DI 13510.005 Responsibilities of SSA Offices
The Office of Disability, Division of Vocational Rehabilitation and Special Programs, (OD-DVRSP) in Baltimore, Maryland will receive claims filed by the State VR agency for reimbursement of the costs of providing VR services to disability beneficiaries/recipients. In addition to receiving claims, DVRSP will be responsible for:
Screening out incorrect claims and resolving SSN, name, and other discrepancies.
Confirming the current benefit status of the beneficiary/recipient and determining the folder location.
Requesting development and verification of the VR continuous period of SGA when necessary.
Notifying the State VR agency of the disposition of each claim submitted and the amount of the reimbursement if applicable.
DVRSP will forward a controlled Form SSA-289-U3 “Request for Certification of SGA for Vocational Rehabilitation Reimbursement” to ODO, the PSC-DRS, or (in some instances) a DO for certification as to whether a VR continuous period of SGA has occurred. The request will show when the VR agency thinks that the work began and what the case control shows as folder location. When the VR agency includes SGA documentation (e.g., State unemployment compensation earnings records, statements by the clients, etc.) with their claims, copies of the documentation will be attached to the SSA-289-U3. The documentation is included as a guide to the resolution of the SGA issue.
DVRSP will maintain an internal control on the certification requests and follow up on every one for which disposition is not reported under the procedures for payment of VR claims below. DVRSP will follow up in 45 days or by sending a second request.
B. Role of ODO, PSC-DRS
Certification of SGA for the VR continuous period may be made in conjunction with a CDR, if a CDR is required in accordance with current CDR instructions. If a CDR is not necessary (a CDR was already completed), verify the VR continuous period of SGA from the information in file, if possible.
ODO or PSC-DRS will do the following:
Obtain the folder, if available.
Review the folder, and if the information is sufficient, verify and certify the VR continous period of SGA by completing the SSA-289-U3 in accordance with DI 13510.010. If a CDR is necessary, ODO or PSC-DRS will route the folder along with the VR certification form via a SSA-5526-U3 to the servicing DO. Item 6.g. of the SSA-5526-U3 will request a contact with the individual or employer to certify the VR continuous period of SGA.
If the information in the folder is not sufficient to certify the VR continuous period of SGA and it is determined that a CDR is not necessary, a form SSA-5526-U3 without the folder, will be sent to the DO for clarification. Item 6.g., of the SSA-5526-U3 will indicate the actual months of SGA (e.g., 9 /81-10/81) as recorded in the claims folder. The name of the employer will be indicated, if known. The DO will contact the individual or the employer to certify the VR continuous period of SGA.
C. Role of the District Office
The DO/BO will receive an SSA-289-U3 referred to it by ODO, PSC-DRS, or OD-DVRSP. The DO/BO will develop the information about the VR continuous period and complete the VR certification form in accordance with DI 13510.010. After certifying the VR continuous period of SGA, or determining that there was not a continuous period, route the SSA-289-U3 to SSA, OD, DVRSP, P.O. Box 17287, Baltimore, Maryland 21203.
The DO/BO will subsequently route the folder and any disability determination according to current CDR procedures in DI 13001.001 ff. It will not send the folder to OD-DVRSP. In SSI cases, make any necessary income adjustments based on the information obtained.
The local VR office may want to know whether a VR client is a SSA beneficiary/recipient before it requests reimbursement from SSA for its expenditures. Although the client may be able to provide this information, the VR office may request the SSA district office to verify entitlement/ eligibility. The DO should comply with the VR request and furnish information of entitlement/eligibility from the MBR or SSR in accordance with the procedures in GN 03305.005.