1. Using eSignature/Upload Documents
During any customer interaction (e.g., taking an initial claim, performing a redetermination, or completing a post-entitlement action) technicians will follow normal business processes to determine whether they require additional forms or evidence, including identity proofing the customer using standard agency procedures. If any evidence or forms on the lists in Sections H, I and J of this EM are required to process the action, the technician can offer the customer the option to submit the documents electronically via eSignature/Upload Documents.
Exceptions - Do not use eSignature/Upload Documents if:
· The technician is unable to speak to the first party customer to obtain consent to perform business electronically.
· Original evidence and/or a certified copy of evidence is required.
· The customer is not the claimant, recipient, or beneficiary (e.g., the customer is a Representative Payee, Legal Guardian, Appointed Representative).
· Customer has an eServices block.
NOTE: Technicians should only request customers submit types of evidence listed in section J that the agency would accept as uncertified copies under existing procedures.
2. Technician Experience Dashboard (TED)
Initiating an eSignature/Upload Documents task for a customer begins in TED. The technician starts by adding the eSignature/Upload Documents task to the customer interaction. They will then obtain the customer's consent to receive a one-time email from SSA, containing an access link and instructions for eSignature/Upload Documents. When obtaining a customer’s email to record in TED, the technician will be able to view the email address previously registered with my Social Security, when applicable. The customer can choose to receive the one-time email at the previously registered my Social Security email address, or at a different email address which the technician will enter and verify.
Next, the technician will select the forms and evidence types needed from the customer within the forms and evidence table in TED. Once all required forms and evidence types are selected, the technician generates and sends the email request to the customer by utilizing the “submit” button. The customer will now have 30 days to submit the requested forms and evidence via eSignature/Upload Documents before the task in TED will automatically close.
Figure 1 Select Forms and Evidence
Once customers successfully submit forms or evidence through eSignature/Upload Documents, the requested forms and evidence are automatically routed to the technician who requested the information and a pending task is created in the “Pending Cases” tab within TED. If the requested forms or evidence should not be returned to the technician who sent the request, they can transfer the eSignature/Upload Documents task to another technician or office within TED. However, this must occur prior to receiving the forms or evidence from the customer in order to profile to the correct technician or office. To transfer a task, select the icon from the “Actions” column and choose the appropriate transfer option.
Figure 2 Transfer Function Screen
3. Request for Evidence Letter
After initiating the request for forms and/or evidence through TED, the technician must send a paper request letter SSA-L1043 using the Document Processing System (DPS) that includes the due date for the request. If the request for evidence is related to an initial claim, technicians should review GN 01010.410 Subsection C.1 for processing instructions. GN 01010.410 Subsection C.2 of the policy references follow-up requests and using the SSA-L1045 notice.
Technicians should also review GN 01070.325 for instructions on handling evidence requests in post-entitlement situations.
NOTE: Customers will not see a due date in eSignature/Upload Documents, but customers will be able to submit forms and evidence within 30 days of the initial TED request. After 30 days, the customer can no longer submit online and will need to submit requested forms or evidence via mail, efax, in-office visit, or request a new eSignature/Upload Documents link be sent.
4. Manually Marking Documents as “Received” in TED
When customers submit their forms and evidence via another business channel (e.g., in-office, mail, efax) while an eSignature/Upload Documents task is pending in TED, the technician can mark that document as received to complete the task.
When more than one document request is pending on an eSignature/Upload Documents task, the technician will have the option to:
· Select “Mark all as Received” (i.e., to indicate that all requested information in the task was received), or
· Select “Mark Received” for individual documents.
Please note, the eSignature/Upload Documents task will remain open until all the documents are marked as received or until the task expires after 30 days.
Figure 3 Mark Documents Received in TED
5. WorkTrack
Once customers successfully submit forms or evidence through eSignature/Upload Documents, the requested forms and evidence are automatically routed to the technician who requested the information and a pending task is created in the “Pending Cases” tab within TED. The assigned technician is notified of successful document submissions in TED.
