Effective Dates: 04/19/2023 - Present
Identification Number:
| EM-21035 REV 3
|
| Intended Audience: | RCs/ARCs/ADs/FOs/TSCs/WSUs/PSCs |
| Originating Office: | DCO OPSOS |
| Title: | Vulnerable Populations Application Coding Instructions |
| Type: | EM - Emergency Messages |
| Program: | All Programs |
| Link To Reference: | See Reference at the end of this EM. |
|
Retention Date: 10/20/2023
Summary of Changes
This EM replaces the publication date of March 30, 2022. This update:
Revises Section B
· Remove reference to the SSI Outreach Mailer and add reference to Supplemental Security Income (SSI) Targeted Zip Code Mailer
· Remove reference to SSI Claims Taking Campaign and add references to a Post Re-Entry model.
· Add update to VPL role that includes additional support to CBOs
Revises Section C
· Update policy references for SSI claim development
Revises Section F
· Adds references and updates policy links.
A. Purpose
The purpose of this EM is to provide temporary instructions for tracking claims submitted by select Third Party SSI Claims Taking Partners (Partners). These instructions are applicable while the EM is in effect.
B. Background
The Social Security Administration continues to ensure that we provide the same level of service to all our customers, including People Facing Barriers (PFB). The PFB Initiatives encompass many workgroups including Outreach to SSI Kids (see Outreach Materials for People Facing Barriers), the Supplemental Security Income (SSI) Targeted Zip Code Mailer (follows AM-23015 and OB 23-004) and Third Party Assistance (TPA). This EM supports the TPA goal of increasing SSI Applications among certain populations who face barriers to apply.
Effective January 2023, TPA is transitioning from the SSI Claims Taking Campaign to a Third Party Post Reentry Transition model that will broaden our scope beyond our current partner relationships and increase direct public access to services for all Community Based Organizations (CBOs) who help people apply for SSI. The role of the Vulnerable Populations Liaison (VPL) as local points of contact for matters related to SSI initial claims submitted by CBOs, including support to any productive claims-taking Partners that existed pre-pandemic or were established and trained by SSA during the pandemic. The Public Affairs Specialists (PAS) will continue to engage new strategic relationships and strengthen existing relationships to ensure effective and productive collaborations. Regional Communications Directors (RCD) will continue as SSA’s Ombudspersons, resolving issues that cannot be resolved at the local level.
Partners may refer to the TPA initiative when contacting SSA to establish a lead for PFB and annotate the code “VPAP” (Vulnerable Populations Application) on the Internet Claim (iClaim) and selected paper forms. This “VPAP” coding will be used for tracking purposes and to evaluate the success of this initiative. The Partner will submit the SSI application via iClaim or a signed and completed paper SSI application (SSA-8000) with a cover sheet via eFax or mail with “VPAP” annotated as indicated below:
· iClaim – in the Remarks section
· i3368 - in the Remarks section
· i3820 - in the Additional Remarks section
· Paper SSA-8001 – page 9, Part 7 – in the Remarks section
· Paper SSA-8000 – page 21, Part 7 – in the Remarks section
· Paper SSA-3368 - page 15, Section 11 - in the Remarks section; and
· Paper SSA-3820 - page 11, Section 10 – in the Date and Remarks section
SSA THIRD PARTY APPLICATION.docx
C. Instructions for Field Offices (FOs) and Workload Support Units (WSUs)
FO or WSU technicians who receive SSI applications from Partners annotated with “VPAP”, should add this code to SSI claims using the instructions below for various methods of receipt. (NOTE: “VPAP” coding is ONLY used for SSI applications submitted by SSA trained Partners)
1. For iClaims: After the FO or WSU imports an iClaim to MCS/MSSICS, the technician will:
a. Locate “VPAP” annotated in the “Remarks” section of iClaim on the MCS Worksheet Remarks (DW03) screen (MS 03508.006). NOTE: iClaims may be routed to a WSU based on terminal digit assignments as outlined in AM-15017 REV 37.
b. If the iClaim is a 3rd party unauthenticated application not flagged as potentially anomalous, follow instructions in EM-18043 SEN REV 4 to determine if the Partner is listed in the Registration, Appointment and Services for Representatives (RASR) system. Follow GN 04108.100, if the iClaim is flagged as anomalous.
c. Review the MCS alert generated per EM-20043, Section F (if any).
d. Take appropriate action to process the iSSI or develop the SSI claim per GN 00204.055, SI 00601.027 and EM-20043 (NOTE: WSUs that do not handle SSI claims or identify exclusions should continue to follow their internal FO referral process. However, please alert the receiving FO at the time of transfer that the case should be coded with “VPAP”).
