Effective Dates: 11/19/2009 - Present Previous | Next

TN 2 (11-09)

GN 01050.056 Processing Center (PC) Effectuation of Favorable Office of Hearings Operations (OHO) Title II Dual Entitlement Cases

A. Introduction to handling OHO favorable Title II dual entitlement actions

This section provides instructions to Processing Center (PC) personnel on handling OHO favorable Title II dual entitlement actions that are routed to different PCs for effectuation and adjudication.

B. Background on processing dually entitled paper and fully electronic disability claims

Dual entitlement claims (paper and electronic) are currently split by OHO and sent to the PC of jurisdiction, as reflected in the OHO Case Processing Management System (CPMS), for each claim. The instructions given below should be followed when OHO issues hearing decisions on dual entitlement claims and sends the claims to separate PCs. There is no need to send the paper folder to the other PC unless the technician in that PC requests it.

C. Fully electronic and paper claim process on a favorable OHO reversal

When a simultaneous favorable OHO reversal is reflected on CPMS, the following rules are applicable.

Case routing for dual entitlement claims

ODO receives dual entitlement claims where the primary account claimant is under age 53 and 9 months.

PSC 1 through 6 will receive dual entitlement claims where the primary account claimant is age 53 and 9 months or older.

Any claim that has a beneficiary with a foreign address must be routed to OEIO for processing.

1. OCO (ODO/OIO) contact information for PSC 1 through 6

If the primary account is in PSC1 through 6 and the secondary account is in OCO, the PSC technician coordinates the processing of the claim with OCO, by phoning the module technician using the numbers listed in DOORS. If the module technician is not available, leave a detailed message on the answering machine. If the call is not returned within 3 working days, phone the appropriate Deputy Module Manager (DMM) or Module Manager (MM).

In instances when this coordination is not successful or timely, the PSC technician should contact the OCO Operations Support Branch (OSB) ALJ Analyst via email. The ALJ Analyst can be located by clicking on the Office of Disability Operations webpage, selecting ODO Components, clicking on the Operations Support Branch link and selecting Projects.

2. PSC 1 through 6 contact information for OCO

If the primary account is in OCO and the secondary account is in PSC 1 through 6, the OCO technician contacts the PSC contacts listed below to coordinate the processing of the claim in the PSC.

PSC1 through 6 technicians will also phone the OCO technician if the secondary account in PSC1 through 6 is ready to be adjudicated, but the status of the primary account is unknown, so that any overpayment can be avoided.

When the primary and secondary accounts are in two different PSCs, the PSC with the primary account phones the other PSC and coordinates the processing of the claim.

OCO technicians should use the following information to contact the PSCs:

  • •

    NEPSC - PSC 1 Contact

    Contact a manager of the PC1 module of jurisdiction, as reflected on DOORS. If a manager is not available, leave a detailed telephone message. If the call is not returned within 3 working days contact the Appeals Analyst on the NEPSC OA Staff via email.

  • •

    MATPSC - PSC 2 Contact

    Locate the module contact number listed on DOORS and request to speak to the technician assigned to processing the ACR. If that person is not available, leave a detailed phone message. If the call is not returned within 3 working days, call back and request to speak with the Assistant Mod Manager or Mod Manager.

    In instances when the coordination is not successful or timely, request to speak with a Manager or contact OAS at 215-597-3552 and request to speak to the Disability or Claims Analyst.

  • •

    SEPSC - PSC 3 Contact

    Locate the module contact number listed on DOORS and request to speak to the technician assigned to processing the ACR. If that person is not available, leave a detailed phone message. If the call is not returned within 3 working days, call back and request to speak with the Assistant Mod Manager or Mod Manager.

    In instances when the coordination is not successful or timely, request to speak with a Manager or contact OAS at 205-801-2229 and request to speak to the Disability or Claims Analyst.

  • •

    GLPSC - PSC 4 Contact

    Contact the Operations Analysis Section at 312-575-4250.

  • •

    WNPSC - PSC 5 Contact

    Locate the module contact number listed on DOORS (call the secretary) and request to speak to the technician assigned to processing the ACR. If that person is not available, leave a detailed phone message. If the call is not returned within 3 working days, call back and request to speak with the Assistant Mod Manager or Mod Manager.

    In instances when the coordination is not successful or timely, please email the WNPSC Operations Support Branch (OSB) at || SF ARC PCO OSB.

  • •

    MAMPSC - PSC 6 Contact

    Locate the module contact number listed on DOORS and request to speak to the technician assigned to processing the case. If that person is not available, leave a detailed phone message. If the call is not returned within 3 working days, call back and request to speak with the Assistant Mod Manager or Mod Manager.

    In instances when the coordination is not successful or timely, send an email to ||KC OAS. Be sure and include your name and phone number.

D. Processing reminders for dual entitlement claims

  1. 1. 

    Unless the DWB claim will be for technical entitlement only, the PC with jurisdiction of the DIB claim should process the DIB claim first. Make contact with the component that has jurisdiction of the DWB claim immediately after the DIB claim is processed.

  2. 2. 

    On fully electronic DIB/CDB claims, if the benefits must be combined, then the PC with jurisdiction of the DIB claim processes both claims simultaneously. For DIB/CDB claims, benefits should only be combined if they are from the same trust fund. When SSI offset is involved and the claims are processed simultaneously, the retroactive benefit data is fully automated to the SSR. If the claims are processed separately, SSI data must be manually computed and transmitted to the field office via the e4345 (which is the electronic version of the SSA-4345, Record of Manual Title II Offset Computation).

  3. 3. 

    Make sure to code all SSI and multiple entitlement information completely and correctly, regardless of which claim is being processed by your component.

  4. 4. 

    Make sure that the initiation of the e4345 is completed whenever the need arises. For more information on processing initial claims with SSI involvement, see SM 00815.300 and SM 00815.200.

References:

GN 01010.050, Adjudicating Claims Involving Multiple Entitlement

GN 01050.055, Determining Processing Center Jurisdiction

SM 00815.200, Processing Amended Awards Involving SSI

SM 00815.300, Processing Multiple Entitlement Awards Involving SSI Background



To Link to this section - Use this URL:
http://policy.ssa.gov/poms.nsf/lnx/0201050056
GN 01050.056 - Processing Center (PC) Effectuation of Favorable Office of Hearings Operations (OHO) Title II Dual Entitlement Cases - 11/19/2009
Batch run: 10/10/2017
Rev:11/19/2009