SSA - POMS: DI 60099.030 - Field Office (FO), Processing Service Center (PSC), and National 800 Number Network (N8NN) Responsibilities under the Benefit Offset National Demonstration (BOND)

A. BOND participant questions legitimacy of project

Abt Associates (Abt) letters tell BOND participants to report work activity contact either

•

Abt’s Teleservice Center for BOND, or
•

Abt’s Work Incentive Counselors (WICs) and Enhanced Work Incentive Counselors (EWICs).

If a BOND participant contacts an FO or the N8NN with questions about the BOND project, refer the BOND participant to one of the following Abt numbers:

•

The BOND toll-free number is 1-877-726-6309 (877-7BOND09). BOND NUMBER NO LONGER IN SERVICE
•

The BOND TTY (for hearing impaired) is 1-877-726-6390 (877-7BOND90). BOND NUMBER NO LONGER IN SERVICE

NOTE: FO, PSC, and N8NN staff can identify BOND participants based on DCF coding and BOND beneficiaries on the Disability Control File (DCF) and Master Beneficiary Record (MBR) coding as described in DI 60099.015.

FOs may tell a beneficiary who comes in inquiring about BOND, that recruitment ended and we selected all BOND participants.

B. BOND participant reports work activity to FO, PSC, or N8NN

1. Establish work report in eWork

If a Social Security disability insurance (SSDI) beneficiary reports work activity, the FO, PSC, or N8NN take the following actions

•

Follow the normal processing instructions to establish a work report in eWork.
•

Fax any other evidence into the electronic file (EF) or Non-Disability Repository (NDRED).
•

Refer the beneficiary to Abt to report the new work activity. For Abt contact information, see DI 60099.030A in this section.

2. Record submitted proof of earnings

If a work continuing disability review (CDR) is pending in L5R OFFICE L5R NO LONGER OPERATING, or you are establishing a new work report in eWork, and a BOND participant submits proof of earnings,

•

fax the documentation into eView or NDRED, and
•

annotate the eWork development worksheet with where the information is located.

For additional information on work reports and receipts, refer to DI 13010.020.

C. Process work CDRs

How work CDRs are processed:

•

eWork identifies a participant in the BOND project and modifies the notice feature for cases with a BOND participant to prevent the generation of incorrect notices.
•

eWork automatically generates a BOND paragraph on the L1013 notice and IRP Decision notice reminding participants they are in BOND.

1. FO and PSC processing work CDRs

Under normal work CDR processing guidelines eWork allows FOs and PSCs to process the following BOND cases:

•

Trial work period (TWP) determinations;
•

Extended period of eligibility (EPE) continuances;
•

Initial reinstatement period (IRP) determinations for expedited reinstatement (EXR) cases; and
•

Work review period starting with the month following the BOND participation stop date on the DCF.

See normal processing procedures:

•

DI 13010.023 Processing Center (PC) Responsibilities for Continuing Disability Reviews (CDRs) involving Work Activity
•

DI 13010.025 Field Office (FO) Responsibilities in Work Continuing Disability Reviews (CDRs)

2. FO processing exclusions

eWork does not allow an FO to process a work CDR that displays the DD (BOND) or D3 (4-State demonstration cases) code in the DCF in the following instances:

•

Cases with a work cessation (applicant’s disability cessation (ADC) date and CDR = E) on the MBR and the beneficiary is still within the BOND participation period on the DCF; and
•

Cases that result in a work cessation determination for the current decision.

Transfer these cases to L5R OFFICE L5R NO LONGER OPERATING per DI 60099.030D in this section.

IMPORTANT: There are no restrictions on the FO, PSC, or N8NN for updating or changing the Supplemental Security Income (SSI) records of concurrently entitled BOND participants or beneficiaries. All requirements for wage reporting, changes of address, changes of living arrangement, etc. for SSI recipients continue (via the local FO) according to current policy.