i. If an iSSI application is filed, the “VPAP” special code will appear on the Person Statement screen.
ii. If an SSI application is not received, add the “VPAP” issue on the MCS DW01 for tracking.
e. Complete the SSI Claims path and enter “VPAP” in the CG field for all application types (e.g., full, deferred, or abbreviated).
i. For MSSICS cases, the CG field can be found on the Clearance Menu of the Build SSR page in the Consolidated Claims Experience (CCE). From an open event, click on the new Claim Determination path in update mode. Select the Clearance Menu checkbox and click Next. Choose last option on the Clearance Menu page "SSR Special Messages". The CG fields are located on that screen. REMINDER: Technician should input “VPAP” coding prior to processing a technical denial or transferring the case to DDS. Per SM 01301.790, the CG data cannot be transmitted to an initially denied record with a RIC of T. Only if the RIC is G, can the SSR accept new CG data if “VPAP” was not added at time of adjudication.
ii. To assist VPEs reviewing “VPAP” coded claims, technicians should record contacts or attempts to contact Partners/claimants on a DROC (for MSSICS claims) or a 5002 (for non-MSSICS claims).
iii. Refer to SM 01005.525 for non-MSSICS cases
f. Import the i3368 into EDCS and locate the “VPAP” special code in the Remarks section.
NOTE: If there is no pending SSI claim and the claimant requests an appointment to complete the SSI application, the technician should schedule the appointment in eLAS and annotate eLAS per TC 10010.070 on the “Create a New Lead” screen (refer to MS 00601.005). Add the “VPAP” code to the “Remarks” text box.
2. For i3820s: The technician will:
a. Follow processing instructions found in DI 81007.045 and
b. Complete the SSI Claims path and enter “VPAP” in the CG field.
i. For MSSICS cases, the CG field can be found on the Clearance Menu of the Build SSR page in Consolidated Claims Experience (CCE). From an open event, click on the new Claim Determination path in update mode. Select the Clearance Menu checkbox and click Next. Choose the last option on the Clearance Menu page "SSR Special Messages". The CG fields are located on that screen. REMINDER: Technician should input “VPAP” coding prior to processing a technical denial or transferring the case to DDS. Per SM 01301.790, the CG data cannot be transmitted to an initially denied record with a RIC of T. Only if the RIC is G, can the SSR accept new CG data if “VPAP” was not added at time of adjudication.
ii. To assist VPEs reviewing “VPAP” coded claims, technicians should record contacts or attempts to contact Partners/claimants on a DROC (for MSSICS claims) or a 5002 (for non-MSSICS claims).
iii. Refer to SM 01005.525 for non-MSSICS cases
c. Once the claim is loaded in MSSICS and the SSR is built, propagate the i3820 into EDCS.
NOTE: If there is no pending SSI claim and the claimant requests an appointment to complete the SSI application, the technician should schedule the appointment in eLAS and annotate eLAS per TC 10010.070 on the “Create a New Lead” screen (refer to MS 00601.005). Add the “VPAP” code to the “Remarks” text box.
3. For Paper Applications via eFax: If the FO receives a paper application via eFax:
a. WorkTrack profiler routes inbound eFax applications to WorkTrack and profiles the application package as “Other.” Enter “VPAP” in the “Alias” description box. The documents will appear on WorkTrack listings as “Other VPAP”.
b. Assign to a technician.
c. A technician reviews the disability or aged application and identifies the code “VPAP” in the following locations and the cover sheet:
d. Establish the appropriate claims in MCS/MSSICS.
i. If an SSI application is not received, add the “VPAP” issue to the MCS DW01 for tracking.
ii. Receipt in the issue once the SSI claim is taken.
e. Complete the SSI Claims path and enter “VPAP” in the CG field for all application types (e.g., full, deferred, or abbreviated).
i. For MSSICS cases, the CG field can be found on the Clearance Menu of the Build SSR page in the Consolidated Claims Experience (CCE). From an open event, click on the new Claim Determination path in update mode. Select the Clearance Menu checkbox and click Next. Choose last option on the Clearance Menu page "SSR Special Messages". The CG fields are located on that screen. REMINDER: Technician input “VPAP” coding prior to processing a technical denial or transferring the case to DDS. Per SM 01301.790, the CG data cannot be transmitted to an initially denied record with a RIC of T. Only if the RIC is G, can the SSR accept new CG data if “VPAP” was not added at time of adjudication.
ii. To assist CTEs reviewing “VPAP” coded claims, technicians should record contacts or attempts to contact Partners/claimants on a DROC (for MSSICS claims) or a 5002 (for non-MSSICS claims).
iii. Refer to SM 01005.525 for non-MSSICS cases
f. Create the appropriate EDCS segment to transcribe the SSA-3368 or SSA-3820 information.
