BASIC (11-96)

SI 00832.002 Processing Self-Identified Anderson Cases - Initial Reviews

A. Process — Class Member Identification

Potential class members who were not identified centrally by computer (including persons who received the July 1990 notice per SI 00832.001 C.) must identify themselves to the FO. The FO will process these first-time inquiries per B. below. Instructions for processing cases requiring second reviews are contained in SI 00832.003.

B. Procedure — Screening Inquiries

Obtain the inquirer's Social Security number and current address. Also follow the screening guide below, until a response indicates you need not continue. Record all of the individual's allegations on a Form SSA-795 (Statement of Claimant or Other Person), another signed statement, or an SSA-5002 (Report of Contact). Document the file with any needed system queries.

  1. Did the inquirer apply for or receive SSI benefits at any time after October 1981? (Verify with queries, including STALE queries, if needed.)

    • If yes, or uncertain (at the time of the interview), go to 2.

    • If no, no underpayment is due. Issue notice per C.3.d. below, and prepare a report per C.5. below.

  2. Was the inquirer eligible for SSI benefits or in suspense because of excess income, or was an initial claim denied because of excess income for any months after October 1981?

    • If yes or uncertain (at the time of the interview), go to 3.

    • If no, no underpayment is due. Issue notice per C.3.d. below, and prepare a report per C.5. below.

  3. Did the inquirer receive a VA protected pension at any time after October 1981?

    (Assume yes if the case appeared on an Anderson case listing or if the inquirer received the Anderson notice to members of eligible couples described in SI 00832.001 C., and skip to 5. Otherwise, ask the individual.)

    • If yes or uncertain, go to 4.

    • If no, no underpayment is due. Issue notice per C.3.d. below, and prepare a report per C.5. below.

  4. Did VA recognize one or more dependents at any time after October 1981?

    • If yes or uncertain, go to 5.

    • If no, no underpayment is due. Issue notice per C.3.d. below, and prepare a report per C.5. below.

  5. Did the inquirer have an SSI eligible spouse at any time after October 1981? (Verify with queries.)

    • If yes or uncertain (at the time of the interview), go to 6.

    • If no, follow the review steps beginning at C.1. below.

  6. At the time the inquirer had an SSI eligible spouse, did VA recognize the eligible spouse as a dependent?

    • If yes or uncertain, go to 7.

      EXCEPTION: If the inquirer resides in Alaska, Arizona, California, Hawaii, Idaho, Montana, Nevada, Northern Mariana Islands, Oregon, or Washington, see SI 00832.316 for necessary actions.

    • If no, follow the review steps beginning at C.1. below.

  7. At the time VA recognized the eligible spouse as a dependent, did it recognize any other dependents?

    • If yes or uncertain, follow the review steps beginning at C.1. below.

    • If no, no underpayment is due for this time period. Go to 8.

  8. At any time after October 1981, did the inquirer not have an eligible spouse, or did VA not recognize the eligible spouse as a dependent, or did VA recognize a dependent other than the spouse?

    • If yes or uncertain, follow the review steps beginning at C.1. below for the relevant time period.

    • If no, no underpayment is due. Issue notice per C.3.d. below, and prepare a report per C.5. below.

C. Procedure — Review Steps

1. Obtain Correct VA Income Amount

Use an SSA-L1103 to request correct VA payment information. Send requests through the parallel FO, unless the parallel FO has notified you of other arrangements.

In Part I (page 1) of the form, show the name of the person(s) you need VA payment information for. If an eligible couple is involved, include the name and relationship of the spouse.

In Remarks, request the months since November 1981 in which the individual received an augmented protected pension and the amount attributable to the individual per M21-1, part III, par. 9.03e of the VA manual.

Use normal follow-up procedures, if needed. Contact the SSA RO for help if a problem arises that cannot be resolved timely and locally.

2. Input Income Information or A-OTP

a. Single Record in Current Pay, E01, or Suspense

For a record in C01, E01, or suspense, input the revised VA income amount for each month already posted with VA type E income in the relief period (SI 00832.001 D.2. and 3.). Do not input other retroactive changes that affect eligibility or payment amount as part of the Anderson case review.

b. Terminated or Denied Record(s)

For records in terminated or denied status, compute the underpayment using the computation method described in D. below. Issue payment by a single A-OTP applied against the most recent record. Create a new record if needed to process the A-OTP. (Use force pay procedures if more appropriate.) Do not make any retroactive changes that affect eligibility or payment amount other than the change in VA income amount. If a member of an eligible couple is due an underpayment (SI 00832.001 D.6.), issue payment to both members of the couple, following normal procedures for underpayments to eligible couples.

c. Combination of Current Pay/Suspense Record and Prior Terminated or Denied Record(s)

For cases currently in C01, E01, or suspense with one or more prior, terminated or denied records covering months in the relief period, first manually compute the underpayment for the prior record(s) per D. below. Next, input the A-OTP to the current record per b. above. Then, input the revised VA income amount to the current record per a. above.

d. CG Code

In each case, input a CG code of “ANDE RSON MMYY” to document the latest record with the month an Anderson relief payment was paid or to document the record that no underpayment is due.

e. Netting Underpayment Against Overpayment

Do not net the underpayment amount against the amount of a prior overpayment if the underpayment and overpayment periods overlap. If necessary, suspend collection of an overpayment until after the Anderson underpayment is released.

f. Follow-up Query

For each input, obtain a follow-up query to confirm payment.