D. Refer cases to BOND work CDR unit

Note:

The BOND processing office L5R is no longer operating, access to the data required to make determinations is no longer available. All BOND decisions are final as beneficiaries are officially outside of their appeal period. Any reconsiderations should be considered automatic denials.

1. eWork prompts you to transfer a BOND case to L5R OFFICE L5R NO LONGER OPERATING

eWork prompts you to transfer a BOND case to L5R OFFICE L5R NO LONGER OPERATING in the following instances:

•

ADC date is on the MBR and a work CDR is required by Abt after a cessation determination for a period prior to BOND participation; or
•

during the current work review a cessation determination is made in L5R.

2. Transfer an eWork case to L5R OFFICE L5R NO LONGER OPERATING

How to transfer an eWork case to L5R OFFICE L5R NO LONGER OPERATING:

•

Enter the claim number and Beneficiary Identification Code (BIC), or the Beneficiary’s Own Account Number (BOAN), of the BOND participant on the eWork Main Menu.
•

Click Initiate/Update Work Review on the Main Menu or Work Review Summary in the eWork Related Links box at the top of the page. Either action takes you to the Work Review Summary page.
•

Click View Case Movement in the middle of the Work Review Summary page. This brings you to the Case Movement for Claim page.
•

Enter “New” under Transfer Case in the Transfer to Unit box. In Transfer to Office, enter “L5R.” OFFICE L5R NO LONGER OPERATING Click the blue Transfer Out button. This action transfers the case to L5R OFFICE L5R NO LONGER OPERATING .

Before you transfer a case that requires a cessation determination to L5R OFFICE L5R NO LONGER OPERATING, verify that all documentation supporting that determination is in eView and NDRED. L5R does not have access to Paperless. Alert L5R OFFICE L5R NO LONGER OPERATING that the beneficiary submitted earnings information by adding an issue to the Development Worksheet (DW) screen in eWork.

For additional information on work reports and receipts, refer to DI 13010.020.

3. BOND work CDR unit responsibilities (L5R) OFFICE L5R NO LONGER OPERATING

L5R OFFICE L5R NO LONGER OPERATING processes cases to completion when:

•

a work CDR for a BOND beneficiary is transferred to the BOND work CDR unit (located in office code L5R) OFFICE L5R NO LONGER OPERATING, or
•

a BOND participant earning over substantial gainful activity (SGA) is transferred by Abt.

See additional information on L5R OFFICE L5R NO LONGER OPERATING processing of work CDRs in DI 60099.045

E. FO and PSC procedure to reopen a BOND beneficiary’s work review

FOs, and PSCs are not able to reopen or reconsider BOND beneficiary’s work review with a cessation prior to the BOND participation stop date. Cases with a cessation prior to the BOND are the responsibility of the work CDR unit in L5R OFFICE L5R NO LONGER OPERATING.

•

eWork generates an alert “Prior BOND Beneficiary”. Do not attempt to update BOND related earnings.
•

eWork generates an alert advising FOs and PSCs to transfer cases to L5R OFFICE L5R NO LONGER OPERATING if earnings should change.

NOTE: If you attempt to reopen a prior determination and the determination includes months during the BOND participation period for a BOND beneficiary, you cannot change any data during this period. These months are in pink.

F. FO and PSC procedure to process BOND work CDR reconsideration requests

The BOND work CDR unit (L5R) OFFICE L5R NO LONGER OPERATING is the only office with jurisdiction to make a decision on BOND work CDR reconsideration requests. Forward all requests for reconsideration to L5R OFFICE L5R NO LONGER OPERATING by taking the following actions:

1.

Key the reconsideration request into the Debt Management System (DMS) if there is an overpayment resulting from the initial work CDR determination;
2.

Fax form SSA-561-U2 (Request for Reconsideration) and any accompanying evidence into the Certified Electronic Folder (CEF) or Non-Disability Repository for Evidentiary Document (NDRED) as appropriate; and
3.