Figure 4 Alert in TED
After reviewing the submitted forms and/or evidence and taking necessary action(s) (e.g., taking an initial claim, performing a redetermination, or completing a post-entitlement action), the technician will follow normal workload procedures regarding form or evidence retention. (GN 00301.286)
If a customer submits a form or evidence via eSignature/Upload Documents that was not requested by the technician and is not on the approved list, print the document from WorkTrack and mail it back to the customer with a notice explaining why we are unable to accept the submission. As an example, if a customer submits a birth certificate, print the birth certificate from WorkTrack, return it to the customer, and advise them via written notice of SSA’s rules regarding acceptability of documentary evidence. (GN 00301.015 and GN 00301.030)
If a customer submits a form that requires a signature and is not included in eSignature/Upload Documents, advise the customer that we cannot currently accept it via the online method and they must submit it through other business channels, such as mail or in person at their local office.
If a customer submits a form or evidence that was not requested by the technician but is on the approved list of non-signature forms or evidence, process the form or evidence. If the customer combines multiple forms or multiple pieces of evidence into a single submission, the technician will need to break out the documents in WorkTrack and reassign appropriately (e.g., a customer submits an SSA-3441 at the same time they submit an SSA-561, the technician will then need to profile the SSA-3441 and SSA-561 separately in WorkTrack).
NOTE: Forms and evidence requested through TED generally will not require additional profiling in WorkTrack unless the customer sends multiple forms or multiple pieces of evidence in a single submission. The documents will be automatically routed to the technician who requested the information.
IMPORTANT: Please note the reference to “eSignature/Upload Documents” is NOT the same as the “Upload” in WorkTrack. The latter is a feature within the WorkTrack application that allows for batch imports into WorkTrack when an electronic document is available.
1. Release 1 Forms
· SSA-561-U2 Request for Reconsideration
· SSA-3368-BK Adult Disability Report
· SSA-3369-BK Work History Report
· SSA-3373 Function Report – Adult
· SSA-3441-BK Disability Report – Appeal
· HA-501 Request for Hearing by Administrative Law Judge
· HA-520 Request for Review of Hearing Decision/Order
· HA-4631 Claimant’s Recent Medical Treatment
· HA-4632 Claimant’s Medications
· HA-4633 Claimant’s Work Background
2. Release 2 Forms
· SSA-1-BK Application for Retirement Insurance Benefits
· SSA-2-BK Application for Wife’s or Husband’s Insurance Benefits
· SSA-3 Marriage Certification
· SSA-8 Application for Lump Sum Death Payment
· SSA-25 Certificate of Election for Reduced Spouse’s Benefits
· SSA-44 Medicare Income-Related Monthly Adjustment Amount-Life Changing Event
· SSA-150 Modified Benefit Formula Questionnaire
· SSA-521 Request for Withdrawal of Application
· SSA-546 Worker’s Compensation Public Disability Benefit Questionnaire
· SSA-632-BK Request for Waiver of Overpayment Recovery
· SSA-634 Request for Change in Overpayment Recovery Rate
· SSA-640 Financial Disclosure for Civil Monetary Penalty (CMP) Debt
· SSA-754-F5 Statement of Marital Relationship
· SSA-760 Certification of Support
· SSA-765 Response to Notice of Revised Determination
· SSA-766 Statement for Self-Employment Income
· SSA-769-U4 Request for Change in Time/Place of Disability Hearing
· SSA-773 Waiver of Right to Appear, Disability Hearing
· SSA-789 Request for Reconsideration - Disability Cessation - Right to Appear
· SSA-795 Statement of Claimant or Other Person
· SSA-2490-BK Application for Benefits Under a U.S. International Social Security Agreement