3. Issue Notice

a. Single Record in Current Pay, E01, or Suspense

If an underpayment is due, only one record is involved, and that record is in C01, E01, or suspense, issue the form letter (SSA-L8165-U2, Important Information) displayed in SI 00832.004 A. at the time of the input, so the class member receives it before the automated notice.

If no underpayment is due, see d. below.

b. Terminated or Denied Record(s)

If the most recent record is in terminated or denied status, issue a single manual notice (SSA-L8100-U2, Notice of Revised Determination) explaining the underpayment for the period covered by this and any prior record(s). See SI 00832.004 B. for the required paragraphs.

If no underpayment is due, see d. below.

c. Combination of Current Pay/Suspense Record and Prior Terminated or Denied Record(s)

If the current record is in C01, E01, or suspense, and one or more prior records exist in the relief period, issue a single manual notice (SSA-L8100-U2, Notice of Revised Determination) explaining the underpayment for the period covered by the prior records. See SI 00832.004 B. for the required paragraphs. If an underpayment is due on the current record as well, permit the system to release an automated notice for the period covered by the current record. Release the manual notice before the system releases the automated notice.

If no underpayment is due, see d. below.

d. No Underpayment Due

If the individual is not due an underpayment, issue the form letter (SSA-L8166-U2, Important Information) displayed in SI 00832.004 C.

e. References

4. Develop for Current Eligibility

See SI 00832.001 D.7. for the requirement to determine the SSI eligibility of class members who do not currently receive SSI benefits.

5. Prepare a Case Report

Complete a copy of the Anderson Case Report (SI 00832.004 G.) for each case reviewed, whether or not the individual is found to be a class member. Forward these reports to the ARC, Programs on the last day of each month.

D. Procedure — Computation Method for Terminated or Denied Records

1. October 1981 - March 1982

For any portion of the underpayment period before April 1982, compute the underpayment using the correct VA income amount (per SI 00832.002 C.1.) and following standard quarterly computation rules. (Contact your RO, if necessary, for advice on quarterly computations.) Although October 1981 may be part of a computation period, do not change the posted VA income for that month since the retroactive relief period begins November 1981. Compute each quarter separately. Total the two amounts together to determine the underpayment due for October 1981 - March 1982.

2. C01 Months April 1982 On

Using the correct VA income amount (per SI 00832.002 C.1.), compute the underpayment for the first C01 month showing VA income after March 1982. If proration was applicable to this test-month, compute the underpayment as if proration were not involved.

NOTE: “Test-month” is defined in SI 00832.001 D.5.b.

Multiply the underpayment result in the paragraph above by the total number of C01 months in the underpayment period (April 1982 or later) on all terminated and denied records, beginning with the test-month, to determine the underpayment due for the C01 months.

3. N01-E01 Blocks April 1982 On

Annotate on the SSIRD's each period of one or more consecutive months after March 1982 of payment status N01, E01, T31 (following N01), or T51 (following N01) to determine the N01-E01 block (SI 00832.001 D.5.b.).

NOTE: An N01-E01 block (SI 00832.001 D.5.b.) can include T31 and T51 months that follow an N01 payment status, but only through the end of the underpayment period or until the starting month of a subsequent record.

Using the correct VA income amount (per SI 00832.002 C.1.), recompute SSI eligibility for the first month showing VA income (the test-month) in each N01-E01 block. Consider the SSI benefit amount as the underpayment for that month if eligibility is found. (If proration was applicable to the test-month, compute the underpayment as if proration were not involved.)

Multiply the underpayment result in the paragraph above by the number of months in the N01-E01 block, beginning with the test-month, to determine the underpayment due for the block.

Determine that the individual is due no underpayment for the block if no eligibility is found for the test-month. Repeat the same procedure for each N01-E01 block on each applicable record. Add the underpayments for each block to determine the underpayment due for the excess income months.

4. Totaling the Underpayment

Add the underpayment results from 1., 2., and 3. above to determine the total underpayment due on the terminated or denied record(s).

5. Issuing Payment

Issue the total amount in 4. above by A-OTP per C.2.b. above.

6. Issuing Notice

Issue a manual notice per C.3. above.

E. References

  • Force pay, SM 01701.025 ff.

