TN 12 (01-14)
RS 01602.630 Railroad Retirement Board (RRB) Form RR-3T, Social Security Administration (SSA) Jurisdiction of Survivor Benefits, RRB Report of Events Affecting SS Payments and Medicare Information, and RRB Form G-37E, Jurisdiction Message
A. Use of Form RR-3T
There are two situations where the RRB uses an RR-3T to communicate with us.
RRB uses Form RR-3T to transmit benefit payment and Medicare information to SSA when RRB determines that SSA has jurisdiction of the survivor benefits.
RRB also uses the RR-3T for new claims with railroad involvement when RRB determines SSA has jurisdiction of the survivor benefits.
B. RRB use of the Form RR-4 cover sheet
The RRB faxes all Form RR-3T’s directly into SSA’s paperless processing center (PPC) via the Form RR-4 cover sheet.
C. Exhibit of Cover Sheet - Form RR-4 - RRB Priority Action FAX Sheet to SSA
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D. PC procedures for processing the Form RR-3T
1. Claims Authorizer (CA) actions
Determine if RR earnings will increase the primary insurance amount (PIA) and benefit rates,
Develop for potential survivor benefits or lump sum death payment (LSDP), when applicable, and
Route the case to the benefit authorizer (BA) for processing.
REMINDER: When developing for potential entitlement to survivor benefits or a LSDP, prior to sending the case to the Development Holding File (DHF) (DHF or DEV depending on the PC) location, route the case to the BA to process any necessary actions on the survivor's own record. For example, the BA may need to change the LAF from E to C and transfer Medicare to SSA. The action should go to the DHF (DHF or DEV) location after BA processing.
If no social security benefits are payable, and item 6 contains Medicare (HI/SMI) information, request FO development to obtain a HI/SMI only application. Include the following in the FO development request:
the HI/SMI dates of entitlement (DOE),
premium paid through date,
State buy-in information,
advise the FO to process the case via the A101 procedure.
For additional information on HI leads from RRB, see HI 00801.116.
2. Benefit Authorizer (BA)
The BA takes action based on the information provided by the RRB on the form RR-3T and by the Claims Authorizer (CA).
Items 5, 6, and 7 on the RR-3T provide the benefit payment and HI/SMI information for the surviving beneficiary based on the RRB records. Take the appropriate action(s) based on the information provided by the CA and RRB.
If the CA initiated development for potential survivor benefits or a LSDP, send the case to the Development Holding File (DHF) (DHF or DEV depending on the PC) location after processing.
Also, take the appropriate action on the account number shown in item 3 of the RR-3T, regardless of SSN jurisdiction, when appropriate.
EXAMPLE: If you establish a Master Beneficiary Record (MBR) for a RR employee’s SSN, you must terminate the deceased beneficiary, process a life to death conversion for the spouse, correct the LAF for the survivors to show payment by SSA, and recompute survivor benefits to include RR earnings, if appropriate.
E. Exhibit of Form RRB G-37e - Jurisdiction Message
The RRB uses this form to report to SSA a reversal in a jurisdiction determination. Treat this form like a RR-3T, as directed in instructions.
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