 

         Request any necessary supplemental information in this respect from ORSI by preparing a Form SSA-4597 U3, Record of Material Referred To.

4. D. 

   If it can be determined that the earnings are covered:

   1. 1. 

      Document the file to show that the employment is covered.

   2. 2. 

      Take any necessary corrective action.

   3. 3. 

      If applicable, prepare any necessary coverage or wage issue determination per RM 03844.060

   4. 4. 

      Prepare a closeout letter

   5. 5. 

      Close the case on the electronic control system.

5. E. 

   If it can be determined that the earnings are not covered and:

   1. 1. 

      An individual earnings record is to be adjusted

      1. a. 

         Prepare a Form SSA-7010 U5 to remove the noncovered earnings for periods not barred to correction.

      2. b. 

         Prepare a closeout letter.

      3. c. 

         Close the case on the electronic control system.

   2. 2. 

      A portion or all of an employer report is to be cancelled:

      1. a. 

         Prepare the appropriate interoffice adjustment per RM 02260 or RM 02261 to cancel an entire wage report, or a portion of a wage report.

      2. b. 

         If applicable, prepare any necessary coverage or wage issue determination per RM 03844.060.

      3. c. 

         Prepare a Form SSA-7010 U5 to notify IRS of the cancellation. Complete the form with the following exceptions:

         1. 1. 

            In item 4, enter “see items 11 and 13, below.”

         2. 2. 

            In item 11, enter the period to be corrected in 11(a), the total amount of wages in 11(d) and “none” in 11(e).

         3. 3. 

            In item 13, enter the reason for the cancellation, the number of employees, and whether the amount in block 11 represents the entire amount of the report or the sum of a portion of the report. Also indicate that we do not need an adjustment report from IRS because our records have been adjusted.

      4. d. 

         Forward the designated copy to IRS, retain the file copy in the employer ED folder and destroy all other copies.

      5. e. 

         Prepare a closeout letter to the individual per RM 03803.071. Also prepare a letter to the employer if the FO has not already advised the employer.

      6. f. 

         Close the case on the electronic control system.

6. F. 

   If FO development cannot determine that the item constitutes wages and:

   1. 1. 

      The amount is sufficient to credit a quarter of coverage for the period in question, return the case to the FO for a determination per RM 03803.055.

   2. 2. 

      The amount is less than that needed to credit a quarter of coverage and the item is posted to the correct SSN:

      1. a. 

         Do not request FO redevelopment unless the case is being returned for some other reason.

      2. b. 

         Do not prepare a SSA-7010 U5 to remove the earnings.

      3. c. 

         Prepare a closeout letter.

      4. d. 

         Close the case on the electronic control system.

   3. 3. 

      If the amount is less than that needed to credit a quarter of coverage and the item is in suspense:

      1. a. 

         Do not request FO redevelopment unless the case is being returned for some other reason.

      2. b. 

         Reinstate the item only if the correct SSN is known.

      3. c. 

         Prepare a closeout letter.

      4. d. 

         Close the case on the electronic control system.

7. G. 

   If FO development cannot resolve the coverage issue, forward the case to the Office of Retirement and Survivors Insurance per RM 03844.047.