F. Example

1. Case Description

George Strong, age 58, visited the FO on May 5, 1992, after seeing a poster about Anderson. Mr. Strong said he switched to the VA improved pension “a few years ago.” He last received SSI benefits in 1986. His wife never received SSI benefits.

2. Obtaining Queries

The CR requested an on-line query, but received only an abbreviated response, indicating a STALE record. The CR then made an off-line request for any STALE records and received them 2 weeks later. (The on-line response would have been “NIF” if no payment had ever been made on the STALE records.)

Two STALE records came back. One covers a period of SSI payment from March 1978 through June 1986. In July 1986, the payment status changed to N01, and eligibility terminated 12 months later. The other record covers a claim filed March 17, 1988 and denied for excess income. (No disability determination was ever made on this claim because of the income denial.)

3. Examining the SSID's

The first record shows payment statuses as follows:

  • 11/81-4/84    C01

  • 5/84        N01

  • 6/84-9/84     N04

  • 10/84-6/86    C01

  • 7/86-6/87     N01

  • 7/87 on      T31

The second record shows payment statuses as follows:

  • 3/88-6/88     N01

  • 7/88 on      T51

4. Verifying the VA Income Amount

The CR mailed a form SSA-L1103 to the VARO to verify the months in which Mr. Strong received an augmented protected pension and the amount attributable to Mr. Strong. On June 11, 1992, the CR receives the completed SSA-L1103. The VARO reports that Mr. Strong received an augmented protected pension from November 1981 through June 1988. His portion of the payment was $86.00.

5. Determining the Relief Period

The relief period begins November 1981, the first month Mr. Strong's VA income amount is subject to correction. The relief period ends June 1988, the last month Mr. Strong received an augmented protected pension.

The potential underpayment period, however, runs from October 1981 (because of the quarterly computation used in that period) through August 1988 (because of RMA).

6. Computing the Underpayment

 

a. First Record

The CR recomputes the SSI benefits for 10/81-3/82, using the new VA income amount for 11/81-3/82. (The 10/81 VA income amount is not subject to correction, per SI 00832.001 D.2. Case facts affecting eligibility or payment amount, other than the VA income amount, also are not subject to correction.) The CR determines that the underpayment for these two quarters is $36 and $48, respectively. (These amounts, and those that follow, are based on the case facts, which are not all provided here.)

The CR then recomputes the SSI benefit for 4/82, the first C01 month after 3 /82. 4/82 is the test-month. The underpayment for 4/82, $16, is considered the underpayment for each C01 month (4/82-4/84 and 10/84-6/ 86). Total C01 UP = $16 x 46 months = $736. The CR then recomputes the SSI benefit for the first N01-E01 block, consisting of 5/84 only, but finds that no benefit is payable using the new VA income amount. Therefore, no underpayment is due for 5/84. (An underpayment also is not due for the N04 months of 6/84-9/84.)

For the second N01-E01 block, 7/86-2/88, the CR recomputes the first month and finds an underpayment of $10 due. Therefore, $10 is considered the underpayment for each of the remaining months of the N01-E01 block. The $10 per month underpayment period continues through 2/88, the month before the second record was established. The underpayment for this N01-E01 block = $10 x 20 months = $200.

b. Second Record

The N01-E01 block consists of 3/88-8/88, ending with the last month potentially affected (under RMA) by the income correction. The CR recomputes 3 /88 and finds a benefit of $4 due. (The CR rightly ignores proration and assumes that the class member was disabled during the relief period.) $4 is considered the underpayment for all subsequent, consecutive N01 months, including T51 months following N01, through 8/88. The underpayment for this N01-E01 block = $4 x 6 months = $24.

7. Paying the Underpayment

The CR adds up the underpayment due ($36 for 10-12/81, $48 for 1-3/82, $736 for 4/82-4/84 and 10/84-6/86, $200 for 7/86-2/88, and $24 for 3/88-8/88) and obtains a total of $1,044. All of the underpayment is for periods covered by terminated records. Therefore, the CR issues a single A-OTP on the more recent record for the total underpayment on both records. If necessary, the CR creates a new record solely for the purpose of issuing the A-OTP.

8. Issuing the Notice

The CR prepares a manual notice on form SSA-L8100-U2 to explain the underpayment, using the exhibit in SI 00832.004 B. as a model.

9. Developing for Current Eligibility

Because Mr. Strong is not currently eligible for SSI, the CR is obliged to determine his current eligibility, using May 1, 1992 (the first day of the month in which the review was initiated) as the protective filing date per SI 00832.001 D.7. Based on the amount of Mr. Strong's current income, the CR denies the application for excess income, following usual initial claim denial procedures.

10. Filing a Report

The CR prepares an Anderson Case Report (SI 00832.004 G.) and sends it to the ARC, Programs. The CR checks “Class Member Due UP” under Outcome of Case Review.


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SI 00832.002 - Processing Self-Identified Anderson Cases - Initial Reviews - 12/10/2012
Batch run: 12/10/2012
Rev:12/10/2012