The PC completes section I to record the title II data necessary for the FO to do an offset computation. This data is transmitted to the FO by phone call, fax, e-mail etc. from the PC.

1. a. 

   D/E cases — only one form is required even if computing title II offset for both benefits at once.

2. b. 

   Couple's cases — complete one if only one member is entitled to retroactive benefits; complete two if both members are entitled to retroactive title II benefits.

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  Enter the CMA paid and month paid.

• •

  D/E cases - enter CMA and date paid for both benefits.

NOTE: If you are providing information in the e4345 system for recomputing a windfall offset and the Title II monthly rates are different from the rates used in the original windfall offset because of HI/SMI rounding, use the rates from the original windfall offset certification showing what was originally show for HI/SMI. This will eliminate the need for the FO to account for the $1.00 rounding tolerance found in SM 03045.910 when the FO technicians are computing any difference in the initial windfall offset amount and recomputed windfall offset amount.

Pay the CMA only in concurrent title II/title XVI cases when processing through MADCAP.

Enter total retroactive title II benefits withheld.

• •

  If establishing new entitlement to a higher rate, (A to HA) show only the difference between old and new rate.

• •

  D/E and RIB/DIB cases - Show the retroactive title II withheld for both benefits.

Monthly Breakdown Section

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  List the months the benefits would have been paid and MBC or the amounts being withheld. e.g. MBC is $200, but $150 has already been paid on another claim so amount to be shown is $50.

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  If more than one type is involved, list the MBC's under the appropriate columns for each type.

  EXAMPLE: The RSI benefits - Show each type under separate RSI headings.

Record all relevant information including:

• •

  Fact that it is a couple's case and another SSA-4345- U2 applies;

• •

  Attorney is involved.

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  D/E cases - The amount that was already paid on another account.