TN 17 (03-97)
GN 00203.005 Reporting Instructions - Title II Claims
Claimants and beneficiaries are required to report changes that may affect their benefits. It is important that they understand their rights and responsibilities at the initial interview.
The applicant's clear understanding of his/her rights and responsibilities will result in:
What, when, and how to report should be explained at every initial interview and again at every pertinent post-entitlement interview.
1. What to Do
Since the initial interview may be the only verbal contact SSA has with the applicant, the interviewer should:
Tailor the explanation of reporting to the individual's needs.
Provide the necessary forms, reporting instructions, fact sheets, etc.
Attempt to ensure the beneficiary understands what must be reported and the importance of accurate reporting.
Explain that reporting forms and instructions are for information only and are not a decision on entitlement/eligibility.
Enter the SSN on the reporting forms and explain the importance of using the SSN on all future correspondence.
Ask the claimant to report to the FO any changes before receipt of an award notice.
NOTE: For title II, remind claimants and beneficiaries when applicable, that a penalty may be charged for failure to file a tax return or annual report timely for self-employment earnings, or report no child-in-care (See GN 02604.000), or for providing false information. For title XVI, explain to claimants/recipients that a penalty could be charge for a late report of a change that affects SSI. (See SI 02301.005D.2.)
2. Examples of some reporting instruction opportunities
A Retirement Survivors Insurance (RSI) beneficiary or Disability Insurance (DI) auxiliary files an annual report of earnings. Tailor an explanation of the current annual earnings test.
An initial interview with a young spouse or mother beneficiary. Explain reporting events such as marriage of the child, no child-in-care or change in custody.
A student reports a change of address or transfer of schools. Explain reporting subsequent changes in schools, attendance, earnings, and marriage.
An SSI redetermination interview is held. Explain the applicable eligibility factors.
An individual files for title II disability. Explain work incentive programs such as trial work period and Extended Period of Eligibility (EPE). If further information is needed, provide the claimant with SSA Publication No. 05-10060 Incentives To Help You Return To Work. Also explain the requirement to report medical recovery, all work activity regardless of the amounts and all changes in work status.
NOTE: Do not promise a trial work period unless one is certain (DI 13010.035 through DI 13010.060).
A disabled claimant or beneficiary indicates a Worker's Compensation and/or public disability benefit (WC/PDB) claim is pending or has been paid. Verify the amount or status of entitlement to WC/PDB or any change in the amount.
3. Reporting instructions for claimants living outside the U.S. - title II
Explain the laws and regulations affecting the payment of benefits outside the U.S. and the events that must be reported.
Provide booklet SSA-10137 (Social Security: Your Payments while you are outside the United States).
Mail an SSA-10076 (Instruction for a Representative Payee) along with an SSA-10137 for benefits paid through a representative payee.
4. Furnishing claim receipt and reporting sheet
The receipt page and reporting sheet of title II applications serve as:
Enter the following information on the receipt:
The date the signed application was received;
The name of the FO employee to contact about the claim (For legibility, managers can decide if name is stamped or printed.);
Local FO telephone numbers to call with questions or reports before an award/denial notice is sent and the 800 number for questions/reports after a decision is made; and
When the claimant can expect to receive a decision. (A brief explanation of the claims process and the involvement of other SSA and external components may be helpful to the claimant.)
Enter the annual and monthly earnings information on the reporting sheet when appropriate.
Give a claims receipt to a claimant only when the signed application is received. In teleclaims, this will be after the signed application is received by SSA.
5. Furnishing claim receipt - title XVI
Give the applicant the receipt page of a title XVI application. Complete it per instructions in SI 00604.105 for the SSA-8000-BK or MSSICS-generated full applications. Use the instructions in SI 00602.010 and SI 00605.045 for the SSA-8001-BK or for MSSICS-generated deferred or abbreviated applications.
NOTE: On a MSSICS application receipt form, many items will already be completed.
The receipt page of a title XVI application provides:
Written acknowledgement that a claim has been filed;
An estimate of the anticipated total processing time after we receive all necessary information;
NOTE: Total processing timeframes for disability cases includes average local DDS and FO processing times.
The procedure to follow if a decision is not reached within the estimated processing time:
Information about the Privacy Act, computer matching and the penalty provision for not reporting timely; and
A summary of the individual's reporting responsibilities.
6. Furnishing reporting forms - title II
Give reporting forms and instructions to claimants based on the situation:
Give a copy of the pamphlet SSA-453 (How Your Earnings Affect Your Benefits). (See RS 02510.000.)
Give a copy of pamphlet SSA-10043 (A Brief Explanation of Medicare) in addition to reporting forms to claimants 64 1/2 years or older.
Review with the applicant the appropriate “Rights and Responsibilities” booklet (SSA-10077, SSA-10153). Explain that a copy will be sent by the Processing Center (PC) upon award of benefits. Provide a copy of the booklet where needed.
Use available foreign-language versions of the reporting forms where appropriate.
Show the claimant how to use the appropriate reporting instruction sheet.
Print any special advice, instructions or clarifications on a blank sheet of paper and attach it to the reporting sheet.
Explain disability reporting instructions because they differ from RSI reporting. Therefore, ability to work, change of address, and discharge from a hospital raise disability or change of payee issues.
7. Reporting Instructions for newly entitled beneficiaries
The processing center mails the following material to the beneficiary when an award of RSDI benefits is made:
The “Rights and Responsibility” booklet serves as a permanent reference on all SS monthly benefits matters.