BASIC (09-08)

DI 52155.010 Modernized Claims System (MCS) Earnings Computation (EC) and Workers' Compensation/Public Disability Benefit (WC/PDB)

After you complete the MCS claims path, always request a preadjudicative MCS EC request. If a disability claim includes WC/PDB common screens, review those EC screens.

Always request the Case Display and the Claim Display screens from the Earnings Comp Determination menu page (MCR1).

A. Case Display

This field allows the user to select the EC screens that display Case Data that will be displayed in the MCS EC path. These screens provide account information that is used for all claimants on the record. WC/PDB screens can be viewed by selecting #1 or #6 in the Case Display field on the MCR1/MCR2 screen. The WRAC screen provides the ACE Computation

  • Even if no WC/PDB is involved, a Y response to Disability Work Related on the DISB screen will cause the WRAC to be included in the Case Display.

  • If a manual ACE computation is necessary, return to the WPCL screen in the claims path to override the systems generated ACE. See DI 52150.010D. for an explanation of when the systems derived ACE would be overridden.

The WRAD displays the factors that are used to determine offset when periodic payments are being made.

  • Verify the stop and start dates and monthly payment amounts.

  • If corrections are needed, return to the WPPR screen in the MCS claims path.

The WRLS displays the lump sum (LS) information used and the results of the three LS proration methods.

  • Verify the LS amount, start date and expenses.

  • Verify that the proration method being used by EC is the most advantageous. See DI 52150.060 - Prorating a Workers’ Compensation/Public Disability Benefit (WC/PDB) Lump Sum Settlement for more information.

  • If the LS information requires correction or the systems derived proration method is not the most advantageous, return to the WPLS screen in the claims path and make the necessary corrections.

    MCS EC will also interface with the records of the Office of Personnel Management (OPM) if the individual is receiving a Federal pension. See DI 52130.001E. for an explanation of the data fields presented.

B. Claim Display

This field allows the user to select the EC screens that display Claim Data that will be displayed in the MCS EC path. These screens provide data that is displayed on an individual claimant basis. Screens displaying WC/PDB information can be seen by selecting #1 or #4 in the Claim Display field of the MCR1/MCR2 screen.

The WRBD screen provides claimant results data for the offset determination.

  • The amount the benefit is being reduced for WC offset is displayed in the WC ONLY OFFSET column.

  • If PDB offset is also involved, the total offset for both WC and PDB are displayed in the COMBINED OFFSET column.

  • Displays the benefit amount due the claimant after WC/PDB offset.

The DBPH screen reflects what will appear in the HISTORY field of the MBR when the claim is processed through EC.

  • When the monthly benefit amount (MBA) is totally offset due to WC/PDB the full MBA will be reflected and the SUSTRM REASON WCOFFS will be shown.

  • The benefit amount after offset is reflected in the MBA field when partial offset applies.

IMPORTANT: Review the offset computation results prior to triggering the claim. If the displayed results are questionable or obviously incorrect, do not process the claim via MCS EC. Instead, do the offset computation in ICF #32 and prepare an A101. For A101 instructions, see DI 52155.025

The result of the WC/PDB offset processed in MCS EC is available for later use in the Workers' Compensation/Public Disability Benefit Data screens used by ICF by selecting #31, 32, 33 and 34 on IC00 (Title II Benefit Computation Menu).


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http://policy.ssa.gov/poms.nsf/lnx/0452155010