TN 8 (10-15)

SI 02309.010 Processing the Insured Status (KZ) Diary - Supplemental Security Income (SSI)

A. Introduction to the KZ diary selection process

The KZ diary sets for eligible recipients and eligible spouses who may qualify for a Title II benefit. The process to determine insured status occurs quarterly. Beginning October 1, 2015, the KZ diary selection process will occur annually.

The KZ diary sets only on Supplemental Security Records (SSRs) that are in current pay, force pay, or 1619(b). For more information on 1619 Policy Principles, see SI 02302.010.

The KZ diary indicates the recipient may:

  • be fully insured for Title II retirement benefits (see RS 00301.105);

  • be fully insured for Title II disability benefits and meet the 20/40 requirement for Title II disability benefits (see RS 00301.120); or

  • meet the special insured status requirement for recipients disabled prior to age 31 (see RS 00301.140).

The system does not set a KZ diary if the recipient receives, or has received, Title II benefits on his or her own record. The system can set the diary for a recipient who receives Title II auxiliary or survivor's benefits. For retirement insured status, the individual must be age 61 years and 9 months, or older, at the time of the redetermination run that sets the KZ diary. For Systems criteria for the KZ diary selection, see SM 01501.250B.

NOTE: The system tests all periods from the SSI date of onset (DOO) and uses any quarters of coverage earned through the test quarter. The issue of an alleged earlier disability onset may arise again. If so, you must consider an alleged earlier disability onset when processing the KZ diary.

B. Requirement to take a Title II application

Technicians are required to take a Title II application to process the KZ diary, with the following exceptions:

  1. The recipient receives a higher Title II benefit than the potential retirement insurance benefits (RIB) or disability insurance benefits (DIB) computation, and filing for a lesser RIB or DIB amount is not advantageous to the recipient (see SI 00510.001C);

  2. The current payment status has a non-pay code, including payment status code E01, suspense, or terminated status code (unless the case is in 1619(b) status; or

  3. A Title II application for the recipient’s only potential Title II eligibility is pending at the reconsideration, hearing, or Appeals Council Review level of appeal.

C. Recipients receiving higher Title II benefits than potential RIB or DIB

When you take a new Title II application, follow the instructions in subsection GN 00201.005C.

  1. Explain to the recipient the advantages and disadvantages of filing an application.

  2. Allow the recipient to decide whether to file. If the recipient does file an application, document the KZ diary development and completion using the Development Documentation (DDKZ) screen in Modernized Supplemental Security Income Claims System (MSSICS).

  3. Document the action taken about the potential entitlement using the appropriate screen shown here:

    • Retirement and Disability Entitlement (BSRD), see MSOM MSSICS 019.016;

    • Spouse, Widow, or Widower Entitlement (BSSW), see MSOM MSSICS 019.017;

    • Child’s Entitlement from Father (BSCF), see MSOM MSSICS 019.018; and

    • Child’s Entitlement from Mother (BSCM), see MSOM MSSICS 019.019.

    For non-MSSICS cases, use the SSR Remarks Data line to document this development.

    In addition, document and fax into the Non-Disability Repository for Evidentiary Documents (NDRED) Form SSA-5002 (Report of Contact), or document the SSR Remarks data line for non-MSSICS cases.

    Indicate that:

    1. The RIB/DIB will probably never exceed the current Title II amount; or

    2. If known, the month and year that the RIB will be higher than the Widow(er)’s (WIB) in RIB/WIB cases. The system reselects the KZ diary each year if no application is taken. The remark provides guidance on when to take a RIB application, if applicable. Filing a RIB application would fulfill the Filing for Other Benefits Requirement (i.e., once the RIB exceeds the WIB).

    For more information on documentation requirements with the application policy, see SI 00601.035.

D. Processing the KZ diary

Coordinate the processing of a scheduled redetermination and KZ diary. Develop the diary when you initiate any development to reinstate the recipient's benefits. If an exception applies, development may not be necessary as described in SI 02309.010B in this section. However, you must not remove the diary. Follow these steps for processing the KZ diary:

STEP

ACTION

1

Review a current SSR to see if you must take other post eligibility actions.

2

Take a Title II application even if it appears that the recipient is not insured. If the Title II application is for disability benefits but the claimant does not meet insured status, you may be able to take an abbreviated application (see GN 00204.009).

Reminder: Consider a possible earlier date of onset when processing the KZ diary as advised in SI 02309.010A in this section.