Send a Modernized development worksheet (MDW) to L5R OFFICE L5R NO LONGER OPERATING to notify them of the pending reconsideration request. For additional information about reconsideration requests on BOND overpayments, see DI 60099.075A.1.b.

NOTE: While it is L5R’s OFFICE L5R NO LONGER OPERATING responsibility to process work CDR reconsiderations on all BOND cases involving a cessation determination, it is the FO’s responsibility to address the reconsideration on any resulting overpayment except those with the designation of BOND. For more information on BOND overpayment reconsideration requests, see DI 60099.075.

G. FO and PSC procedure to process work CDRs for beneficiaries whose BOND participation ended

Beginning May 1, 2016 BOND participants and BOND beneficiaries began exiting their 60-month demonstration participation period. SSA must review the case to determine the need for a work CDR. The FO or PSC is responsible for adjudicating all reviews that cover a period that begins after the BOND participation stop date found on the DCF DEMO screen.

Work Incentive Counselors (WICs) instruct BOND participants to report their earnings to their FO after their BOND participation ends. If a former BOND participant reports work, follow these steps:

•

Issue a work report receipt;
•

Check the END date on the DCF DEMO screen (Function #16);
•

Establish a work review in eWork; eWork establishes a work review beginning the month after the BOND end date on the DCF;
•

Update monthly earnings and effectuate the review.

NOTE: Most BOND participants exhaust their 36-month extended period of eligibility (EPE) by the time they exit BOND. Therefore, an SGA determination results in a termination of benefits. Consider this when reviewing the case to determine the need for a CDR.

•

Follow normal processing guidelines when a termination decision results in a Post-entitlement system (POS) direct input exclusion, see DI 13010.025B.4.
•

Place the beneficiary in LAF-S0 DEVDIB to prevent further overpayment.

H. Determining Medicare Termination Date Following a Tittle II EPE Termination for BOND Participants

Participation in the BOND permits continuation of Medicare even if the individual is not in pay due to the level of his earnings. The regular rules for Medicare termination (as shown below) will apply once the BOND participation ends.

If benefits terminate due to work, the end date of Medicare entitlement depends on the work activity in the first 16 months of the EPE.

For BOND Participants, any months coded with a WIC (Work Indicator Code) of Z indicate work above SGA.

Medicare may NOT end earlier than the:

•

last day of the 93rd month from the beginning of the EPE, or
•

the DBC.

Where title II disability benefits end because of substantial gainful activity (SGA) following a TWP, D-HI ends as follows:

•

If disability cessation (the first month of SGA following the end of the TWP) occurs prior to the 14^th month of the extended period of eligibility (EPE) and the individual engaged in SGA in the 16^th month of the EPE, D-HI ends with the last day of the 57^th month* following the end of the 36 month disability re-entitlement period or, if later, the end of the month following the disability benefit termination notice. *Prior to 10/00, replace “57th month” with “3rd month”.
•

If disability cessation occurs prior to the 14^th month of the EPE, but the individual does not engage in SGA in the 16^th month of the EPE, D-HI ends with the last day of the 77^th month* following the first month of SGA which occurs thereafter or, if later, with the end of the month following the disability benefit termination notice. *Prior to 10/00, replace “77th month” with “24th month”.
•

If disability cessation occurs after the 13^th month of the EPE, D-HI ends with the last day of the 80^th month* following the disability cessation month or, if later, with the end of the month following the disability benefit termination notice. *Prior to 10/00, replace “80th month” with “27th month”.

Prior to 1/88, an individual was eligible only for a 15-month re-entitlement period. In such cases, D-HI ended with the last day of the 23rd month following the disability benefit cessation (DBC).

Beginning 7/1/90, individuals whose D-HI ends solely because of SGA are eligible to enroll in premium-HI for the Working Disabled. For more information, see HI 00820.025A.4.

I. Verify earnings (VY) issues for ticket to work cases

If the FO receives a systems-generated VY issue with TICKET as the type for a BOND participant,

•

review the DEMO screen in the DCF for the DD demo indicator;
•

close out the issue by keying the current date in the CLOSED field;
•

annotate the reason for close out in the remarks section as “BOND case.”