· SSA-2512 Pre-1957 Military Service Federal Benefit Questionnaire
· SSA-2574 Information About Joint Checking/Savings Account
· SSA-2855 Statement of Funds You Received
· SSA-2935 Authorization to the SSA to Obtain Personal Information
· SSA-3885 Government Pension Questionnaire
· SSA-4111 Certification of Election for Reduced Widow(er)’s and Surviving Divorced Spouse’s Benefits
· SSA-4162 Childcare Dropout Questionnaire
· SSA-4178 Marital Relationship Questionnaire
· SSA-5062 Claimant’s Statement About Loan of Food or Shelter
(Note: The SSA-7050 was removed from eSignature/Upload Documents on March 30, 2024)
· SSA-7104 Partnership Questionnaire
· SSA-7156 Farm Self-Employment Questionnaire
· SSA-7157-F4 Farm Arrangement Questionnaire
· SSA-8000-BK Application for Supplemental Security Income (SSI)
· SSA-8001-BK Application for Supplemental Security Income (SSI) (Deferred or Abbreviated Application)
· SSA-8510 Authorization for the Social Security Administration to Obtain Personal Information
· SSA-8552 Interview Confirmation
3. Release 3 Forms
· SSA-820-BK Work Activity Report – Self Employment
· SSA-821-BK Work Activity Report – Employee
4. New to eSignature/Upload Documents - Fillable Webforms
1. Release 1 Evidence
· Bank Document
· Bankruptcy Documents
· Burial Contract
· Change of Address Related Document
· Child Support Documentation
· Claimant Correspondence
· Claimant Supplied Medical Evidence
· Claimant's Change of Address Notification
· Claims Earnings Related Document
· Co-Owner Statement-Not Allowed to Cash
· Critical Inquiries or Critical Payment System (CPS) Related Document
· Critical/Dire Need Request
· Custody Documents
· Earnings Discrepancy Doc
· Earnings Inquiry Request
· Education Records-Non-Medical
· Employer Prepared Earnings Statements
· Estate Document or Signed Statement
· Filing for Other Benefits Records
· Foreign Related Document
· Fraud Allegation Document
· Fraud Related Document
· Government Pension Offset
· Hospital Records
· Impairment Related Work Expense (IRWE) Documentation
· Income Tax Return
· Inheritance Document or Signed Statement
· Inpatient Hospital Records
· Life Insurance Policy or Assignment
· Medicare/Medicaid/Health Insurance
· Municipal, Corporate, and Government Bonds
· Mutual Funds
· Overpayment Related Document
· Pay Stubs
· Pension Related Documents
· Prison Records
· Special Wage Payment Document
· SSI Income and Resources Documents
· SSI Living Arrangement/ISM Documents
· State Disability Benefits Statement
· Stock Ownership
· Tax Form/Returns
· Temporary Institutionalization
· Trust Agreement and Amendments
· Trust Court/Legal Documents
· Trust Financial Records
· Unearned Income
· VA Disability Rating Verification
· Wage Verification
· Waiver Related Document
· Windfall Elimination Provision
· Worker's Compensation Document
2. April 2024 Release – 27 Additional Evidence Types
· Behavioral Health Hospital Discharge
· Child Born Out of Wedlock Document
· Claimant's Revocation Letter of Auth Rep Related Evidence
· Prison Release Documentation
· Deemed Marriage Related Claim Evidence
· HIV Related Document
· Hospital NGRI Discharge
· IEP School Related Evidence
· Legal Guardianship / Conservatorship documents
· Long-Term and Short-Term Disability Related Evidence
· PASS Application Related Evidence
· Randolph Sheppard Program Document
· Rent Document
· Reopening Supporting Documentation
· Self-Employment Tax Related Evidence
· SSDI EXR Supportive Documents
· SSI Disposal of Resources Proof
· SSI EXR Supportive Documents
· SSI Hospital Discharge
· SSI Interim Assistance Reimbursement documents
· SSI Life Insurance/Cash Surrender Value Document
· SSI Out of the Country Evidence
· SSI Savings Bond Documentation
· STAT Blind Only Dec Related Evidence
· Uninsured Medicare/State Buy-In Letter
· Work Related Evidence - VR Services/Special Conditions/Job Coaching
· Work Related Out of Pocket Expenses