NOTE: Effective April 14, 2021, faxes of applications will be temporarily acceptable, per EM-21030 SEN.
4. For Paper Applications via another delivery channel: If the FO receives a paper application via another delivery channel:
a. WorkTrack profiler scans the paper application into WorkTrack and profiles the application package as “Other.” Enter “VPAP” in the “Alias” description box.
b. Assign to a technician; and
c. Follow 3.c – 3.f above.
5. For Paper SSA-8000 or SSA-8001 only: If the FO receives a paper SSA-8000 or SSA-8001 only, and a separate Title 2 application is required per SI 00601.035, the technician should:
a. Contact the Partner or claimant to obtain the appropriate T2 application.
b. Establish the appropriate claim(s) in MCS; and
c. Continue to follow regular signature requirements per GN 00201.010 and GN 00201.015.
NOTE: If there is no pending SSI claim and the claimant requests an appointment to complete the SSI application, the technician should schedule the appointment in eLAS and annotate eLAS per TC 10010.070 on the “Create a New Lead” screen (refer to MS 00601.005). Add the “VPAP” code to the “Remarks” text box.
6. For Appointments with “VPAP” coding in the Remarks Section of Lead: If the FO takes a DIB/SSI claim for an appointment with “VPAP” coding in the Remarks Section of the lead, code “VPAP” in the claim following 3.d – 3.f above.
D. Instructions for the National 800 Number (N8NN)
1. If the claimant or their representative contacts SSA to schedule an appointment, follow normal procedures for identifying the caller and the applicant and refer to instructions found in OB 21-021 REV 3.
NOTE: Use the Customer Help and Information Program (CHIP) to screen the applicant for benefits and schedule the appointment in eLAS per TC 10010.070.
a. Ensure that the caller’s information (e.g., name, relationship to claimant, telephone number) appear appropriately on the “Create a New Lead” screen (refer to MS 00601.005).
b. If the caller advises the technician that this is a “VPAP” case, on the “Create a New Lead” screen, add the “VPAP” code to the “Remarks” text box.
2. If N8NN receives inquiries from an agency or organization, advise organizations to reach out to the Social Security Regional Communications Director for their state to learn more and sign up to be a Partner organization.
E. Closing
Direct all program-related and technical questions to your Regional Office (RO) support staff or Program Service Center (PSC) Operations Analysis (OA) staff. RO support staff or PSC OA staff may refer questions, concerns, or problems to their Central Office contact.
F. References
AM-15017 REV 37 iClaim Routing Changes for the Workload Support Units
AM-23015 Supplemental Security Income (SSI) Targeted Zip Code Mailer
DI 11005.023 Completing the Disability Report Adult Form SSA-3368
DI 11005.030 Completing the SSA-3820
DI 22515.025 Use of Form SSA-3368-BK (Disability Report – Adult)
DI 81007.045 Receiving the i3820
EM-18043 SEN REV 4 Authenticated and Unauthenticated iClaim Business Process – Instructions Will Follow Shortly
EM-20043 Internet Benefit Application (iClaim) Enhancements - Policy and Procedures
EM-21030 SEN Accepting Faxed Applications During the COVID-19 Pandemic – One Time Instruction
GN 00201.010 Signature Requirements
GN 00201.015 Alternative Signature Methods
GN 00204.055 Internet Claim (iClaim) Application
GN 04108.100 Pre-Adjudicative Anomalous Claims
MS 00601.005 eLAS – Create A New Lead (CANL)
MS 03508.006 Worksheet Remarks (DW03)
OB 21-021 REV 3 Handling Inquiries Regarding Vulnerable Populations Applications
OB 23-004 Supplemental Security Income (SSI) Targeted Zip Code Mailer
Outreach Materials for People Facing Barriers
SI 00601.027 Title II Application as a Supplemental Security Income (SSI) Oral Inquiry
SI 00601.035 Adjudicating Title II When a Title XVI Application Is Filed
SI 00604.002 Form SSA-8000-BK
SI 00605.000 Use and Completion of Form SSA-8001-BK
SM 01301.790 Housing Case Related (Case Characteristics) Data on the SSR - Process
SM 01005.525 Case Related Data
Social Security Regional Communications Director
TC 10010.070 Making Claims Referrals or Scheduling Appointments When NH's SSN is Known
Third Party Post Reentry Transition
EM-21035 REV 3 - Vulnerable Populations Application Coding Instructions - 04/19/2023