TN 1 (01-12)

DI 60099.045 BOND Work CDR Unit Responsibilities

The Benefit Offset National Demonstration (BOND) work continuing disability review (CDR) unit in the Office of Program Development and Research (OPDR) develops work activity for all BOND participants assigned to a treatment group and for the control group members of the stage 2 random assignment. They complete work CDRs under usual processing rules through eWork for the stage 2 control group members.

The Field Office (FO) and payment centers (PC) forwards any work documentation for the BOND participant or beneficiary via facsimile to the BOND work CDR unit at (410) 597-0149. See contact information for the BOND work CDR unit in DI 60099.005E.2.

When you transfer a case in paperless to L5R:

  • close out the paperless file;

  • enter a remark in paperless that you have transferred the case to L5R; and

  • fax all development in paperless to (410) 597-0149. This is important because the work CDR unit in L5R does not have any access to paperless and cannot see any development in that system.

NOTE: FO’s and PC’s can initiate and process to completion work CDR’s for members of the control group.

A. Initiating the work reviews

For those beneficiaries assigned to the stage 1 treatment group (T1), SSA identifies the need for a work CDR and sends a pre-populated SSA-820 or SSA-821 (Work Activity Report) and two SSA-3288 (Consent for Release of Information) forms to the beneficiary with instructions to return the forms to the BOND Site Office. The BOND Site Office will develop wage evidence and proof of work incentives (e.g., subsidy, IRWEs, etc.) and send the completed package to the centralized BOND work CDR unit (L5R).

For beneficiaries assigned to the stage 2 treatment group (T21 or T22), the BOND Site Office identifies the need for a work CDR and schedules an appointment with the beneficiary. SSA sends the beneficiary and BOND Site Office a pre-populated SSA-820/821 form when the SSA-3288 is in the BOND stand-alone system (BSAS). The BOND Site Office can share the pre-populated SSA 820/821 with project service providers (WIPA, WIC, or EWIC) if the 3288s is recorded in BODS.

B. Cessation determinations

For those beneficiaries assigned to a treatment group, the BOND work CDR unit:

  • codes earnings over the substantial gainful activity (SGA) limit for months after the grace period and during the BOND participation period as “zero”;

  • uses eWork remarks and documents decisions with full explanation detailing any proofs used as the basis for the determination,

  • “commits” the decision in eWork;

  • generates a due process notice modified by BOND rules based on the proposed SGA cessation. The due process notice includes the name and the phone number of the OPDR member working the case;

  • sets a 15-day tickle date in eWork;

  • uses eWork to process the SGA cessation determination;

  • updates the disability control file (DCF) via eWork;

  • processes a manual adjustment credit and award date entry (MACADE) action to post the SGA cessation month and issues a proper final notice explaining any overpayments or underpayments and BOND rules;

  • faxes documents (an SSA-821-BK, (Work Activity Report-Employee ) or SSA-820-F4, (Work Activity Report - Self Employed Person) and any pertinent impairment related work expenses (IRWE), and subsidy proofs and determinations) into eView or non-disability repository for evidentiary documents (NDRED) according to current policy; and

  • supplies (BPQY) information to site offices, as requested.

C. Continuance disability determinations

The BOND work CDR unit processes continuance decisions by:

  • processing the decision to eWork;

  • generating a continuance decision notice modified by BOND language based on the SGA determination;

  • using eWork to process the decision and update the DCF via the eWork push; and

  • faxing documents (an SSA-821-BK or SSA-820-F4 and any pertinent IRWE and subsidy determinations) into eView or NDRED according to current policy.

D. Non-countable income determinations

We apply the BOND $1 for $2 offset after we determine the annual countable earnings estimate. To determine the countable estimate, you must include the gross estimate of wages or self-employment provided by the beneficiary, and subtract any annual estimate of work incentives including IRWEs, subsidies, and special considerations. A determination on these work incentives deductions is the responsibility of the BOND work CDR unit in OPDR. Abt Associates (Abt) instructs BOND beneficiaries to submit proof of work incentives and other non-countable income proof. Abt forwards that information to the BOND work CDR unit. The BOND work CDR unit is responsible for reviewing the evidence and making a determination on the deductions. The CDR unit documents the decision in the BOND stand-alone system (BSAS) and faxes evidence associated with the decision into NDRed.

During the end-of-year reconciliation process, we exclude any non-proven work incentives, non-proven countable income, or denied estimates.

