TN 28 (08-99)

RS 00605.407 Disadvantageous Recomputations

A. Policy

A recomputation of the PIA can result in a decrease in total family benefits. This can occur in various ways:

  • When the PIA is recomputed and the maximum of record does not change, the new distribution among the family members can cause the total family payment to be lowered due to rounding.

  • A shift of a simultaneously entitled child from one ER to another can also cause loss of payment in some circumstances.

  • In primary/secondary dual entitlement cases, a recomputation on the primary record may cause a decrease in the total payable after rounding.

Use the following procedure to determine when not to process a recomputation because it is truly disadvantageous. Any recomputation found to be disadvantageous will be processed when it becomes advantageous.

NOTE: If a recomputation is not covered by the rules in RS 00605.407B. and is still disadvantageous in any way, the numberholder may ask that the recomputation not be processed. Obtain a signed statement waiving the recomputation and follow the steps in RS 00605.407B.9.a. On a survivor claim all beneficiaries must waive the recomputation.

B. Procedure - Determining Whether a Recomputation is Disadvantageous

To determine whether a recomputation is truly disadvantageous it is necessary to consider both the MBA and the MBC.

There are many possible situations that may occur. Determine which description below applies and follow the instructions for that heading.

1. The MBA and the MBC increase

Process the recomputation.

2. The MBA increases and the MBC decreases

Process the recomputation. The decrease in the MBC is caused by rounding. Use existing waiver instructions for any overpayment which results.

3. The MBA increases and the MBC stays the same

Process the recomputation.

4. The MBA stays the same and the MBC increases

Process the recomputation.

5. The MBA and the MBC stay the same

Process the recomputation.

6. The MBA stays the same and the MBC decreases

Process the recomputation. The decrease in the MBC is caused by rounding. Use existing waiver instructions for any overpayment which results.

7. The MBA decreases and the MBC increases

Process the recomputation.

8. The MBA decreases and the MBC stays the same

Process the recomputation.

9. The MBA and the MBC decrease

a. Underpayment is not due

If no underpayment is due, do not process the recomputation. List the case using code 434. Add a special message to the MBR explaining that the recomputation is disadvantageous and that the recomputation will be processed only when it is no longer disadvantageous.

NOTE: The effective month for the recomputation will be the first month for which the recomputation is advantageous.

b. Underpayment is due

If an underpayment is due, contact the numberholder (NH) and explain that the recomputation results in an underpayment but continuing rates will be decreased. Document the NH's decision. If the NH desires the recomputation, process it. If the NH does not desire the recomputation follow the instructions in RS 00605.407B.9.a.

10. Some benefits increase but total to family decreases

If one or more beneficiaries are due an increase, but the total benefit payable decreases and:

a. Decrease is caused by rounding

Process and use existing blanket waiver procedure.

b. Decrease not caused by rounding

Contact the numberholder (NH) and explain. Document the NH's decision. If the NH desires the recomputation, process it. If the NH does not desire the recomputation follow the instructions in RS 00605.407B.9.a.

11. NH rate decreases but total to family increases

If the NH's benefit decreases but the total payable to the family increases contact the numberholder (NH) and explain. Document the NH's decision. If the NH desires the recomputation, process it. If the NH does not desire the recomputation follow the instructions in RS 00605.407B.9.a.

12. Dual Entitlement cases when the spouse benefit is in suspense

If