Tickles may reappear if alleged wages are posted to the DCF and no verified wages are posted for the BOND cases. FO should

•

continue to close the Title 2 verified earnings (T2VY) issues, and
•

post only Title 16 verified earnings (T16VY) issues to the Supplemental security income record (SSID).

The Ticket-to-Work (TTW) staff manually processes payments for employment numbers (ENs) for these T2VY issues, in the Office of Research, Demonstration, and Employment Support at headquarters in Baltimore, MD. For additional assistance, contact your BOND regional coordinator.

For more information on VY issues for TTW cases, see

•

DI 55030.010 Program Manager (PM) Responsibilities for Reporting Alleged Gross Earnings to SSA
•

DI 13010.605 The CDR Development Worksheet (CDRW) Screen

J. Expedited reinstatement (EXR) requests or initial disability application

To be eligible for the $1 for $2 offset, a BOND participant must have an SGA cessation. Depending on the timing of the last work CDR, a retroactive work activity determination could terminate benefits prior to the start of the BOND project. In those situations, the participant remains in the BOND project, but is not eligible for the $1 for $2 offset until the participant becomes re-entitled to disability benefits through a new application or EXR and meets all other offset requirements.

If the beneficiary decides to pursue a new application or EXR, the BOND work CDR unit and Abt

•

refers the beneficiary to the N8NN to make an appointment to file the appropriate paperwork.
•

notifies the AWIC in the area of the referral if the action they take on a work CDR results in a termination of benefits prior to the BOND participation period. This action allows the AWIC to monitor the BOND case during the EXR process.

IMPORTANT: The beneficiaries need to understand clearly how EXR works if they pick EXR versus initial claim (IC). Include this information in your explanation to BOND beneficiaries.

•

The beneficiary is not eligible for the BOND offset computation until the 24-month IRP and TWP is completed, and their benefits cease due to SGA under normal rules.
•

The beneficiary must complete their new TWP by 09/30/2017 to be eligible for BOND offset; if the 24-month IRP begins after 01/2015, they will never be able to use the offset.

K. Medical CDRs and work development

A beneficiary participating in the BOND project is subject to medical CDRs.

1. BOND work CDR unit discovers need for a medical CDR

When a medical review is due, the BOND work CDR unit (L5R) OFFICE L5R NO LONGER OPERATING must

•

transfer the case to the local FO to develop the case, and
•

send it to the local DDS for a medical decision after completing the work CDR development.

2. FO or PSC discovers need for a medical CDR

If the FO or PSC discovers a need for a medical review for a case pending in L5R OFFICE L5R NO LONGER OPERATING in eWork, alert the Office of Research, Demonstration, and Employment Support (ORDES) via an MDW to L5R OFFICE L5R NO LONGER OPERATING. The MDW can say “Medical CDR needed, please expedite processing of the Work CDR decision and forward to DO ____, Attn: (insert CR or FO contact information).

3. Work development during the BOND offset period

If a medical CDR is required, do not complete another work CDR to send the case to the DDS, for a beneficiary whose

•

benefits ceased due to SGA (ADC date on the MBR with CDR=E), and
•

last completed work review is past the BOND participation period start date, and
•

BOND participation period has not ended.

The beginning and ending date of offset is on the MBR in the HISTDEMO group.

The participation period is in the DCF on the DEMO screen under #16 Demonstration Project on the CDR Selection Menu.

Annotate the following in your SGA determination to DDS:

ISSUE: Evaluation of work performed for a participant in the Benefit Offset National Demonstration (BOND).

POLICY: When a BOND beneficiary is eligible for BOND offset, he or she no longer has an evaluation under SGA guidelines. Only use past relevant work (PRW) in steps 7 and 8 of the medical CDR process for BOND cases in offset.

