TN 22 (04-12)
Windfall offset affects a claimant and couples who are concurrently entitled and due
retroactive payments from Supplemental Security Income (SSI) and Retirement, Survivors,
and Disability (title II) benefits for the same months. The windfall offset prevents
a claimant from receiving more benefits retroactively than he or she would have received
if we paid all benefits in the months they were due. Claimants entitled to both title
II and title XVI benefits should receive their title XVI benefits first to retain
eligibility for Medicaid benefits.
Effective for title II claims adjudicated after 06/30/81, the law prevents a windfall
to claimants concurrently entitled to both title XVI and title II retroactive benefits
for the same period. Retroactive title II benefits resulting from an initial award
are reduced by the amount of title XVI that would not have been paid if the title
II had been paid when due.
Effective 02/01/85, Congress amended the law to permit reduction:
of either title XVI or retroactive title II benefits;
of retroactive title II benefits resulting from a reinstatement or a title II postentitlement
event when administratively feasible, and
to take into account retrospective monthly accounting (RMA) to eliminate a two-month
windfall that was caused by RMA. For the policy on RMA, see SI 02005.001.
We apply windfall offset to the retroactive title II benefits even if we pay the title
II current monthly accrual (CMA) before the title XVI benefits. The system will control
the release of the title II retroactive benefits until after we pay the title XVI
You must have an understanding of windfall offset terms to understand the windfall
For a list of the types of benefits subject to offset, see GN
The reduction of retroactive title II or title XVI benefits prevents a windfall. A
windfall occurs when the combined title XVI and retroactive title II benefits exceed
the amount of benefits due if the title II benefit had been paid when due rather than
Benefits paid in a month later than the month or months they were due; i.e., a prior
month accrual (PMA). For information about the treatment of retroactive title II benefits
in the PMA month, see SI 02006.201.
SSI benefits, including any federally administered State supplementation that has
accumulated for any month after the calendar month they are due.
Benefits paid in the month after the month the person is entitled; i.e. current month
EXAMPLE: The title II benefit due for February paid in March.
The offset period is the maximum period that retroactive title II benefits could affect
title XVI payments. For determining the offset period, see GN 02610.022.
The reduction of retroactive title II benefits to prevent a windfall. It is the amount
of title XVI benefits that would not have been paid had the title II benefits been
The reduction of retroactive title XVI benefits to prevent a windfall. It is the counting
of retroactive title II benefits if paid on time. For instructions for processing
a title XVI offset, see SI
The total offset computed for the record exceeds the amount of title II offset withheld.
For instructions on processing excess offset, see GN 02610.050F and SM 01320.206D.
When we would have paid more title XVI if we paid the title II amount timely for one
or more months in the offset period. The new federal amount due based on the offset
computation (FAM/SAM) results in a higher payment amount than the due amount (FAM/SAM)
on the SSID screen of the Supplemental Security Record (SSR). For instructions on
processing a negative offset, see SI 02006.010A and SM 01320.206.
The amount of title XVI payment the recipient would have received if we paid the title
II retroactive payments when due.
An automated computation occurs when the system can determine, compute, and post the
windfall offset amounts to the Supplemental Security Record (SSR) for all months in
the windfall period.
When the system cannot determine the offset amounts for one or more months in the
windfall offset period, the field office (FO) must manually compute the offset amounts.
The FO must post the results from the manual offset computation to the SSR. For instructions
how to manually compute offset amounts, see GN 02610.035.
Any title II event that occurs after title II entitlement and affects the amount of
title II benefits previously paid. For information about postentitlement events and
their effect on windfall offset, see GN 02610.016B.
The resumption of title II benefits following a suspension or termination. For specific
conditions where windfall offset applies to reinstatements, see GN 02610.016B.
The amount of income used in the title XVI monthly payment computation to determine
the SSI amount due.
The title II benefits payable for months in the windfall-offset period after the offset
amount is subtracted from the title II retroactive benefits that accrued for months
in the windfall offset period. For instructions how to compute NCI in the windfall
offset period, see GN 02610.042.
We may reimburse a State for assistance the State provided to a claimant in the form
of cash or through vendor payments to meet his or her basic needs. Apply windfall
offset to all retroactive months including the amount used to reimburse the State.
For information about IAR, see SI 02003.003.
A written statement signed by the claimant and the appointed representative specifying
the fee the representative expects to charge and collect and the claimant expects
to pay. For an overview of the fee agreement process, see SI 02006.200B.3.
A written statement, signed by a claimant’s representative, requesting the fee the
representative wants to charge and collect for services. For information about the
fee petition process, see SI 02006.200B.2.
A subsequent award results in additional title II benefits becoming due because of
an application (e.g. dual entitlement, retirement benefits (RIB) to disability benefits
(DIB), widow(er) (WIB) to RIB, child (C1) to disabled claimant (HA).
Corrects or changes a material factor of entitlement of a prior award. For instructions
for recomputing windfall offset when an amended award changes the title II date of
entitlement or title II amount, see GN 02610.050B.
The e4345 is a web-based application created to facilitate communication between Program
Services Centers (PSCs) and FOs on windfall offset cases requiring a manual computation.