TN 7 (11-16)
DI 42010.210 ODAR Requests Payment of Interim Benefits in Own-Motion Review Cases Involving a Disability Issue - Title II
A. Office of Appellate Operations (OAO) contacts Office of Central Operations (OCO) and Program Service Center (PSC)
Office of Appellate Operations (OAO) will contact the Office of Central Operations (OCO) or the Program Service Center (PSC) to request payment action if a final decision is not issued within 110 days after the favorable administrative law judge (ALJ) decision. OAO will fax a “potential interim benefit case” information sheet to the appropriate OCO or PSC paperless system.
If a start order is not received to initiate interim benefits, see DI 42010.225A.
Listed below are the PSC paperless system fax numbers.
Northeastern Program Service Center (NEPSC-PSC 1): 877-358-0640
Mid-Atlantic Program Service Center (MATPSC-PSC 2): 877-385-0644
Southeastern Program Service Center (SEPSC-PSC 3): 877-310-6767
Great Lakes Program Service Center (GLPSC-PSC 4): 877-311-5797
Western Program Service Center (WNPSC-PSC 5): 877-310-7807
Mid-America Program Service Center (MAMPSC-PSC 6): 877-311-8738
Office of Disability Operations (ODO-PC 7): 877-385-0643
Division of International Operations (DIO-PC 8): 877-385-0645
NOTE: Office of Central Operations (OCO) includes ODO Processing Center (PC) 7 and DIO PC 8.
B. Information needed to process an interim benefit request
OAO provides OCO or the PSC with a completed information sheet titled “potential interim benefit case.” For an example of this form please see DI 42010.210D. The form will contain the following information:
Social security number (SSN) of record,
Any known cross reference social security numbers,
Type of claim (Disabled Adult, Child, or Spouse),
Date of the ALJ decision and the ALJ’s name,
Date of onset established by the ALJ,
Individual's name, address, date of birth, date of application, telephone number, and payee information,
Name, address, and telephone number of attorney or representative (if applicable),
Information regarding workers' compensation or other Public Disability Benefit (PDB) offset payments (e.g., civil service),
Name, position title, and telephone number of the OAO contact authorizing interim benefits,
Proof of military service if applicable,
Earning or self-employment not posted to the earnings record,
Prison confinement and conviction information if available,
Office code and phone number of the field office contacted to initiate Supplemental Security Income (SSI) payments in concurrent case situations, and
Last month of eligibility to interim benefits if SSA made a final decision on the issue of disability.
NOTE: OAO obtains leads for workers' compensation and public disability benefits from responses to the SSA-16 (Application for Disability Insurance Benefits) (e.g., question 24) or the presence of an SSA-546 (Workers' Compensation/ Public Disability Benefit Questionnaire) in file. Recorded on the SSA-546 you will find payment amounts, date of payment, etc. In an electronic claim, information similar to the SSA-16 and SSA-546 would still be in file.
C. OCO and PSC processing responsibilities
When the “potential interim benefit case” information sheet is received in OCO or the PSC, refer to DI 42010.215B and DI 42010.215C for claims specialist and benefit authorizer interim benefit processing responsibilities.
1. Special situations
Pay interim benefits on all SSNs for which there is an ALJ disability decision on entitlement (e.g., combined disabled number holder/ disabled child (HA/CDB), disabled number holder/disabled widow(ers) (HA/DWB), etc.).
Determine if one or more payments should be issued in dual-entitlement situations (e.g., HA/CDB, HA/DWB, etc.). See GN 02401.025 and GN 02401.030.
Follow RS 00615.730, RS 00615.740, RS 00615.756, and RS 00615.770 in a family maximum case.
Pay the adjusted rate to the disabled child in family maximum cases. Do not adjust other family members’ payments until the disabled child decision is final.
Follow RS 00615.420 (D-HA) in Disability Insurance Benefits (DIB) or RS 00615.410 (A-HA) in Retirement Insurance Benefits (RIB)-DIB situations. If the claimant is currently entitled to RIB and interim benefits are payable for the DIB, do not convert the RIB to DIB, rather pay the difference as the interim benefit.
Adjust the interim benefit, if the individual is in current payment on another SSN.
Do not withhold or adjust interim benefits to recover a prior overpayment.
In concurrent Title II/XVI, coordinate with the field office (FO) to avoid creating an SSI windfall, as follows:
Contact the servicing FO and provide the Title II interim benefit amount, and to ensure SSI payment deferment until processing of Title II interim benefits. See SI 02007.001.
FO will count the Title II payments as income for SSI purposes. SSI interim benefits must not begin until payment of Title II interim benefits.
Follow GN 02610.000 for the handling of payments under the windfall offset provisions, if SSI is in pay status before Title II.
D. Exhibit: Potential interim benefit case (information sheet)
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