TN 30 (01-15)
GN 02607.500 Processing Claims When a Prisoner Update Processing System (PUPS) Record Exists
A. Identifying PUPS records in initial claims
PUPS establishes a record for every reported inmate whose Social Security number (SSN) we can verify. When a verified SSN matches with a Master Beneficiary Record (MBR) with current entitlement or a Supplemental Security Record (SSR) with current eligibility, PUPS establishes a pending record and generates a PUPS alert when we receive the inmate report electronically. When a verified SSN does not match an MBR with current entitlement or an SSR with current eligibility, PUPS creates a skeleton record.
When PUPS establishes either a pending or a skeleton record, the MBR and SSR display the following message: "A RECORD IS PRESENT ON THE PRISONER UPDATE PROCESSING SYSTEM DATABASE FOR BOAN: XXX-XX-XXX, JOHN DOE, BIC-X."
For more information on PUPS record establishment, see GN 02607.410. For more information on PUPS skeleton records, see GN 02607.520.
B. Processing initial claims with PUPS records or prisoner data
1. PUPS record established before claim filed
When a PUPS skeleton record exists for a claimant who is now filing an initial claim or appeal, complete the following actions:
The PUPS skeleton record contains the latest inmate information reported for the individual. Develop for other periods of confinement the claimant may have when developing for the period of confinement on the skeleton record.
Example: A claimant files for disability benefits. During the interview, you discover that there is a PUPS skeleton record for the claimant’s SSN. If the claimant meets all factors of entitlement and eligibility, take the initial claim and transfer it to DDS for a medical decision. While the claim is at DDS, develop the PUPS record and investigate for other periods of incarceration. Prior periods of incarceration may affect a potential period of back pay.
2. Discovering a period of confinement while developing a claim
When you discover that a claimant for Title II or Title XVI benefits has a period of confinement that would affect the payment of benefits, fully develop the confinement period. Create a PUPS record before processing the claim. For instructions on creating a PUPS record, see GN 02607.460.
C. Processing a PUPS alert for a deceased beneficiary or recipient
When the PUPS alert date of conviction or confinement is later than the date of death, the PUPS record may indicate that:
another confined individual is using the deceased’s identity;
we incorrectly identified the deceased as the reported inmate; or
the beneficiary or recipient is alive and is, or was, confined in a correctional institution or mental health facility.
Resolve any discrepancies between the date of conviction or confinement in PUPS and date of death shown on the MBR or SSR.
1. Developing the date of conviction or confinement
When the date of conviction or confinement is later than the date of death, develop as follows:
use the facility identification (FID) code in PUPS to identify the reporter;
contact the reporter to verify conviction or confinement dates and inmate identity (name, date of birth, sex, race and SSN) following instructions in GN 02607.600. Inquire about other dates of confinement. To verify information for the Federal Bureau of Prisons (RID: 3BOP) inmates, follow instructions in GN 02607.790D and SI 02310.092;
update PUPS to reflect all periods of confinement that overlap periods of Title II entitlement or Title XVI eligibility that we can reach under the rules of administrative finality. (For information on administrative finality, see GN 04001.000.)
Periods of confinement before a Title II beneficiary’s death could affect payment of auxiliary benefits (e.g., adjustments may be necessary to satisfy an overpayment; or when the prisoner is an auxiliary, we may increase payments to other auxiliaries per GN 02603.040 and GN 02607.001); and
clear the PUPS record if the deceased was not the confined person. (For information on clearing erroneous PUPS records, see GN 02607.710.
2. Developing the date of death
Verify the date of death by checking for proof of death on the MBR, SSR, and the NUMIDENT. For information on use of the NUMIDENT, see GN 00304.100.
If the MBR, SSR, or NUMIDENT show that we have proof of the date of death, you do not need further development for the date of death.
If the MBR, SSR, or NUMIDENT does not show proof of date of death, develop the death report following GN 02602.050B. If the beneficiary or recipient is alive, correct the MBR, SSR, and NUMIDENT. Consider whether to suspend benefits based on the prisoner information before reinstating benefits.
3. Resolving discrepancies between date of conviction or confinement and date of death
a. Date of conviction or confinement is before the date of death
If the deceased’s date of conviction or confinement is before the date of death and we have proof of the date of death, take any necessary action on the report of confinement.
b. Date of conviction or confinement is equal to or later than the date of death
If the deceased’s date of conviction or confinement is equal to or later than the date of death, and we have proof of the date of death, contact the reporter to verify the inmate’s identity as instructed in GN 02607.500C.1. in this section.
D. Processing Title II survivor claims with PUPS records or prisoner information
The presence of a PUPS record on a deceased wage earner’s (DWE) MBR or the receipt of prisoner information for the DWE during the processing of a survivor’s claim may indicate that either the prisoner information or death information is incorrect and calls into question the legitimacy of the survivor claim. Before processing the survivor claim, resolve any discrepancies between the PUPS date of conviction or confinement and the MBR date of death as instructed in GN 02607.500.C. in this section. Take the actions in this subsection after resolving all discrepancies.
1. DWE is alive
If the wage earner is alive, deny the survivor claim. If we have already awarded survivor benefits, consider administrative finality before reopening the survivor’s erroneous entitlement. Before reinstating the wage earner’s erroneously terminated benefits, consider whether benefits are payable based on the information in PUPS. Suspend benefits as appropriate.
For erroneous entitlement actions, see GN 01010.480. For information on erroneous death termination case processing, see GN 02602.055.
2. DWE is not the inmate
If the inmate data on the PUPS record does not belong to the wage earner, and we have proof of death, continue processing the survivor’s claim. Survivor benefits already awarded may continue.
3. DWE is both deceased and the inmate
If you find that the wage earner is deceased, continue processing the survivor’s claim. Determine whether benefits prior to the DWE’s month of death were payable based on the information in PUPS. Suspend the DWE’s benefits before the month of death as appropriate.
Example: A woman files for survivor benefits for her minor child upon the death of the child’s father. The father’s record shows that a PUPS skeleton record exists. In addition to processing the survivor claim, develop the PUPS record and update the PUPS system as needed. The DWE’s prior period of confinement does not affect auxiliary eligibility.
GN 00304.001 Proof of Death Requirements
SM 00380.040 Non-Disability Disallowance, Abatement and Withdrawal Codes – Exhibit