E. SGA appeals

The BOND work CDR unit processes and adjudicates requests for reconsideration of SGA cessation decisions. The Abt site offices collect appeal forms and submit them to the BOND work CDR unit.

If a request for waiver accompanies a request for reconsideration, the work CDR unit renders a decision on the reconsideration. When that decision is final, the BOND work CDR unit forwards the waiver to the appropriate FO for a decision.

The process for appeals on BOND cessations includes the following:

  • A BOND beneficiary may file an appeal on an SGA cessation determination;

  • The field office (FO) faxes any SSA-561 (Request for Reconsideration) to the centralized BOND work CDR unit at (410) 597-0149. FOs should also fax the reconsideration into eView or NDRed. The eWork Development Worksheet should be annotated with the appeal information;

  • Abt or the BOND beneficiary can mail or fax the SSA-561(U-2)’s to OPDR’s centralized work CDR unit. Abt annotates the receipt of the request in their system;

  • FO’s handle all other appeals under usual procedures. FO staff handles hearings requests, appeals council requests, and requests for a waiver of non-Bond related overpayments and residual overpayments resulting from reconsidered SGA cessation decisions. Abt site offices can assist BOND participants with appeal and waiver forms;

  • While the BOND beneficiary is waiting for a decision on his appeal, we can continue to apply the benefit offset based on the last determination made prior to the appeal;

  • OPDR handles reconsiderations resulting from trial work period (TWP) and SGA cessation determinations for BOND participants in the stage 1 and stage 2 treatment and control groups; and

  • OPDR processes reconsiderations on overpayments related to BOND offset calculations. These occur primarily after the end of year reconciliation process.

F. Final work CDR

The BOND work CDR unit completes final work CDRs to return BOND cases back into normal processing rules upon completion of the BOND offset participation period. This process protects the demonstration period from a re-opening of work CDRs after the beneficiary returns to normal rules.

An eWork exclusion prevents proper processing of BOND cases when the cessation month occurs after the normal 36th month of the extended period of eligibility (EPE). OPDR flags these cases in the special message block of the master beneficiary record (MBR) as cases that require manual processing by OPDR.

G. eWork functionality for BOND

The eWork system recognizes the DCF demonstration code of “DD” for BOND participants and generates a pop-up alert for users. The pop-up alert states the following: “BOND Case-special processing required. Please transfer to L5R”.

Only users assigned to the BOND work CDR unit in OPDR, office code L5R, will have the ability to adjudicate BOND work CDRs and any SGA reconsideration requests. The presence of the DCF demonstration code for BOND also requires the BOND work CDR unit to perform a final work CDR transitioning the BOND beneficiary back to normal rules after the BOND participation period ends. The other eWork enhancements for BOND include:

  • Suppression of the POS input,

  • Suppression of the notice feature. This feature suppresses the online retrieval system (ORS) archiving of beneficiary adjudicative notices and restricts the printing of beneficiary adjudicative notices; and

  • Non-generation of the pop-up alert for users in L5R.

1. Future eWork enhancements

  • Automatically protect the BOND participation period, so non-BOND users may effectuate work CDRs for participants who have never been in BOND offset during the participation period. Final work CDRs would only be required if a BOND beneficiary had been in offset for at least one month during the participation period.

  • Have eWork recognize a 60-month EPE for BOND cases and a 72-month EPE for BOPD cases. Currently eWork recognizes a 36-month EPE for all beneficiaries. This creates permanent eWork exclusions for all BOND and BOPD beneficiaries that cease after the normal 36-month EPE.

2. eWork limitations

  • eWork will not recognize a case as being part of the BOND demonstration projects if the “DD” code is not present on the DEMO screen of the DCF.

  • The POS “push” and notice suppression features will not work for a trial work period (TWP) determination or a reopening in eWork. The work CDR unit in L5R must annotate the notice from eWork automatically sent to ORS as an incorrect notice. Do not reprint this notice or mail it to the beneficiary, as it does not contain BOND language.

    NOTE: L5R does not mail this notice to any beneficiaries.

H. Undeliverable BOND Notices

Send undeliverable BOND Notices to L5R for review. Follow normal undeliverable mail procedures in GN 02605.005.

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DI 60099.045 - BOND Work CDR Unit Responsibilities - 02/10/2012
Batch run: 02/10/2012