Identification Number:
EM-22034
Intended Audience:All RCs/ARCs/ADs/FOs/TSCs/
PSCs/OCO/OCO-CSTs/OHO/OARO
Originating Office:DCO OPSOS
Title:Resumption Instructions for cases held under EM-21079 Temporary Hold on N20 (Failure to Provide Information) Suspensions—One–Time Only Instructions
Type:EM - Emergency Messages
Program:Title XVI (SSI)
Link To Reference:See References at the end of this EM
 
Retention Date: 12/31/2022

A. Purpose
This emergency message (EM) informs you that effective June 13, 2022, field offices (FOs) may resume processing of Redeterminations (RZs) and SSI Only and Concurrent Medical Continuing Disability Reviews (CDRs) held while the agency deferred making determinations that a recipient was ineligible due to failure to provide information and using payment status (PSY) N20 to suspend payments. This EM also provides processing instructions for the cases held during the N20 moratorium under the instructions in EM-21079 (now archived).


For cases in development that did not reach the point during the moratorium where it appeared a determination of ineligibility for failure to provide information was supported, follow the updated instructions in SI 02301.235.

B. Background
Effective June 11, 2022, we made the following changes to processing Title XVI (SSI) N20 Failure to Provide Information (N20) suspensions:

    • Moved the Claimant Payment Status (CPAY) screen in MSSICS to the Payment Status page in Consolidated Claims Experience (CCE) and retired the MSSICS CPAY screen.
    • Modified permissions to post a payment status of N20 to the SSR to FO management Management Support Specialist (MSS) and above.
    • Modified permissions so non-management technicians below MSS level, including Claims Technical Expert (CTE), will not have the access to select the payment status N20 from the drop-down list of available PSY codes or sending the N20 suspension to the SSR.

      Note: All technicians have access to remove N20 from the SSR when benefit reinstatement is appropriate.

    • Updated the Workload Action Center (WAC) to allow only an MSS and above to send Failure to Cooperate (FTC) for both SSI Only and concurrent CDR suspension inputs to the Disability Control File (DCF) using the WAC CDR Toolbox. Technicians will be unable to send FTC actions through WAC and will receive a message indicating that management must input the suspension.
    • Technicians must follow the steps in the newly revised SI 02301.235 to develop non-medical post-eligibility actions including RZs and also follow DI 13005.025 and DI 13015.005 for CDRs. To obtain management approval of the suspension decision, technicians will document all N20 suspensions for post-eligibility actions including RZs AND CDRs in accordance with SI 02301.235H by completing the N20 Checklist and MSSICS Report of Contact (DROC) in addition to the Report of Contact required in DI 13015.005A for CDRs.
The documentation steps required to obtain management concurrence in SI 02301.235 apply whether the suspension code is transmitted in CCE SSI, the DCF, or the FTC functions in WAC.

During the moratorium that began on December 23, 2021, FOs followed normal processing instructions for RZ and CDR actions as required in SI 02301.235, DI 13005.025, and DI 13015.005 until all efforts to obtain needed information were exhausted. FOs took the following development actions:

    • Made all required requests: initial written notice, telephone follow-up, and written follow-up;
    • Reviewed all available systems, applications, data exchanges, and queries for the needed information; and
    • Determined if another payment status was applicable (e.g., S06, S08, N19, etc.).
If the FO could not obtain the evidence after following the development steps above, and PSY N20 would otherwise apply, technicians documented the case per the instructions in EM-21079 REV (now archived) and held the case until the recipient (or their payee or legal guardian) complied with requests or the end of the moratorium.

On May 7, 2022, we updated WAC to prevent posting of N20 suspensions to the SSR through the DCF for SSI only and concurrent Medical CDRs.

C. Procedure

Effective June 13, 2022, in accordance with the instructions in this EM, technicians may resume processing Failure to Provide Information (N20) suspensions for RZs and both SSI only and concurrent CDRs held under the moratorium.

To determine whether Steps Three, Four, or Five in this section apply, calculate the period the case has been held starting with the latest of:

    • The date on the MSSICS DROC or SSA-5002 which documented the failure to provide information in accordance with EM-21079 (i.e., the date the case was held under the moratorium)

      OR

    • The date of the most recent written Request for Information notice if additional contact attempts were made while the case was held. Phone contacts that are not accompanied by a written follow-up do not count for the purposes of determining the period held under these instructions.

    1. Identifying held cases

      Cases held under the moratorium can be identified by the coding listed below:
        • MSSICS DW01 (All held cases including RZs, CDRs, and other PE actions)

            o Unit code of XXXN20

            o N20SUSP issue with a tickle date of 6/30/22.


              Note: EM 21079 REV published on April 11, 2022, updated the tickle date from 3/5/22 to 6/30/22
        • DCF Development Worksheet (Concurrent and Title XVI Only CDRs)

            o Unit code of XXXN20

            o S0SUSP issue with a tickle date of 06/30/2022


              Note: EM 21079 REV published on April 11, 2022, updated the tickle date from 3/5/22 to 6/30/22
        • SSR Remark:

            o “Failure to provide evidence for (select RZ/CDR/PE)// N20 suspension cannot be applied – moratorium in effect”
      NOTE: Some FOs maintained a log of held cases as part of the sign-off process.

    2. Determine if the recipient, payee, or legal guardian has complied with requests during the moratorium.

      Technicians must review MSSICS, DCF, and all available FO resources (e.g., physical mail, WorkTrack 2.0, etc.) to determine if the recipient, payee, or legal guardian has complied with the request for information since the case was held.

      Query the SSR, MBR, and/or Customer Service Record (CSR) to check for recent changes to address, phone number, or changes in representative payee (including change from payee to direct payment) which may indicate that additional development or requests are needed before an FO can determine that N20, or another suspension code, applies.

      Review all applications (e.g., The Work Number, Unemployment (IBIQ) data exchange, Electronic Access to Financial Information (eAFI), and Non-Home Real Property (NHRP), etc.) to determine if the required information is available since the case was held.

      If the recipient, payee, or legal guardian has complied, or the information is now available, take the appropriate action. Determine if there is any remaining development needed. If new information is needed, follow normal development steps to request the information.


    3. Recipient, payee, or legal guardian did not comply, and case has been held less than 30 days

      If the case has been held less than 30 days, the technician determines that the required information has not been received, and it appears that suspension of payments due to failure to provide information is supported, the technician will:
      • Ensure all documentation requirements in SI 02301.235 for non-medical cases, and in DI 13005.025 and DI 13015.005 for medical CDRs have been completed.
      • Complete the documentation checklist in SI 02301.235.
      • Complete the required Report(s) of Contact per the policies above, and add the following language which is specific for held cases to the MSSICS DROC:
          o RZ/CDR/PE Action (Select one) held per instructions in EM -21079 REV on XX/XX/2022. Reviewed file and all available resources and recipient has not complied with requests for [description of needed information]. Case held for less than 30 days, N20 suspension applies.
      • Refer the case to the designated management individual in your FO (MSS or above) using local procedures for review and, if approved, posting of PSY N20 to the SSR.
    4. Recipient, payee, or legal guardian did not comply, and case has been held more than 30 days but less than 75 days

      If the case has been held more than 30 days but less than 75 days, the technician determines that the required information has not been received, and it appears that suspension of payments due to failure to provide information is supported, the technician will:
      • Ensure all documentation requirements in SI 02301.235 for non-medical cases, and DI 13005.025 and DI 13015.005 for medical CDRs have been completed,
      • Send a final request notice in the Document Processing System (DPS) for the requested information. Tickle for follow-up in 15 days.
      • If, after 15 days, the information is not received, complete the required Report(s) of Contact per the policies above, and add the following language which is specific for held cases to the MSSICS DROC:
          o RZ/CDR/PE Action (Select one) held per instructions in EM -21079 REV on XX/XX/2022. Reviewed file and all available resources and recipient has not complied with requests for
          [description of needed information]. Final request sent on XX/XX/2022 and no response after 15 days. N20 suspension applies.
      • Complete the documentation checklist in SI 02301.235
      • Refer the case to the designated management individual in your FO (MSS or above) using local procedures for review and, if approved, posting of PSY N20 to the SSR.
    5. Recipient, payee, or legal guardian has not complied, and the case has been held more than 75 days

      If the case has been held more than 75 days, the technician determines that the needed information has not been received, and it appears that suspension of payments due to failure to provide information is supported, the technician will:
      • Ensure all documentation requirements in SI 02301.235 for non-medical cases, and DI 13005.025 and DI 13015.005 for medical CDRs have been completed.
      • Send a new initial request in DPS for the required information. Tickle for follow-up in 15 days.
      • As described in SI 02301.235, if the information still has not been received after 15 days, make a follow-up attempt by phone to obtain the information. If the phone contact is unsuccessful, send a final written request and tickle for 15 days.
      • If after the final request, the information has not been received, complete the required Report(s) of Contact per the policies above, and add the following language which is specific for held cases to the MSSICS DROC:
        o RZ/CDR/PE Action (Select one) held per instructions in EM -21079 REV on XX/XX/2022. Reviewed file and all available resources and recipient has not complied with requests for [description
        of needed information]. Claim held more than 75 days since last request. New initial request sent on XX/XX2022, and final request sent on XX/XX/2022, no response after 15 days from final
        request. N20 suspension applies.
      • Complete the documentation checklist in SI 02301.235.
      • Refer the case to the designated management individual in your FO (MSS or above) using local procedures for review and, if approved, posting of PSY N20 to the SSR.

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 02301.235 Failure to Provide Information (N20)

DI 13005.025 Field Office (FO) Actions to Initiate a Continuing Disability Review (CDR)

DI 13015.005 Failure to Cooperate-Insufficient Evidence Decision (FTC) Suspension Procedures for Continuing Disability Reviews (CDR)- Field Office (FO)

DI 13015.250.Exhibit of Form SSA-5002 (Report of Contact) Decisions Documentation Sheet-CDR FTC



EM-22034 - Resumption Instructions for cases held under EM-21079 Temporary Hold on N20 (Failure to Provide Information) Suspensions—One–Time Only Instructions - 06/14/2022