RS 02807.050 Processing Center Activity
A. RECEIPT OF CPS OUTPUT
The first notice that a valid preliminary payment request has been filed on a claim is a CPS Folder Document Output Process (FDOP) document with the informational remark: PRELIMINARY PAYMENT displayed in the Remarks section (see SM 00635.700 and SM 00635.750). Subsequently, a photocopy of the SSA-1877 will be received from the DO. The CPS output is delivered to the appropriate PC Inquiries Staff. Upon receipt of the CPS output, prepare a temporary folder and file the CPS output document. Any subsequent CPS output documents are also filed in the temporary folder.
Upon receipt of the SSA-1877 photocopy from the DO/BO, the Inquiries Staff will prepare a log, in addition to the control card, showing the name, SSN, date of the SSA-1877, originating source, and date of receipt in the PC. This log will be maintained indefinitely and will provide ready statistical information on the number of requests for preliminary payments. The log should also reflect the PC actions on each case. The SSA-1877 should be associated with and filed in the dummy folder awaiting the claim from the DO/BO.
NOTE: Based on preliminary payment procedures, only 3 checks can be issued to the claimant. If the DO/BO or PC has not received the needed evidence for a final determination establishing entitlement to benefits by the time the 4th check is due to be issued, the preliminary payments must cease since the presumption that the evidence is available is substantially weakened. When a TPT of C03 is input on a CPS initial payment transaction, the system will automatically stop payment after three CPS checks have been issued.
C. DIARY FOR RECEIPT OF CLAIM
After the initial CPS output is received by the PC, the Inquiries Staff will tightly control these payments until the claim is received from the DO/BO. Establish a diary for the first day of the month following the month that the third check is issued.
The first check was paid on 9/5, representing monthly benefits payable through August. The second check issuing date is 10/3, the third on 11/3. Therefore, the diary date will be 12/1.
D. MATURED DIARY — CLAIM NOT RECEIVED
If the claim has not been received by the diary due date, obtain an MBR printout to verify that the award has not been processed through MCS. If not, call the DO/BO for the status of the development efforts made to obtain the needed evidence. Ascertain from the DO/BO what evidence is outstanding and prepare a Report of Contact (SSA-5002). If the DO/BO has received the evidence for a final determination and advises that the claimant is entitled to benefits, every effort must be made to ensure regular benefit payments continue. If the award cannot be established immediately on the MBR, input a new initial payment transaction through CPS using a TPT code of C99.
If the DO/BO has not received the evidence for a final determination showing the claimant is entitled to monthly benefits, send a notice to the claimant advising that no further benefits are payable under the preliminary payment procedures and that payment must stop until the evidence for a final determination has been received. Include in the notice a statement of the evidence needed and instructions to contact the DO/BO if he or she has any questions.
File the SSA-5002 and copy of the notice to the claimant in the temporary folder.
E. RECEIPT OF CLAIM FROM DO/BO
When the initial claim with the original SSA-1877, SSA-795, and possibly SSA-5015-U2 are received, the Inquiries Staff will prepare a claims folder for the claim and related material and consolidate it with the material in the temporary folder. The Inquiries Staff will control the case through final processing stages. If an overpayment has occurred, follow GN 02230.010.
F. RECEIPT OF CPS STOP PAYMENT OUTPUT FROM DO/BO
A CPS stop payment transaction will be input by the DO/BO when it is subsequently determined that the claimant receiving preliminary payments is not entitled to benefits. Associate the CPS stop payment output with the temporary folder and establish a 10-calendar day control for receipt of the claim.
G. MATURED DIARY — DISALLOWANCE NOT RECEIVED
If a disallowed claim is not received within the 10-calendar day control period, call the DO/BO to ascertain the date it will be sent. If the claim is still pending at the DO/BO level, request that it be sent to the PC immediately since the claimant must receive a formal determination notice by the PC of the disallowance action and reason for that action. Establish a 7-calendar day control for follow up.
Continuous control dates of 7-calendar days will be established and the DO contacted at the end of each period until the claim is received.
H. DISALLOWED CLAIM RECEIVED
As soon as the disallowed claim, SSA-1877, SSA-795, possibly the SSA-5015-U2, and copy of the claimant's letter sent by the DO are received, process in accordance with E above. The PC is responsible for releasing the disallowance notice and annotating the overpayment to the Recovery of Overpayments, Accounting, and Reporting (ROAR) system. After all necessary actions (e.g., overpayment recoupment), forward the claims folder (temporary transfer) to:
- Office of Retirement and Survivors Insurance
Division of Payment and Adjudicative Policy
Room 3-A-21 Operations Building
6401 Security Boulevard
Baltimore, Maryland 21235-6401
The claims folder will be returned to the respective PC after analysis.