GN PHI01010.007 Claims of Employees and Their Relatives or Friends (TN 6 - 07/2004)
See GN 01010.001 and GN 01010.007
A. Handling Title II and Title XVI Claims and Waiver Requests, and Title XVI Redeterminations of Relatives or Friends
Employees must disqualify themselves from acting on any official matter which involves themselves, a relative (spouse, parent, child, or immediate member of their household) or friend. Claims, redeterminations, waivers, and other requests for payment filed by a relative or friend should be brought to the attention of the manager and processed by an employee having no direct connection with the claimant. Guidance for Employees on How to Transact Social Security Business That Requires Systems Access further explains employee responsibility. The claimant can choose to have another field office process the action.
B. Handling Title II and Title XVI Claims and Waiver Requests, and Title XVI Redeterminations of Employees.
Employees who desire privacy may contact the 800 number or go to another SSA office for service. If employees visit a servicing office that is not the office in which they work, call SSA’s 800 Number, or make use of the internet to transact SSA business, the interviewer should follow the operating rules normally used when dealing with the general public as long as the employee is not a relative or friend of the interviewer.
C. Processing Instructions for Employee Claims Processed in the Employee’s Resident Office
All claims filed by an employee, employee’s spouse, or member of the employee’s immediate household must be reviewed by management. The manager’s should conduct a review that verifies proper documentation and the recording of evidence is present and supports the adjudicative decision (e.g., presumptive disability, earning adjustment, etc.), month of entitlement, medical decision, insured status, etc. Managers must complete the following steps when handling Employee Claims:
On the Development Worksheet screen (DW01), managers are required to:
Create an issue using the annotation “EE CLM”
Enter the managers name in the “Remarks” section
On the Report of Contact (RPOC) screen on MCS, managers are required to:
State that this is an employee or employee related claim
State that the claim has been reviewed by management
For paper claims, managers are required to mail a completed package that includes the entire file and a signed printout of the (RPOC) screen.
If the claim is processed using a paperless application, managers should mail a signed printout of the (RPOC) screen.
Employee Claims must be mailed in an envelope mark “Employee Claim - Do Not Open in the Mailroom” to the following address:Social Security Administration
P.O. Box 8788
Philadelphia, PA 19101
Attn: Center for Security and Integrity
CSI will ensure the procedures in GN 01010.007B were followed, and annotate the file with the result of their review. CSI will notify the manager if additional action is needed.