TN 18 (02-16)

HI 03010.020 Leads and Protective Filing

Citations:

20 CFR 418.3230

Technicians can establish a subsidy application filing date based on a written or oral indication of intent to file, including an appointment for an initial claim made via the National 800 Number Network (N8NN) or a partially completed Internet Application for Extra Help with Medicare Prescription Drug Plan Costs (i1020). See HI 03010.015 for policy for determining the application filing date.

A. Establishing a protective filing

1. Criteria for establishing a protective filing

a. The claimant must be a proper applicant

A proper applicant is the claimant or his or her personal representative. See HI 03010.010B for the definition of “personal representative” for purposes of the Extra Help subsidy.

b. There must be an intent to file

Intent to file for the subsidy may be made orally or in writing. A partially completed i1020 meets the intent to file requirement. The start date for the partial i1020 is available using the I-Main menu by clicking on the “i1020 Internet Query” link.

c. Intent to file document must be filed with the Social Security Administration (SSA)

A beneficiary may establish a protective filing:

  • at an SSA office,

  • with an SSA employee on official duty at a place other than an SSA office, or

  • by partially completing an i1020 online via SSA’s online website (socialsecurity.gov).

2. Applications used to establish protective filing

a. Applications submitted by State Medicaid agencies

SSA will use the date the State annotates on the SSA-1020 (Application for Extra Help with Medicare Prescription Drug Plan Costs) when applications are submitted by State Medicaid agencies. The State Medicaid agency will follow the Centers for Medicare & Medicaid Services’ instructions regarding protective filing.

b. Title II application with Medicare involvement

When you take a Title II application for a claimant who is entitled to or filing for Medicare, you must follow the interviewing guidelines in HI 03010.005B when determining subsidy eligibility.

If the claimant wants to file a subsidy application, take the application and promptly closeout the protective filing.

If the claimant does not want to file a subsidy application, issue a closeout notice per HI 03010.030. After the issuance of the closeout notice, document the Modernized Claims System (MCS) Development Worksheet (DW01) with the Title XVIII closeout issue and enter the date you issued the closeout notice in the REC field.

NOTE: If the claimant files an internet claim (iClaim) and does not want to file for the subsidy, no further action (recontact or closeout) is necessary.

c. Subsidy application and Supplemental Security Income (SSI) implications

A filed subsidy application is also a protective filing for SSI benefits. The subsidy award or denial notice includes an SSI protective filing closeout paragraph. No additional closeout notice is necessary.

NOTE: If an SSI claim is completed and we based the protective filing date on a scanned SSA-1020 mailed to the Wilkes-Barre Direct Operations Center or an i1020, Field Offices (FOs) may enter ZZZ in the unit field to exclude the case from processing time counts.

B. Documenting a protective filing

Technicians must document a protective filing date either via the 800# System Worksheet or MCS. For the protective filing closeout notice requirements, see HI 03010.030.

1. N8NN instructions

See TC 24020.020 for N8NN instructions for Medicare prescription drug subsidy eligibility and filing information.

  • If the claimant expresses an intent to file an application and is willing to complete a paper application, follow instructions in TC 10003.010.

  • If the claimant expresses an intent to file an application and the Workload Support Unit exclusions do not apply, follow the procedure in TC 10008.020B.

  • If the claimant expresses an intent to file an application and the Workload Support Unit exclusions apply, follow the procedure in TC 10010.070.

2. FO instructions when claimant wants to delay filing a subsidy application

If the claimant expresses intent to file a subsidy application but is unable to file during the Title II claims taking process, document the DW01 screen in MCS with the date and the claimant’s intent to file a subsidy application.

C. Closing out a protective filing

Technicians must close out a protective filing right away or the protective filing date will remain open indefinitely. Close the protective filing by taking an application or issuing a closeout notice (protective filing closeout is automated for the i1020). See HI 03010.030 for the notice requirements. The protective filing closeout period begins with the date on the closeout notice and ends 60 days after that date.

EXCEPTION: When the 60th day falls on a Federal non-workday, as defined in 20 C.F.R. § 418.3010(b)(9), the protective filing period ends with the following workday. See SI 00601.037B.4 which also applies to the subsidy protective filing period.

1. Protective filing received from N8NN sites - FO Action

If you receive a referral from a N8NN site establishing a protective filing date:

  • Issue the closeout notice promptly if the referral indicates a notice is needed, and

  • Contact the individual on the appointment date to take the application. See SI 00601.030 for the policy and procedures for discussing SSI and documenting the claimant’s filing decision.

2. Protective filing received in FO

If the FO receives the protective filing:

  • Take the application, or

  • Document the protective filing on the 800# System, schedule an application appointment, and issue the closeout notice per HI 03010.030.

REMINDER: If the individual calls to reschedule an appointment, make every effort to reschedule it within the protective filing period. If the next available teleclaim appointment is after the protective filing closeout period, the interviewer should schedule an in-office appointment within the protective filing period. If this is not possible, contact local FO management to facilitate an immediate claim or advise the claimant to visit the local FO without an appointment.


To Link to this section - Use this URL:
http://policy.ssa.gov/poms.nsf/lnx/0603010020
HI 03010.020 - Leads and Protective Filing - 08/26/2016
Batch run: 08/26/2016
Rev:08/26/2016