TN 18 (02-11)

HI 03035.012 Verification Process for Documenting Pensions and Annuities

A. Introduction to pension and annuity verification

To complete the verification process for documenting pensions and annuities, the SSA interviewer must contact the applicant if the applicant disagrees with the agency data or is unaware of receiving the pension or annuity benefit. The interviewer must ask an applicant who disagrees with the Internal Revenue Service (IRS) pension or annuity agency data to submit evidence to rebut the IRS data. The interviewer must document the evidence on the Medicare Application Processing System (MAPS) report of contact (DWRC) screen.

IMPORTANT: Only when the applicant agrees with the IRS information is the interviewer required to accept the applicant’s allegation without evidence.

B. Evidence development requirements for pensions and annuities

Pension or annuity data requires verification when the amount alleged on the application is less than the agency data and the difference in the amounts would result in either a change in eligibility or subsidy category. For more information on when verification is required, see HI 03035.005.

1. When evidence is not required

When the applicant agrees with the agency data, you do not need evidence of a pension or annuity.

2. When evidence is required

The interviewer must request and document evidence of a pension or annuity when the:

  • Applicant does not agree with the agency data concerning the pension or annuity amount;

  • Applicant is unaware of receiving a pension or annuity benefit; or

  • Applicant answered the question about a recent unearned income decrease (question 9 on the SSA-1020, Application for Help with Medicare Prescription Drug Costs), and the application data indicates lower total unearned income than the agency data, which includes pensions and annuities.

3. Acceptable evidence of pension or annuity

The following is acceptable evidence when verifying pension and annuity evidence:

  • Internal Revenue Service (IRS) data (e.g., 1099-R);

  • award letter from payer showing amount of pension or annuity;

  • denial letter (or termination of pension or annuity) from payer;

  • severance letter from employer showing amount of pension or annuity;

  • current payment stub from payer;

  • telephone verification from the payer;

  • current bank statement (if the funds are directly deposited); or

  • any other evidence the applicants provided that establishes the amount of the pension or annuity.

    NOTE: The interviewer only needs to document evidence received if the applicant disagrees with the IRS agency data. See HI 03035.012B., in this section on when to document evidence.

4. Responsibility of the interviewer when evaluating evidence

The interviewer must:

  • ensure that the tax year covered by the evidence is the most current available to the applicant;

  • use the most recent evidence. If the applicant or payer submits evidence more recent than what is shown in the agency data, use the more recent evidence;

  • document the accepted evidence on a DWRC before submitting the application for a determination.

  • determine the correct monthly countable amount. It is necessary to determine whether deductions are needed prior to entering the monthly pension or annuity amount as the verified amount and submitting the application for a subsidy determination.

5. How to obtain the payer’s name and address in MAPS

If it is necessary to obtain evidence from the payer, follow these instructions to find the payer’s contact information in MAPS.

  1. Retrieve the information on the “Current Agency Data” section on the MAPS Query (MEDQ) screen.

  2. Click on “View Detailed Agency Data” to obtain the employers identification number (EIN).

  3. Go to the SSA Main Menu (MAIN) screen under PCOM.

    • select #09, Master File Query (MFQM);

    • select #16, Miscellaneous Menu (MISM), and then

    • select #13, Alpha Access to EIF Query (AEQY).

    • Enter the EIN, press “Enter,” and PCOM will provide the payer’s name and address information.

6. When an SSA-8510 is needed

If the applicant is unaware of receiving the pension or annuity or does not agree with the agency data and cannot provide evidence, the interviewer must obtain a signed SSA-8510 (Authorization for the Social Security Administration to Obtain Personal Information) from the applicant in order to obtain proof from the payer of the pension or annuity.

C. Reviewing IRS data on MAPS

To prepare for the verification interview or to answer questions from the applicant, the interviewer must review the “Current Agency Data” section on
the MEDQ screen and click on “View Detailed Agency Data.” The screen shows:

  • IRS data including the type of IRS form;

  • tax year;

  • employer identification number; and

  • the monthly amount of the pension or annuity.

    If the applicant does not agree with the agency data, the interviewer will need to obtain the most recent evidence from the applicant or payer to verify or refute the monthly income amount stated on the “View Detailed Agency Data” screen. For more information about MEDQ, see MSOM INTRANETMEDQ 001.001.

D. Reviewing the 1099-R submitted by the applicant or payer

Follow these steps if the applicant provides the 1099-R (Distributions from Pensions, Annuities, Retirement or Profit-Sharing Plans, IRAs, Insurance, Contracts, etc.) as evidence of the pension or annuity amount.

  • Ensure that the 1099-R is for the most recent tax year available.

  • Review item #1 (Gross Distribution) on the 1099-R. Divide this gross distribution by 12 if the pension or annuity is paid monthly. Input this amount as the verified amount of income.

  • Compare the information on the 1099-R to the agency data to ensure the most recent evidence is being used. Verify the payer’s name and address listed on the “Current Agency Data” section on the MAPS Query (MEDQ) screen with the 1099-R provided by the applicant.

  • Determine the correct monthly amount if the pension or annuity is not received monthly over a 12-month period. For example, if the applicant receives the pension or annuity twice per year in payments of $12,000 each, the total pension for the year will be $24,000, and the verified monthly amount to input is $2,000.

  • Document the evidence on the report of contact screen in MAPS before you submit the application for a determination.

    For instructions on documenting pension and annuity evidence, see HI 03035.012E in this section

E. Documentation instructions for pensions and annuities

The following are instructions for documenting the pension and annuity evidence. Follow the documentation requirements in HI 03035.012 for pension and annuities and HI 03035.007 for an IRA, 401(k), or similar account. Once you have documented the evidence, refer to HI 03035.006 and HI 03035.007 for instructions on completing the verification process. If the applicant alleges that funds shown by the IRS data are withdrawals from an IRA, 401(k), or similar account, complete the verification per HI 03035.020 and document the verification per HI 03035.006. Verify the amount in the underlying IRA, 401(k) or similar account.

NOTE: For determining eligibility for Extra Help, consider an IRA, 401(k), or similar account a resource. Withdrawals from an IRA, 401(k), or similar account are a conversion of a resource, and we do not count them as income.

1. Documentation needed when evidence is not required

If the applicant or payer agrees with the agency data, you must document how you obtained the verification information by completing the comment section of the DWRC screen. For example:

  • “I spoke with the applicant (in person, or by telephone) and he (or she) agrees with agency data for the pension or annuity”; or

  • “The applicant submitted a letter from the payer of the pension or annuity and this information agrees with the agency data (include payer name, address, contact’s name and contact’s number).”

    Before indicating “Verification Completed” and submitting the case for a subsidy determination, document your discussion and findings on the other verification issues.

    NOTE: Do not use abbreviations or shorthand that others may not understand.

2. Documentation needed when evidence is required

The interviewer must document the following information on the DWRC screen:

  • contact information, i.e., name of the person contacted, contact method, contact subject, contact address, contact phone number;

  • type of evidence used to verify the pension or annuity (see HI 03035.012B.4. in this section for acceptable evidence);

  • tax year listed on the submitted evidence;

  • verified monthly amount of the unearned income that will be used in the determination; and

  • allegation of the applicant or payer (including the type of contact, e.g., face-to-face, telephone, or letter) which says the individual does not agree with the agency data and the type of document he or she submitted as evidence.

    For acceptable evidence, see HI 03035.012B.4., in this section

    NOTE: If this information is not documented on the DWRC, the verification process is not complete. If you need to obtain evidence from the applicant, refer to HI 03035.006C.2 for additional instructions on sending an evidence request notice.

3. Documenting the report of contact screen (DWRC)

Use the following chart as a guide for the type of documentation required on the DWRC screen.

If the following applies:

Then document or develop the file accordingly:

The applicant agrees with the IRS data

Document DWRC: Complete the preliminary fields on the DWRC screen such as the name of the person contacted, contact method, contact subject, contact address, contact phone and record the statement received from the applicant or payer.

For example, “I spoke with the applicant on 1/15/2010 and he agrees with the agency data for the company pension.”

The applicant disagrees with the IRS data

Obtain evidence from the applicant

  1. Inform the applicant that he or she must provide evidence before SSA can make a determination on his or her Extra Help application. Refer to HI 03035.006C.2. when sending an evidence request notice.

  2. Inform the applicant that he or she can mail or bring in the evidence to a field office. Provide the applicant with the address and telephone number of the SSA office, and contact person of the SSA representative to submit the evidence.

    NOTE: If this is an Workload Support Unit (WSU) verification issue, provide the applicant with the address and telephone number for the servicing or most convenient SSA office as stated in HI 03035.006A.

    OR

    Obtain evidence from the payer

    If the applicant is unable to provide evidence, send the applicant an SSA-8510 (Authorization for the Social Security Administration to Obtain Personal Information) for signature along with a return postage paid envelope. When the applicant returns the signed SSA-8510, send a request to the payer to obtain the necessary information.

    Document DWRC

    After receiving the evidence, complete the required fields such as the name of the person contacted, contact method, contact subject, contact address, contact phone and record the statement received from the applicant or payer. Record the type of document submitted as evidence. Include the tax year and the monthly amount used as the verified amount. Refer to HI 03035.006 for instructions for completing the verification process.

The IRS data and the payer data conflicts (use the most current data)

Document DWRC

Complete the required fields with the name of the person contacted, contact method, contact subject, contact address, contact phone and record the statement received from the applicant or payer.

Record the type of document submitted as evidence. Include the tax year and the monthly amount listed. Include the following statement, “The IRS data and the payer data conflict. The IRS (or payer) data is the most recent evidence for pension (or annuity) and will be used as the verified amount to process the subsidy application.”

F. Office of Personnel Management (OPM) annuity income reported in MAPS

In the past, MAPS received OPM annuity data from two sources, OPM and IRS. Effective with the Medicare software release on 5/23/09, MAPS no longer posts OPM pension information from IRS. MAPS is updated with only the OPM pension information received from OPM. SSA made this change to avoid the possible double counting of an OPM pension. However, previous entries of IRS OPM data may still be on the database and you can view those entries through the MEDQ “Detailed Agency Data” screen. For verifications, always use the annuity data that comes from OPM, displayed on the Current Agency Data screen as “OPM/Civil Service” and on the Verification screen (VRAI) as “Other Pensions or Annuities.”

G. References

  • HI 03035.005, Verification Policy within the Medicare Application Processing System (MAPS);

  • HI 03035.006, Verification and Documentation Process for Medicare Application Processing System (MAPS);

  • HI 03035.007, Verification and Documentation Instructions for Internal Revenue Service (IRS) Data within the Medicare Application Processing System (MAPS);

  • HI 03035.008 Chart of IRS Transaction Types for the Medicare Application Processing System (MAPS) During the Verification Process;

  • MSOM INTRANETMEDQ 001.008 - Medicare Query Display (QDIS) – Part D (Prescription Drug Plan);

  • MSOM INTRANETMEDQ 001.009 - Detailed Agency Data Screen (DADS);

  • MSOM INTRANETMAPS 006.003  - MAPS Report of Contact (DWRC);

  • MSOM INTRANETMAPS 006.006 - MAPS Development Worksheet – Issue Verification (VRAI).


To Link to this section - Use this URL:
http://policy.ssa.gov/poms.nsf/lnx/0603035012
HI 03035.012 - Verification Process for Documenting Pensions and Annuities - 05/06/2013
Batch run: 05/06/2013
Rev:05/06/2013