PROGRAM OPERATIONS MANUAL SYSTEMPart DI – Disability InsuranceChapter 521 – Workers' Compensation/Public Disability Benefit (WC/PDB) OffsetSubchapter 35 – State Specific Public Disability Benefit (PDB) ProceduresTransmittal No. 4, 01/17/2019
This is a Quick Action Transmittal. These revisions do not change or introduce new policy or procedure.
This is a minor update to this POMS to include a reminder to discuss reporting responsibilities during the initial FO interview.
Summary of Changes
DI 52135.001 Introduction to State Specific Public Disability Benefits (PDB)
Added 2nd paragraph below the chart.
The following states have special features related to their public disability benefit (PDB) plans to consider when applying the PDB offset provisions.
It is important to remind claimants of their reporting responsibilities of PDB payments during their initial interview and explain how their failure to report these payments to SSA timely may lead to an overpayment.
The FICA may tax some PDB benefits. This taxation does not preclude offset of Social Security disability insurance benefits (DIB). SSA computes offset at the full payment rate before any FICA deductions.
Code the verified expected end date when imposing offset where benefits are payable for only a prescribed period. When the end date is on the Master Beneficiary Record (MBR), Regular Transcript and Selection Pass Alerts (RETAP) sends a finder to T2 permitting the system to automatically adjust the Workers’ Compensation/Public Disability Benefit (WC/PDB).
EXCEPTION: RETAP (RT47) selects California PDB cases after 52 weeks; therefore, no manual diary is necessary unless payments are not expected to continue the usual 52 weeks.
Verify that PDB ceased, before resuming full DIB benefits.
If a State has a reverse offset plan, code the case with offset type “REV JURISDICTION”, and the appropriate start and stop dates. For additional instructions for coding the Interactive Computations (ICF) WC/PDB Claims Data (WCCD) screen, see DI 52165.010C.7.
If the PDB is a pension (as defined in RS 00605.360B.1.) and based at least in part on non-covered employment, you must consider WEP.
The requirements for conversion of a PDB to a “service pension” differ between states/plans. The particular State law or local government plan pursuant to which the pension is paid determines whether the benefit in question is or is not a PDB. Because State laws and local government plans will differ, it is possible to find that some of these converted pensions will be PDBs and others will not.
Generally, the benefit no longer meets the definition of PDB set forth in Section 224 of the Act if the pension is no longer based on a disability where:
a worker receiving a PDB attains the age and years of service required for conversion of the pension to a service pension, AND
the worker is not required to still be disabled in order to be eligible.
If the worker clearly states that he or she must continue to be disabled in order to receive the service pension, the pension continues to be a PDB and offset procedures still apply.
Where there is a question or conflicting information, seek an opinion from the OGC Regional Chief Counsel's office with responsibility for the State in question on the particular State law or local government plan under which the pension is paid. See DI
52140.015 for information on preparing an OGC referral.
DI 52105.001 - Reverse Offset Plans.
MSOM COMMON 001.003 - WC/PDB Claim Data (WPCL)
MSOM ICFT2 031.012 - WC/PDB Offset - Claim Data (WCCD) for ICF WC/PDB processing of reverse offset
DI 52165.010 - How to Complete the Interactive Computations Facility (ICF) Workers’ Compensation/Public Disability Benefit (WC/PDB) Screens
RS 00605.360 - WEP Applicability
DI 52140.015 - Field Office/Processing Center Request for Policy Decision Regarding Workers’ Compensation/Public Disability Benefit (WC/PDB)
Resource Page – WC National Website link also in DI
Temporary Disability Insurance (Office of Policy)