TN 16 (09-95)
GN 02610.047 How To Complete Section I of Record of Manual Title II Computation — SSA-4345-U2
Form SSA-4345-U2 is used to record data exchanged by the PC and the FO when manual title II offset computations are necessary. GN 02610.049 covers completion of section II and section III.
NOTE: The e4345 was developed for the PC and FO to be able to exchange windfall-offset data electronically. It is a web-based application of the paper SSA-4345.For instruction on completing the e4345 see http://atlnet1.bi.ssa.gov:3690/e4345/fouserguide.doc and http://s65da58/e4345/pcuserguide.doc .
B. When to Use Form SSA-4345-U2
The PC completes section I to record the title II data necessary for the FO to do an offset computation. This data is transmitted to the FO by phone call, fax, e-mail etc. from the PC.
2. Number of Forms
D/E cases — only one form is required even if computing title II offset for both benefits at once.
Couple's cases — complete one if only one member is entitled to retroactive benefits; complete two if both members are entitled to retroactive title II benefits.
C. Procedure — PC
Complete section I according to the following directions:
1. Block A
Pay the CMA only in concurrent title II/title XVI cases when processing through MADCAP.
2. Block B
Enter total retroactive title II benefits withheld.
If establishing new entitlement to a higher rate, (A to HA) show only the difference between old and new rate.
D/E and RIB/DIB cases - Show the retroactive title II withheld for both benefits.
3. Block C
Monthly Breakdown Section
List the months the benefits would have been paid and MBC or the amounts being withheld. e.g. MBC is $200, but $150 has already been paid on another claim so amount to be shown is $50.
If more than one type is involved, list the MBC's under the appropriate columns for each type.
EXAMPLE: The RSI benefits - Show each type under separate RSI headings.
4. Remarks Section
Record all relevant information including: