Social Security

Retention Date: 11/30/2024


Summary:
This Emergency Message (EM) outlines new procedures for technicians to follow when documenting Supplement Security Income (SSI) cases involving underpayments (UPs) of $15,000 or more requiring prepayment reviews.

Revisions 5/22/2024:
Intended Audience

· Expanding the intended audience to include the Workload Support Units (WSUs)

A. Purpose

This Emergency Message (EM) outlines new procedures for technicians to follow when documenting Supplement Security Income (SSI) cases involving underpayments (UPs) of $15,000 or more.

B. Background

There are a significant number of SSI underpayments that occur because of an SSI initial claim allowance involving past-due benefits or changes in the recipient’s non-medical eligibility factors such as changes in income (earned or unearned), living arrangements or resources. These changes potentially impact the recipient’s monthly payment and may result in an UP. In general, UPs should be paid to the recipient the month after it is discovered. As reflected in SI 02101.025, a prepayment review is required for any SSI initial claim or post eligibility case resulting in an UP of $15,000 or more.

A recent audit of SSI UP reviews found that sampled cases had insufficient documentation to confirm proper development and that a second signoff was completed in accordance with policy. Therefore, the Office of Public Service and Operations Support (OPSOS) created the Underpayment Case Control Log to assist the field offices (FOs) and Workload Support Units (WSU) with tracking cases.

C. New Procedure

SI 02101.025 instructs technicians to conduct prepayment reviews on any SSI UPs of $15,000 or more. To assist with the review process, the Office of Public Service and Operations Support (OPSOS) created the Underpayment Case Control Log application to assist the field offices (FOs) Workload Support Units (WSU) with tracking cases.

Effective 5/14/2024, all FOs and WSUs must utilize the application to track pending underpayments of $15,000 or more. The Underpayment Case Control Log is the official log for all SSI underpayment reviews.

D. Important Definitions

· Adjudicator - is a claims specialist (CS) or above, who performs the prepayment review. The adjudicator can be the person who made the original determination. The responsibility of the adjudicator is to ensure the record is updated with current information to issue the recurring check.
· Reviewer - is a CS or above and someone other than the adjudicator. The reviewer examines the file after the adjudicator completes the prepayment review, but prior to releasing the UP.

E. Processing Instructions

1. Create a User Profile
When using the application for the first time, the user (adjudicator, reviewer, management) must create a user profile by selecting “User Settings,” then updating the options with the appropriate Region, Area, and Field Office. After the user updates the information, click “Register [Name Here].”

2. Adjudicator
To begin the prepayment review using the Underpayment Case Control Log:
· Select New Underpayment;
· Complete the recipient’s name and SSN.
· Enter the underpayment start date, underpayment end date by selecting the month and year from the dropdown menu.
o Enter any additional comments, if needed
· Enter the associated dollar amount.
· Answer the questions that appear to confirm proper development was completed as required for the prepayment review per SI 02101.025E.1.
· Copy Language for Report of Contact and paste into the CCE report of contact.
· Select Post for Review

3. Reviewer
To begin the UP review using the Underpayment Case Control Log:
· Select Pending Case list.
· Select the appropriate case and select review.
· Answer the questions that appear as they relate to the underpayment review to confirm proper development was completed by the Adjudicator.
o If the underpayment is incomplete or requires further development
§ Select Further Development Required
o If the review is complete select
§ Review Complete – No Further Development Needed
§ Copy Language for Report of Contact and paste into the CCE report of contact.
§ Submit Completed Review

Direct all program-related and technical questions to your Regional Office (RO) support staff using vHelp 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 02101.025 - Basic Requirements of Supplemental Security Income (SSI) Underpayment (UP) Review
SI 02101.020 - Large Past-Due Supplemental Security Income (SSI) Payments by Installments- Individual Alive
SI 02101.010 - Past-Due Benefits Payable - Individual Alive Under Age 18 with Representative Payee - Dedicated Account Required