BOND offset period began: (later of Participation Period Start Date in the DCF or three months after the Work ADC date on MBR)

BOND offset period ends: If the last work CDR completed is prior to the BOND start date of participation and there is a prior ADC date on the MBR, L5R must complete a work CDR in eWork to address the work prior to the BOND offset period. Please send a priority MDW to L5R OFFICE L5R NO LONGER OPERATING asking them to expedite this case due to medical CDR processing.

4. Medical cessation

If the DDS finds medical improvement, review the MBR for a HISTDEMO group and a DPI code of DD.

a. MBR has HISTDEMO group and a DPI code of DD

If the MBR has a DPI code of DD, send a high priority MDW to L5R OFFICE L5R NO LONGER OPERATING indicating medical denial. L5R OFFICE L5R NO LONGER OPERATING codes the medical CDR determination on the MBR.

If the FO tries to code this data via POS, it will send an edit to PC7, which may delay posting the medical information to the MBR.

b. MBR does not have a HISTDEMO group or a DPI code of DD

If the MBR does not have a HISTDEMO group, the system automatically processes the termination when the proper medical cessation coding appears on the MBR DIB line.

NOTE: Follow normal procedures to process a medical CDR and appeal for all BOND cases, including Section 301 payment continuation. The local FO takes control of this case and processes it normally.

L. Post-entitlement changes for BOND participants and beneficiaries

The PSC may use the following programs to process changes on the MBR for BOND participants and BOND beneficiaries:

•

Recovery of Overpayments and Accounts Receivable (ROAR);
•

Beneficiary Annotation and Communication (BACOM);
•

Returned Check Action (REACT);
•

Retirement, Survivor, and Disability Insurance (RSDI) Accounting; and
•

MBR Maintenance (MUMAINT).

The MBR can also change by interactions from the Beneficiary and Earnings Data Exchange (BENDEX), which is a data exchange between SSA and participating state agencies.

1. BOND participant

Follow normal procedures for post-entitlement changes.

2. BOND beneficiary

If a beneficiary contacts us about changing an address, phone number, direct deposit, or has a payee change, check the MBR for the HISTDEMO group. A BOND beneficiary case has a DPI code of DD on the MBR. L5R OFFICE L5R NO LONGER OPERATING notifies the FO via an MDW if a beneficiary needs his or her SSI information updated.

a. MBR does not have DPI code of DD

If there is no HISTDEMO group or the HISTDEMO group has a DPI code of something other than DD, follow normal procedures to process changes to the master beneficiary record (MBR).

b. MBR has DPI code of DD

•

If the action date is after the BOND stop date, the HISTDEMO group has a DPI code of DD, and the date of the action is after the stop date, follow normal procedures to process changes to the MBR.
•

If the action date is on or before the BOND stop date, the HISTDEMO group has a DPI code of DD, and the date of the action falls between the start and stop dates on the HISTDEMO line, generate an MDW to L5R OFFICE L5R NO LONGER OPERATING with the new information. The BOND work CDR unit will update the MBR. Document the file with all evidence to support the changes. The BOND work CDR unit or the centralized unit in the Office of Central Operations (OCO) verifies the information before they process changes.

3. PSC attempts to input a PE action

If a program service center (PSC) or OCO attempts to input a PE action through a MADCAP or MACADE transaction within the start and stop dates of the demonstration project, an alert specifies the need to access an additional screen to override the current demonstration information on the MBR. This is a preventative measure to avoid incorrect inputs by the PSCs. PSC staff refer necessary actions within the demonstration period to the OCO centralized unit (DEMOB) in PC7 for processing.

M. Special processing scenarios

When you encounter situations where special processing applies, use the instructions in this chart to assist you.