Review the certified earnings record (CER) with the recipient to develop incomplete earnings, gaps in postings, or lag earnings.

For more information on CERs, see GN 01010.009.

For more information on the Wage Development policy, see RS 01404.003B.

Follow these actions:

  • Adjudicate the application after considering when the recipient can file. For more information about an applicant filing a claim before entitlement, see GN 00204.007C;

  • Check for possible entitlement to auxiliary or survivor benefits (see GN 00204.022);

  • For disability claims, consider an earlier disability onset date than that established for SSI. Also consider whether the evidence in file would suggest disability insured status at any time in the future;

  • Make sure there is no open Title II application based on the SSI application that the recipient filed previously, or an earlier date that you could use to establish the Title II application filing date;

For more information, see GN 00204.027; and

For protective filings, see GN 00204.010.

  • A redetermination may serve as a protective filing for Title II benefits (see GN 00204.015).

If an earlier application filing date does not exist, the protective filing date is the date we contact the claimant (or proper applicant) and determine that the claimant wishes to file for Title II benefits. Do not use the date the KZ diary set as a protective filing date.

For more information on the Application Filing Date policy, see GN 00204.007.

3

Follow these actions:

  • Explain the effect of receiving Title II benefits on the individual's SSI payment;

  • If the recipient does not file for Title II, follow the procedures in SI 00601.035C.4;

  • If the recipient fails to file for other benefits, follow the procedures in SI 00510.001 through SI 00510.030;

  • If the recipient files for Title II, but does not elect full retroactivity, see SI 00510.001 through SI 00510.030. Suspend SSI payments using payment status code N06 when the recipient does not comply with the requirement to file for other benefits;

  • If the recipient does not comply with the general requirement to provide information, such as complete a redetermination, suspend SSI payments using payment status code N20 (see SI 02301.235). For a description of the suspension codes, see SM 10802.130; and

  • Do not delete the KZ diary at this time.

4

Once you have a signed Title II application, transmit type Title II entitlement ("A" unearned income) with recent filing code (code "R") to the SSR (see SM 01305.240).

For information about posting type “A” unearned income using MSSICS, see MSOM INTRANETSSI 014.044.

5

Follow these actions:

  • Clear the KZ diary only after you have received a valid Title II application.

  • If the exception in SI 02309.010B.1 in this section applies, update the DDKZ screen accordingly, and clear the KZ diary without further development.

  • Do not clear the KZ diary if you suspended benefits for failure to file for other benefits or failure to cooperate or any other reason. Update the DROC screen accordingly. For non-MSSICS cases, document Form SSA-5002 and fax into NDRED.

    IMPORTANT: When a KZ diary resets, do not re-develop or clear the subsequent KZ diary if it was correctly developed and documented in the claims path. Enter Remarks (RMKS) on the SSR and document MSSICS via a DROC to assist in identifying these cases. If the reset diary is associated with a pending RZ or LI profiled for a reason other than the reset KZ diary, clear the KZ diary to complete the pending RZ or LI. Document the DDKZ screen with the following file documentation remarks, “Reset KZ Diary Previously Developed and Documented.” To identify reset diaries, look for limited issues profiled solely on a KZ diary.

6

If the field office uses specialization, follow up with the Title II adjudicator using local procedures to determine that the recipient has filed and is pursuing the claim. For more information on monitoring the compliance for filing for other benefits, see SI 00510.025.

E. References

  • SI 02302.010 1619 Policy Principles

  • RS 00301.105 Fully Insured Status

  • RS 00301.120 DIB Insured Status

  • RS 00301.140 Special Insured Status for Disability Before Age 31

  • SM 01501.250B Procedure for clearing diaries and alerts

  • SI 00510.001C General exception to filing requirements

  • GN 00201.005C Policy-Filing an application

  • MSOM MSSICS 019.016 Retirement and Disability Entitlement (BSRD)

  • MSOM MSSICS 019.017 Spouse, Widow, or Widower Entitlement (BSSW)

  • MSOM MSSICS 019.018 Child’s Entitlement from Father (BSCF)

  • MSOM MSSICS 019.019 Child’s Entitlement from Mother (BSCM)

  • SI 00601.035 Adjudicating Title II When A Title XVI Application is Filed

  • SI 02309.010B Requirement to take a Title II application

  • GN 00204.009 Abbreviated Applications-Title II

  • SI 02309.010A Introduction to the KZ diary proce