Suspension, deduction, and nonpayment provisions of the law affect a beneficiary's eligibility to receive benefits for a given period. Examples include prisoner suspensions, work deductions, no child-in-care deductions, Workers' Compensation/Public Disability Benefit offset, and applicability of the Windfall Elimination Provision (WEP) or Government Pension Offset (GPO).

Some changes may result in an adjustment of the beneficiary's benefit amount. Examples include new entitlement on another record, termination of benefits for another auxiliary on the record, or credit for additional earnings.

Entitlement to monthly Title II benefits continues until a terminating event occurs. Examples of terminating events include death of the beneficiary, marriage, divorce, and attainment of age 18 for a child beneficiary who is not disabled or a full-time student.

A terminating event ends a beneficiary's entitlement to benefits until we establish a new period of entitlement.

Prompt delivery of benefits depends on accurate Social Security records. To ensure records remain up-to-date and accurate, technicians must evaluate and process changes in address, direct deposit, or representative payee needs in a timely manner.

T2R automatically processes many PE actions to update the Master Beneficiary Record (MBR) (see SM 03001.000). In some circumstances, T2R cannot fully process all necessary updates. When this happens, T2R sends an exception or processing limitation to the Processing Center Action Control System (PCACS), and a PC employee must manually update the beneficiary's record via MACADE. T2R also produces alerts, where the input action has processed, but the record may need additional actions.

The RETAP program identifies MBRs that require action in a given month (see SM 03020.001). RETAP also produces alerts to the PCs to notify them of necessary actions. For descriptions of RETAP alerts, see SM 00619.050.

Since the release of T2R, the MBR must be free of any inconsistencies in order for automated actions, as well as most manual actions, to update to the record. During case processing, technicians must review the entire MBR and examine all pending actions.

Some things to consider when reviewing the MBR include:

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  Ledger Account File (LAF) status,

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  Special messages,

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  Suspension codes,

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  MBR data lines,

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  Dual entitlement, and

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  Accuracy of the Primary Insurance Amounts (PIA) and Month Benefit Amounts (MBA).

Additional factors may be involved, such as:

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  Critical Payment System (CPS) payments,

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  PCACS diaries,

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  MDWs,

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  Medicare,

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  Workers' Compensation,

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  Attorney fees/Appointed Representative fees,

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  Garnishment,

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  SSI offset,

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  Levy for unpaid federal taxes,

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  WEP,

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  GPO,

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  Overpayments, and

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  Underpayments.

The Post Entitlement Online System (POS) is the most common method for FO technicians to input Title II PE actions, but there are other systems the FO may use to take action on a reported change, such as the:

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  Miscellaneous Online Edited Transactions (MONET) system,

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  Income Related Monthly Adjustment Amount (IRMAA) data collection screens,

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  Change in Primary Insurance Amount (CIP) application,

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  Interactive Computation Facility (ICF), or

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  Debt Management System (DMS).

When processing PE actions in the FO, take the following steps:

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  Review the documentation provided by the beneficiary or third party;

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  Review the entire MBR (see GN 02602.005D.1);

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  Check for any other pending inputs or WorkTrack files;

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  Complete all necessary development;

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  Make the necessary input to update the beneficiary's record (POS, CIP, EF101, ICF, DMS, etc.);

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  Include remarks to explain the action taken;

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  Retain any documentation per GN 00301.286 Electronic Evidence Documentation and Retention; and

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  Follow instructions in GN 02602.005E for disposition and documentation.

NOTE: If the POS action excepted in the PC, do not re-input the action unless you can determine the reason why it excepted and correct your input. Simply re-inputting the action creates multiple exceptions in the PC. You can review the Transaction History Query (THIS) to determine if your input excepted (see MS 02901.002 and MSOM 05203.012).

To request PC assistance and to follow-up on your request, refer to GN 01070.425 for modes of responding to request for assistance and GN 01070.440 for follow-up timeframes.

Pending PE actions are controlled in the PC by an Action Control Record (ACR). PC technicians input Title II PE actions using a variety of systems, such as:

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  Manual Adjustment, Credit and Award Data Entry (MACADE),

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  CIP,

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  POS,

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  MONET,

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  ICF, or

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  DMS.

When processing PE actions in the PC, take the following steps:

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  Review the source document (which may include the diary, alert, fax, etc.);

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  Check for any other pending actions (be alert to ACRs pending in other PCs);

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  Review the entire MBR (see GN 02602.005D.1);

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  Review the completed side of Paperless for reference purposes;

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  Complete all necessary development (keep the ACR active during development);

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  Make the necessary updates to the beneficiary's record (be sure to address the issue that resulted in the T2 exception or processing limitation as well as the input action);

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  Document the disposition of the ACR (see GN 02602.005E); and

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  Clear the ACR. Be sure to change the ACR retention to long-term as needed per GN 01085.000.

If you receive an exception or processing limitation, you must address the reason that caused the exception or processing limitation as well as the input action that did not process. Each technician who takes action in a case must document the action and disposition of the ACR. "Action" and "disposition" include sending the ACR to an end-of-line read (FIN/FIN) without systems input (see GN 02602.005E).

NOTE: When processing an action you must process all the ACRs that are pending for your job type, i.e. Benefit Authorizer (BA), Claims Authorizer (CA), Check Claims and Recovery Examiner (CCRE), etc. To do this you must always "GET FOLDER." In addition, you must look at all the ACRs with a different job type to see how they may affect your action. When a case has multiple ACRs pending, work the oldest ACR and send any younger, subsequent alerts/ACRs to FIN if it can be determined that they are duplicates. Prior to sending any duplicate ACRs to FIN, document the ACR according to GN 02602.005E.2. Remember that after taking your action you need to route all the ACRs you processed from the "GET FOLDER" view.

The FO technician must document their action on the case. The documentation must include:

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  A remark to support the action taken or reason for not taking an action,

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  The technician's identifier (unit code, name, or initials), and

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  The date.

NOTE: Some PE systems, such as POS, automatically add the technician's name and the date.

Most PE actions in the PC are accompanied by an ACR in Paperless. Each technician who takes action in a case must document the action and disposition of the ACR. "Action" and "disposition" include sending the ACR to an end-of-line read (FIN/FIN) without systems input. The Paperless disposition of the technician's action must include:

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  A brief description of the action taken (for example: "Notice released," "MACADE with 1 letter," or "Action controlled by ACR SSNX____," etc.);

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  The technician's identifier (name or initials); and

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  The date.

NOTE: Paperless e-forms electronically add the technician's name and date.

When the disposition is "No Action Necessary" (NAN), include an explanation of why there was no action necessary by attaching a Claims Folder/Material Transmittal (Form SSA-559) within Paperless ACR.

If the technician's action will clear multiple ACRs, the technician must post a disposition on all ACRs, including:

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  The controlling one, i.e., the one going to the Payment Holding File (PHF) in MACADE;

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  The non-controlling ACR(s), i.e. the one(s) going directly to FIN, indicating "ACR worked in conjunction with SSNX_____"; and

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  Any duplicate ACRs. Send duplicate ACRs to FIN with a comment "Duplicate ACR/Action being controlled by ACR SSNX_____."

IMPORTANT: Only send duplicate ACRs to FIN when taking action on the controlling one.