TN 18 (10-98)

SI 02301.325 How to Correct the PPL During Appeal (Including COLA)

A. Introduction

Changes in a recipient's circumstances (including COLA or legislative changes) can increase or reduce the PPL in effect during an appeal period. FOs must manually recompute payments due on all records in protected payment status, correct the PPL and issue the appropriate manual notice for the change. When a recipient appeals a subsequent change to the PPL, multiple appeals may exist before there is an appeal determination or decision rendered on all issues.

B. Process

1. COLA

Annual COLA increases to the FBR are effective on January 1 of each year. PPL cases that are not scheduled for redetermination are selected as limited issues in November, December, and January of each fiscal year and are controlled on the Post Entitlement Operational Data Store (PE ODS) system. These limited issues can be identified in the CRZD segment of a Supplemental Security Income Display (SSID) query as a profile X with a selection indicator of G. PE ODS offline counts/case data queries can be obtained for PPL limited issues by entering selection indicator G in the optional fields segment of the PE ODS mask. PPL cases that have pending redeterminations will not be selected as limited issues.

For all cases in protected payment status whether selected as limited issues or scheduled for redeterminations (including cases in N07 or N08 due to a disability or blindness cessation), FOs will check on the status of the appeal, determine if benefit continuation is still appropriate, and correct the PPL, as necessary (see SI 02301.325C.).

2. Systems Interfaces

When an interface with the MBR results in an income change to a record in protected payment status, FOs receive a G6 alert with the legend, “G/K INVOLVEMENT - INTERFACE APPLIED-POSSIBLE PPL ADJUSTMENT.” FOs follow instructions in SM 01305.630H.2. to manually recompute the PPL and correct it as necessary. FOs also follow instructions in SI 02310.005 when they receive information from a computer match affected by CMPPA.

3. Reports of Change

FOs investigate reports of change, manually recompute the PPL and correct it as necessary. They follow instructions in SI 02301.010 on how to act on reports.

C. Procedure - COLA Cases

Follow the steps below for all records in protected payment status.

NOTE: Related instructions are in:

  • SI 02005.010, COLA coordination and SSI computations,

  • SI 02301.307, manual notice requirement for change in the protected payment amount,

  • SI 02305.017C.3., limited issue development for payment continuation cases - COLA,

  • SM 01501.002, limited issue selection indicator, and

  • DI 12027.001, statutory benefit continuation in medical cessation cases.

STEPACTION

1

Obtain a current supplemental security income record display (SSIRD), other queries from the SSR and MBR as appropriate, and any available FO records.

2

Is the record still in protected payment status and is there a decision rendered at the first level of appeal on all issues?

  • IF YES, effectuate the appeal decision and correct the record (see SI 02301.330). STOP.

  • IF NO, go to Step 3.

3

Is the PPL in effect correct? That is, does the PPL reflect known changes in the recipient's circumstances that are not being appealed?

  • IF YES, go to Step 4.

  • IF NO, correct the PPL if possible before COLA (see SI 02301.325D.) and go to Step 4.

4

Recompute and input the new PPL based on changes due to COLA and, if applicable, other changes not under appeal. Go to Step 5.

5

Issue a manual notice for the change (see SI 02301.325D.). STOP.

D. Procedure - Correcting the PPL

Use the chart below to correct the PPL and issue a manual notice when:

  • a subsequent change (including COLA or a legislative change) occurs, and

  • an appeal decision cannot be rendered immediately on all issues under appeal.

NOTE: System input instructions on correcting the PPL are in SM 01305.615. See SI 02301.320C., on how to pay benefits due based on systems cutoffs.

If...then input...and send...

a subsequent change increases the PPL*

and pay the new PPL including any past benefits due based on the new PPL

an SSA-L8151-U2 (suppress the system notice). Select appropriate paragraphs from NL 00803.025. Include GBKM01 when paying past benefits. For COLA, also select COLM50 and appropriate paragraphs from NL 00803.050.

a subsequent change reduces the PPL, but not down to $0

a subsequent change reduces payment to $0
and pay the new PPL



the new payment status when applicable and correct the PPL
an SSA-L8155-U2 (suppress the systems notice). Select appropriate paragraphs from NL 00803.025. For COLA, also select appropriate paragraphs from NL 00803.050. Include COLM50 if a monthly payment is due. (For exceptions to advance notice, see SI 02301.300E.)

a subsequent change results in no payment change

the recomputed PPL (equals the PPL on the record)

an SSA-L8166-U2. Select appropriate paragraphs from NL 00803.050 including paragraphs that describe the facts on which the payment is based.

the recipient appeals a subsequent change and reduction to the PPL

and pay the prior PPL including any past benefits due based on the prior PPL if the FO cannot issue a decision immediately on the subsequent change under appeal

  • no notice if the prior PPL will continue uninterrupted

    OR

  • an SSA-L8165-U2 with no appeal rights to restore the PPL to the prior PPL (suppress the systems notice). Select appropriate paragraphs from NL 00803.025. Include GBKM01 when paying past benefits.

there is an appeal decision on a subsequent change and reduction to the PPL

and pay the correct PPL.

an SSA-L8457-U2 (SSI Notice of Reconsideration (PE)). Suppress the systems notice and follow instructions in NL 00803.095. Select appropriate paragraphs from NL 00804.105.

*See NL 00804.700 for sample COLA notices, notice numbers 6 and 7.


To Link to this section - Use this URL:
http://policy.ssa.gov/poms.nsf/lnx/0502301325
SI 02301.325 - How to Correct the PPL During Appeal (Including COLA) - 08/06/2014
Batch run: 08/06/2014
Rev:08/06/2014