SSA's goal is to pay all benefits due on time. Processing critical cases has priority
over all other workloads. Through routine processing, this goal is usually met. However,
when a beneficiary is adversely affected because payment is not made timely, our goal
is to resolve the problem and make payment as soon as possible. Some of these cases
are considered “critical.”
Most critical cases are identified and processed in the FO and paid via the Critical
Payment System (CPS) (SM 00635.001, MSOM INTRANETCPS 001.001). CPS is a method of
payment designed for use primarily (but not exclusively) in critical case situations.
NOTE: The existence of a CPS exclusion does not also exclude the case from critical case
processing. When a CPS exclusion exists, the FO will complete an MDW 2560HP Request
(High Priority Payment Center Request) (MSOM MDW 001.003 MDW Worksheet (MMDW).
There are two methods of replacing payments which have not been received by an individual.
The critical payment--a check is issued by the Treasury Department and received by
the individual in 5-7 days. The critical payment process is used for limited situations
and the FO should be certain the problem cannot be resolved through routine processing.
The immediate payment (IP)--a check is issued immediately in the field office because
of a dire need situation (see RS 02801.010). Both of these payment processes are recorded via CPS.
For all critical cases, there must be evidence of:
entitlement with the paper evidence submitted to SSA, and
payment is due (for terminal illness (TERI) cases, there are developmental tolerances).
1. A critical case exists when
a due payment has not been received and an urgent need exists and/or there is a public
NOTE: For all garnishment situations, use COGS per GN 02410.210.
2. A critical case may be
An initial claim for retirement, survivors or disability benefits with all factors
of entitlement met. All TERI cases are critical.
NOTE: An initial claim critical case may qualify for preliminary payment (RS 02807.005) or expedited payment (RS 02805.001).
A reinstatement of payment -- cases that have been suspended and evidence has been
submitted showing the suspension no longer applies.
A delayed or interrupted payment for a beneficiary due to a processing error (e.g.,
failure to convert life benefits to survivors benefits, incorrect death termination).
With these cases
PC's may make payment in AC and ALJ reversals and RSI reconsideration cases. If an
FO identifies such a case as a critical case, an MDW 2560HP Request (High Priority
Payment Center Request) should be completed and sent to the PC.
NOTE: In concurrent Title II/XVI cases, the PC coordinates payment with the FO to avoid
creating a windfall. See GN 02610.005.
The method of payment for a DIB reconsideration reversal identified as a critical
case in an FO depends on the location of the file. In all cases CPS processing should
be used. If there is a CPS exclusion, or the FO has not received a copy of an approved
SSA-831-U5 or SSA-833-U5, the MDW 2560HP Request (High Priority Payment Center Request)
should be completed and sent to the PC.
Nonreceipt of issued payment(s) - EFT or dire need
When nonreceipt is alleged involving EFT and the payment has been sent to the incorrect
bank (e.g., wrong routing transmit number or RTN), a CPS payment may be issued. Refer
to GN 02406.007 to determine appropriate action. When nonreceipt is reported for a
nonrecurring paper check, see GN 02406.003 and GN 02406.200.
If the beneficiary reports nonreceipt and indicates dire need, SSA can issue an immediate
payment if the criteria in RS 02801.010 are met. If there are any additional benefits due in excess of the immediate payment
limitation, payment may be made through CPS. See GN 02406.125C and GN 02406.125D to determine what action to take for a missing paper check when dire need exists.
NOTE: If processing a CPS payment for nonreceipt of a check, DO NOT also do a nonreceipt
input, as this would cause 2 replacement checks to be issued.
Cases identified in the PC
The following types of cases identified in the PC may need CPS processing.
Correspondence from the beneficiary, their representative payee, or someone writing
on their behalf (e.g., a congressional inquiry) which indicates a payment problem
that meets the criteria in RS 02801.001A.1., or
A delayed payment inquiry indicates a payment problem that meets the criteria in RS 02801.001A.1. or an inquiry that is not associated with the folder within 15 days of receipt in
the PC, or
A disability to survivor conversion, not automatically processed by the Death Termination
Program, that has subsequently failed two attempts to process the survivor award through
A MADCAP adjustment action for nonpayment to payment status that has excepted three