TN 24 (11-15)

GN 01070.782 Handling Initial Claim Diaries Established by the Workload Support Units (WSU)

A. Overview of the WSUs and their role

This section outlines the responsibilities of the WSUs in handling initial claim diaries that they establish in partial adjudication cases. These instructions should help ensure consistent handling of claims diaries across all Operations' components.

The WSUs process first-party English language iClaim Retirement and Medicare-only applications where the claimant provides a domestic residence address and has proven age and citizenship status.

B. Development responsibilities for partial claims

The WSUs will initiate all necessary developmental action and requests for proof in the process of adjudicating their claims. If the WSU is not able to fully adjudicate because there is an unresolved issue (for example, involving military service, missing earnings), the WSUs will process the claim as a partial award, if it meets the requirements of GN 01010.110.

The WSUs will document and maintain control of partial claims until they receive the requested evidence and the outstanding issue(s) are resolved, as described in GN 01010.110D.

The process for handling diaries established on partial awards is the same process that the field offices (FO) follow.

For diaries established for future events, such as future Windfall Elimination Provision (WEP) entitlement, annotate the Modernized Claims System (MCS) Report of Contact (RPOC) screen with the reason for the diary and the local FO Code for future follow-up action.

The WSUs will monitor their Modernized Development Worksheet (MDW) diary alert listings, and follow-up on outstanding requests when needed. When the WSU completes the development, they will take the necessary action to clear the diary and adjust benefit rates, if necessary. The WSU will send an MDW or Request for Assistance form to the Processing Center (PC) to request they cancel the diary.

C. FO responsibility when partial diary development received (WSU processed original claim)

If the claimant brings in his or her documentation for the outstanding issue into the local FO instead of sending it to the WSU, the FO should take the necessary action and update any proofs they receive on the evidence screen. Review the MDW or original claim Development Worksheet (DW01) for other outstanding issues that may be pertinent to the diary. The FO must contact the WSU so they can close out their controls on the partial claim development. The WSU will also notify the PC to cancel its diary.

D. PC responsibility when partial award diary matures

When the diary for an outstanding issue on a partially adjudicated claim matures, the PC will first review the Workload Management System (WMS) query to ascertain which office originated the diary. If a WSU FO code is present, the PC will forward the follow up to the WSU rather than the servicing FO shown on the Master Beneficiary Record (MBR).

Here is a list of the office codes for the WSUs:

Boston WSU

C98

NEPSC WSU

C25

San Juan WSU

C36

MATPSC WSU

C12

SEPSC WSU

C34

Tampa WSU

319

GLPSC WSU

C02

Albuquerque WSU

A54

MAMPSC WSU

C33

Golden WSU

C88

WNPSC WSU

C87

Salinas WSU

165

Auburn WSU

C84

OCO WSU

C61

OCO WBDOC

00A