TN 13 (11-11)

GN 01010.010 Modernized claims system (mcs) earnings computation (ec) screens

A. Policy on EC methods

Always use the earnings computation method that will process a claim in the most accurate and timely way. If possible, process claims completely through MCS rather than manual adjustment, credit and award process (MADCAP) or manual adjustment credit and award data entry (MACADE). See MSOM MCSEC 001.001 for MCS EC processing limitations and MSOM MCSEC 001.036 for EC exception remarks messages.

NOTE: MCS EC determination screens can also represent certified earning record (E/R);

B. MCS processing considerations

1. Adjudicative EC

Use an adjudicative EC to process a title II claim to payment, disallowance, denial, abatement, or pre-effectuated withdrawal using MCS rather than MADCAP/MACADE.

2. Pre-adjudicative EC

A pre-adjudicative EC can help to identify and develop potential issues within a claim (e.g., consider an EC used as a trial benefit computation to be a pre-adjudicative EC).

3. Archiving MCS EC screens

MCS archives EC screens used to support the adjudicative determination as part of the claims segment. Once the adjudicator completes EC screens (either pre-adjudicative or adjudicative), the screens become part of the claims path and MCS archives them with the other MCS screens. MCS however, can only archive data from the latest requested EC.

a. Claim effectuated via MCS

The adjudicative EC screens overlay any formerly requested pre-adjudicative EC screen data and MCS archive only the latest adjudicative screens.

b. Claim effectuated outside MCS

If the adjudicator establishes the claim via MCS but it cannot be effectuated due to system limitations, the adjudicator must process the claim manually (i.e., automated 101 (A101) or electronic form 101 (EF101)). The MCS system automatically archives the pre-adjudicative EC computation requested after transferring the claim to the processing center (PC). However, if the adjudicator requested more than one pre-adjudicative EC, MCS archives only the screens from the latest request. Therefore, ensure that the pre-adjudicative EC that supports the adjudicative determination is the last one requested.

Note: It is essential to update completely all MCS EC screens prior to exiting MCS since MCS archives this data for possible future reference or propagation to another system (e.g., A101).

C. General use of MCS EC screens

EC screens can help develop as well as adjudicate claims by:

  • comparing primary insurance amounts (PIAs) with and without alleged military service (MS) or lag earnings, this comparison helps to determine whether proof is needed;

  • determining whether insured status is met;

  • checking for gaps or other inaccuracies in the E/R;

  • communicating with the Modernized Office of Earnings (OEO) System and in some cases updating earning records (E/R)s (e.g., Item Correction (ICOR)); and

  • obtaining earnings information and computations for most title II claims.

Caution: MCS has an override function that allows a pre-adjudicative EC to generate a computation that can ignore either or both railroad (RR) involvement and prior Master Beneficiary Record (MBR) entitlement data. See MSOM MCSEC 001.004 MECN for more information. Apply discretion when using these “override” computations, as they are not accurate without considering the excluded data.

D. References

  • GN 01010.009 Certified and Uncertified E/Rs

  • MSOM MCSEC 001.001 Earnings Computation Screens - Overview

  • MSOM MCSEC 001.036 MCS EC Messages

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GN 01010.010 - Modernized claims system (mcs) earnings computation (ec) screens - 11/10/2011
Batch run: 01/28/2015