DI 52130.001 Types of Federal Public Disability Benefit (PDB) Payments
A Federal public disability benefit (PDB) includes the following payments:
Civil Service Retirement System (CSRS) disability benefits and CSRS Offset benefits. See DI 52130.005 in this subchapter.
Federal Employees' Retirement System (FERS) disability benefits. See DI 52130.010 in this subchapter.
Military disability benefits including military retirement pensions based on disability (not Veterans' Administration or VA benefits excluding payments from the Office of Veteran’s Affairs.). See DI 52130.015 in this subchapter.
Part B Black Lung benefits (BLB) from the Federal Mine Safety and Health Act (FMSHA). These are only offsettable when the mine employment is in non-covered service. See offset information for Part B BLB in DI 52125.020.
A. Federal PDB offset - covered service exclusion
The decision whether to offset depends on the date of onset of disability and the amount of covered service. Covered service is employment on which Federal Insurance Contribution Act (FICA) taxes were paid either through payroll deduction or other arrangements. Medicare Qualified Government Employment (MQGE) is not covered employment for this purpose.
B. Federal PDB exclusion test
1. DIB onset is 05/01/1986 or later
If the PDB plan is based on a period of service that was used both to establish eligibility to the PDB and to compute the amount of the PDB, and that period of service is at least 85 percent covered service, the PDB is not offset.
However, if the PDB plan is based on one period of service to establish eligibility to the PDB, and a different period of service to compute the amount of the PDB, either period can exclude the PDB from offset if at least 85 percent of the period used is covered. In these situations, take the following steps to determine if the PDB is offsettable:
Evaluate the first period of service (e.g., the period of service used to establish eligibility to the PDB). If this period is based on at least 85 percent covered service, the PDB is excluded from offset.
If the first period of service does not satisfy the 85 percent test, look at the second period of service (e.g., the period of service used to compute the amount of the PDB). If the second period of service (evaluated on its own and without regard to the first period) satisfies the 85 percent test, the PDB is excluded from offset.
If the second period also does not satisfy the 85 percent test (i.e., neither period satisfies the 85 percent test), the PDB is offset.
NOTE: The 85 percent must be satisfied by one of the periods considered alone. Do not add the separate percentages from the two periods. See DI 52125.010, Determining When a Public Disability Benefit (PDB) is Based on Covered Service, for more information and examples on determining when a PDB is offsettable.
2. DIB onset 03/01/1981 through 04/30/1986 and month of entitlement (MOET) 09/1981 or later
Do not offset if Federal PDB is based on at least one day of covered service.
NOTE: A coverage indicator “Y” on the Informational/Certified Earnings Record Screen (ICERS) or a “Y” in the CS ANNUITY SSA COV: field on the Civil Service Data (DCSD) screen in the Modernized Claim System Earnings Computation (MCS EC) path is verification of covered service. However, you must check the Detailed Earnings Query (DEQY) for the years in question to make sure the covered employment is Federal and not private employment. MCS cannot distinguish between Federal and private employment and may errantly provide the remark “PDB Exception.” See obtaining proof of Federal PDB in DI 52130.001D in this section.
3. DIB onset prior to 03/01/1981 or MOET prior to 09/01/1981
Do not offset. PDB offset did not exist prior to the 1981 Social Security Amendments.
C. Relationship of Federal PDB to other offsets
1. Federal Employees’ Compensation Act (FECA)
A disabled Federal employee may decide that retiring on disability is more beneficial than continuing to receive FECA payments. If FECA payments stop and there is no indication that the individual is working, develop to see if Federal PDB are being paid.
NOTE: If the NH is receiving a scheduled award (e.g. a disfigurement payment), it is possible for the NH to receive both FECA and disability retirement at the same time. For information on FECA payments see DI 52115.010.
2. Windfall Elimination Provision (WEP)
A PDB benefit that causes offset may also result in the PIA being reduced under WEP. WEP is a reduction of the Social Security retirement or disability PIA when the beneficiary also receives a pension from work not covered by Social Security.
If Federal PDB is involved, refer to RS 00605.360 to determine if the WEP applies regardless of whether PDB offset applies. WEP and PDB offset are applied due to the receipt of a pension based on non-covered earnings.
NOTE: The PDB offset exclusion requirements differ from the WEP exemption requirements. One, both or neither may apply.
3. Government Pension Offset (GPO)
If the NH receiving PDB is also entitled to spouse or widow(er) benefits, determine if GPO applies. See GN 02608.100 - Government Pension Offset (GPO) Provision. It is possible for PDB offset to apply to the NH’s DIB benefit at the same time GPO applies to the spouse’s or widow’s benefit the NH also receives.
D. Obtaining proof of Federal PDB
If the individual is unable to provide adequate proof of the CSRS or FERS disability pension or the years used in determining eligibility or payment amount, request proof from the Office of Personnel Management (OPM) by mail or fax:
To obtain proof of Part B BLB, see DI 52125.020.To obtain proof of military disability benefits, see DI 52130.010.
1. OPM claim number
Use the OPM claim number, also referred to as the civil service annuity (CSA) number, on all requests to OPM, if available. The CSA number consists of an alpha character followed by seven digits (e.g., A1234567).
NOTE: Do not confuse the CSA number with the FECA claim number. The FECA claim number is nine digits long and begins with a two-digit code separated by a hyphen (e.g., 01-2345678).
2. Completing the Form SSA-1709, Request for Workers’ Compensation/Public Disability Benefit Questionnaire
To complete the SSA-1709 – see exhibit in OS 15020.295:
Annotate in red on the back of the SSA-1709 the remark “For the period beginning MM/YYYY” at the top after “Information Requested,” (replace MM/YYYY with first month and year for which verification is being requested).
Circle in red only those items for which verification is needed
EXAMPLE: If you only need verification for the covered service issue, circle item 11.
Circle number 12 – Remarks - in red and annotate “Please indicate which three years make up the High-3 upon which the payment is based.”
Mail the form to: Office of Personnel Management
Employee Claims Correspondence Center
Boyers, PA 16017
Diary for 60 calendar days for OPM’s reply.
NOTE: The Employee Claims Correspondence Center only has information on claims that are at least one year old.
3. Faxing a request to OPM
If the PC faxes the request to OPM, diary for 30 days for OPM’s reply. If there is no response within 30 days, mail or fax a second request.