Scenario	Alert	Action
You attempt to create a Work Report in eWork when the BOND case has an ADC and is still within the BOND participation Period.	BOND Beneficiary – Issue work receipt through DPS and refer beneficiary to the BOND Call Center (877)-726-6309	Complete the Work Report Normally and refer the beneficiary to the BOND Call Center.
You attempt to create a Work Review when an ADC date is on the MBR and the Work Review created is during the BOND Participation Period (DCF).	BOND Beneficiary. The Beneficiary for Claim SSN xxx-xx-xxxx BIC_ BOAN xxx-xx-xxxx is currently within Offset phase of the BOND project. A new review cannot be established at this time.	PSC User: Annotate the Action Control Record (ACR) “NAN-BOND beneficiary in offset period” if you are attempting to set this case up in eWork because the continuing disability review enforcement operation (CDREO). Send the ACR to FIN. Clear the Enforcement via the CDR PC Input (IPCA) screen on the DCF using 8=SSR/MBR CONDITIONS-STOP CDR FO User: Clear the Enforcement via the CDR FO Input (IFOA) screen using 5=SSR/MBR/STOP CDR
There is no ADC date on the MBR but eWork shows the latest determination is a cessation. The current date is after the BOND Participation Stop Date on the DCF.	The prior eWork decision was an EPE cessation but there is no ADC date on the MBR. A new work review cannot be established until the prior eWork decision is processed to the MBR. Do you want to reopen the prior EPE cessation processed on mm/dd/yyyy?	Send an MDW to L5R OFFICE L5R NO LONGER OPERATING with information on this BOND case and the message you received. Tickle the eWork development worksheet for 10 days. Once L5R posts the ADC date on the MBR, process your work CDR normally. Jurisdiction of these cases remains with the originating component.
A non-BOND office user attempts to establish a review in the same month that we made a previous decision, and the previous review contains protected BOND months.	There was a prior eWork decision processed mm/yyyy. You cannot establish a new Work Review in the same month a prior decision was made. This prior decision is blocked due to BOND Beneficiary participation and can only be reopened by L5R OFFICE L5R NO LONGER OPERATING.	Send an MDW to L5R OFFICE L5R NO LONGER OPERATING with the information on this BOND case and the message you received.
A non-BOND office user attempts to save new information for a protected BOND month in a Short Path, or attempts to reopen a month in the protected period from a prior review on the Earnings Details Screens.	Work Review Summary Screen will display: *Prior BOND Beneficiary* The information you changed is in the Short Path period. The EPE events (e.g. EPE Begin Month, Cessation, Reinstatements, and Suspensions) during the Short Path period are based on the months previously entered. This period contains months within a protected BOND demonstration period and cannot be reopened. Please transfer to L5R OFFICE L5R NO LONGER OPERATING for special processing.	Send an MDW to L5R OFFICE L5R NO LONGER OPERATING with the information on this BOND case and the message you received.
FO reopening case to process a denial.	There is no alert for this scenario.	If there is no ADC date on the MBR, FO may reopen the case. If there is a prior ADC date, you cannot reopen the case. Send MDW to L5R OFFICE L5R NO LONGER OPERATING.
A non-BOND office navigates to the Case Summary screen for a case determined a BOND beneficiary.	BOND Demonstration beneficiary, please transfer to BOND office L5R OFFICE L5R NO LONGER OPERATING to complete adjudication.	Send an MDW to L5R OFFICE L5R NO LONGER OPERATING.

N. Fraud issues and BOND

Do not transfer fraud cases to the BOND work CDR unit (L5R) OFFICE L5R NO LONGER OPERATING. If L5R OFFICE L5R NO LONGER OPERATING receives a fraud case, they transfer the case back to the originating location.

Normal processing procedures apply for all fraud cases.

A BOND beneficiary remains in BOND when fraud is involved. However, if the decision involves removing earnings that influence our cessation determination or the offset decision, we modify our decisions accordingly. Send an MDW to L5R OFFICE L5R NO LONGER OPERATING if you need a cessation determination changed or reopened.

For more information on handling fraud, see DI 11006.025.

Social Security

Program Operations Manual System (POMS)

DI 60099.030 Field Office (FO), Processing Service Center (PSC), and National 800 Number Network (N8NN) Responsibilities under the Benefit Offset National Demonstration (BOND)