TN 14 (02-02)

SI 00603.032 Exceptions to Conducting a Preeffectuation Review Contact (PERC)

A. Policy - all claims

No PERC is required when the claimant has died and no SSI underpayment is payable (e.g., death is in the EO2 month). This means you either have enough evidence to determine there is no underpayment (e.g., excess resources) or there is no one eligible to receive a potential underpayment. (See SI 02101.001 ff. regarding who may receive an SSI underpayment.) See SI 01730.015 when there are alleged unpaid medical expenses.

B. Policy - simultaneous development claims

Do not conduct a PERC in the following situations involving a simultaneous development claim.

1. Claimant Becomes Ineligible

Do not conduct a PERC when the claimant becomes ineligible for benefits within the 4 calendar months following the latest of:

  • the month of first eligibility, (PRSN segment, DOE field on SSR), or

  • the date the initial application was received, (PSRN segment, DF field on SSR), or

  • the date the SSA-8000-BK or full MSSICS application was completed when the claim was switched from deferred to simultaneous development prior to receipt of the medical allowance,

and ineligibility is expected to continue through the end of the evaluation period (see SI 00601.008B. for the definition of evaluation period).

EXAMPLE: After contacting the teleservice center on January 15, an appointment was set up for Mr. Jones to take his disability claim by phone. The FO received Mr. Jones' application in the mail on February 10. The claim was handled as a simultaneous development claim. On May 20, Mr. Jones called the FO to report that he started to receive monthly Veterans benefits in May in an amount that would make him ineligible for SSI. On June 22, the FO received a notice of disability allowance on the claim. Although more than 120 days had elapsed since the date the application was received, no PERC is required since Mr. Jones is ineligible within 4 months of the date the application was received and ineligibility is expected to continue through the end of the evaluation period.

2. PD/PB Claims

Do not conduct a PERC when a presumptive disability/presumptive blindness (PD/PB) determination was made by either the FO or the DDS within 120 days of the latest of:

  • the date of first eligibility,

  • the date the initial application was received by SSA, or

  • the date the SSA-8000-BK or full MSSICS application was completed when the claim was switched from deferred to simultaneous development prior to receipt of the medical allowance and the claim is still in current pay when the final medical allowance is received.

C. Procedure - systems input

1. Non-MSSICS Processing

To avoid a PX edit (generated when the record shows some payment due at the time the disability allowance is posted and no PERC date input), give the system a PERC date of the current month/year in order to adjudicate the claim. Follow instructions in SM 01005.660 to make the input.

2. MSSICS Processing

Select PERC EXCLUSION on the Preeffectuation Review Contact (PERC) screen.

3. Delete Posted Date

Although a PERC date is necessary to avoid a PX edit, the PERC date should be deleted if the MSSICS or non-MSSICS cases meets the PD/PB exception to a PERC or the possibility exists that the case may be reopened (e.g., the claimant is receiving unemployment benefits that makes him ineligible for SSI, but the benefits are expected to end in three months). Delete the PERC date information from the system after the record is paid using code F and four zeroes per SM 01005.661D.

RATIONALE: This action will ensure that for these cases, the system will correctly select the reference date for the first redetermination.


To Link to this section - Use this URL:
http://policy.ssa.gov/poms.nsf/lnx/0500603032
SI 00603.032 - Exceptions to Conducting a Preeffectuation Revi