Identification Number:
EM-22026
Intended Audience:All RCs/ARCs/ADs/FOs/TSCs
/PSCs/OCO/OCO-CSTs/OHO/OARO
Originating Office:ORDP OISP
Title:Procedure for processing T2 prerelease claims
Type:EM - Emergency Messages
Program:Title II (RSI)
Link To Reference:See References at the end of this EM.
 
Retention Date: November 11, 2022

A. Purpose

This EM provides temporary instructions for processing Title II (T2) prerelease claims, while OISP develops a new POMS section to house the instructions permanently.

B. Background

SI 00520.900 through SI 00520.930 provide general information about the prerelease process, which allows individuals who are institutionalized to file SSI and T2 benefit applications before their anticipated release. Those POMS sections also provide instructions for establishing prerelease agreements with institutions and processing prerelease claims.

However, the instructions for processing prerelease claims in SI 00520.920 apply only to SSI prerelease claims. Therefore, we are issuing this EM to provide instructions for processing T2 prerelease claims. The EM will soon be replaced by a new POMS section housing the T2 instructions permanently.

C. Procedure for Processing T2 Prerelease Claims
    1. Initiating the prerelease procedure

      Upon receipt of a prerelease referral, obtain all information and forms required for an initial claim, reinstatement, or change in living arrangements. Obtain a signed release from the individual allowing the field office (FO) to discuss the case with the institution's staff. Use the form SSA-3288, Consent for Release of Information, for all prerelease cases except those involving individuals housed in a Federal Bureau of Prisons (BOP) facility. For those cases, instead use the modified form SSA-3288 located in SI 00520.930, Exhibit 3.

      NOTE: Process an application under the prerelease procedure without regard to whether an agreement exists with the institution. For more information about prerelease agreements, see SI 00520.910.


    2. Timeframes for processing prerelease claims

      Obtain a statement from the institution with the approximate date the individual will be released. Record the statement on a DROC screen. Apply the prerelease procedure to claims using the following timeframes:

      a. Claimants housed in non-BOP institutions


        Apply prerelease procedures when the individual’s release date will be within 30 days of the estimated time for getting a medical decision from the Disability Determination Services (DDS). For example, if the DDS processing time averages about 90 days, the FO can take the claim 120 days before the scheduled release date of the claimant.


      b. Claimants housed in BOP institutions

        Apply prerelease procedures to claims using the following timeframes:

        · For T2 retirement and survivor’s claims: Apply prerelease procedures to claims received within 30 days prior to the individual’s scheduled date of release from BOP custody or 30 days prior to the home confinement placement date.



        · For T2 disability claims: Apply prerelease procedures to claims received within 120 days prior to the individual’s scheduled date of release from BOP custody or 120 days prior to the home confinement placement date.

    3. Developing proper applicant or representative payee in prerelease claims

      If the institution files on behalf of the individual, determine who the proper applicant is and, if necessary, develop for representative payee.

    4. Document exclusion from earnings computation (EC) non-medical completion

      Document the exclusion from EC non-medical completion in the Modernized Claims System (MCS) by:

      · Entering PRISON or PRERELEASE on the issue line and “DEVELOPMENT NEEDED” on the remarks line of the development worksheet screen (DWO1)

      · Explaining the reason why we excluded the claim from the non-medical completion procedure on the MCS Worksheet Remarks screen (DW03).


    5. Referring claims to DDS:

      · The FO must obtain all available medical evidence from the institution in prerelease claims along with a signed SSA-827.

      · Apply any existing regional or local prerelease procedures between the institution and DDS/FO.

      · The FO does not question the adequacy of the medical information contained in the medical report submitted by the institution. If the institution refuses to submit medical evidence, or states it has no medical evidence, or the evidence appears incomplete and no other source of medical evidence is available, do not attempt further development and forward to DDS with the information available.

      · Flag the Electronic Disability Collect System (EDCS) as a “Prerelease Case”. Explain any missing or incomplete medical evidence using EDCS 3367. For more information about flags in EDCS, see DI 81010.080. For information on completing the SSA-3367, see DI 11005.045.



    6. Adjudicating disability claims after obtaining a favorable DDS medical decision

      a. All T2 prerelease claims except BOP conditional release and BOP skilled nursing care claims

        Once the FO receives a favorable medical decision from the DDS, follow these steps:
        · Contact the institution promptly to:
          o Advise the institution that we cannot pay benefits until we verify the release date and;

          o Ask the institution for the expected release date.


        · If the applicant has not been released from confinement when the claim is approved by DDS adjudicate into prisoner suspense status as seen in MS 03509.016.
        · Once the inmate is released, follow the T2 procedures for post-entitlement reinstatement in GN 02607.840.
      b. Exception/Special processing instructions for BOP conditional release and BOP skilled nursing care prerelease claims


        For BOP conditional release and skilled nursing case claims if the applicant has not been released from confinement when the claim is approved by DDS adjudicate into prisoner suspense status as seen in MS 03509.016. Once the inmate is released, follow the T2 procedures for post-entitlement reinstatement in GN 02607.840.

    7. Processing prisoner reinstatements under prerelease

      We cannot reinstate T2 benefits until after the institution releases the prisoner. However, the FO and the institution should do prerelease development appropriate to reinstatements, so we can reinstate benefits more quickly after the prisoner’s release.

      For example, the FO can:


        · provide the institution with information about what documents the FO needs to process a reinstatement;

        · set up an appointment for an interview shortly after the release; and

        · encourage close cooperation between the institution, the prisoner, and the FO to avoid unnecessary delays.


      The institution can:

        · provide the FO the prisoner’s new address;

        · provide documents to verify the prisoner’s release; and

        · encourage the prisoner to respond immediately to any FO requests for information, and not to miss any interview appointments. For instructions about prisoner reinstatements, see GN 02607.840 and GN 02607.875.



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 contacts.

References:
SI 00520.900 Prerelease Procedure - Institutionalization
SI 00520.910 Prerelease Agreements with Institutions
SI 00520.920 Processing Prerelease Claims
SI 00520.930 Exhibits of Prerelease Agreements, Referrals, and Forms


EM-22026 - Procedure for processing T2 prerelease claims - 05/10/2022