Identification Number:
EM-19020
Intended Audience:Informational for All Employees RCs/ARCs/ADs/FOs/
TSCs/PSCs/OCO/OCO-CSTs
Originating Office:DCO OEST
Title:Preliminary Claims System (PCS) Beta Release
Type:EM - Emergency Messages
Program:Title II (RSI); Title XVI (SSI); Disability; Medicare
Link To Reference:See References at the end of this EM.
 
Retention Date: January 31, 2020

A. Purpose

This Emergency Message (EM) explains the use and functionality of the new web-based tool, the Preliminary Claims System (PCS). PCS assists technicians in determining to which types of Title II, XVI, and XVIII benefits individuals are potentially entitled.

B. Background

At this time, technicians in eight field offices (FO) nationwide will use PCS in a beta release starting July 27, 2019.

The participating offices are:

    · FO 958—Long Beach, CA
    · FO D63—Columbus, OH
    · FO C40—Bloomington, MN
    · FO 485—Chicago, IL
    · FO 080—Hartford, CT
    · FO 290—Staunton, VA
    · FO 273—Downtown Baltimore, MD
    · FO 294—Alexandria, VA
    Currently, technicians must use various tools and applications, such as the Disability Insured Status Calculator Online (DISCO), Interactive Computations Facility (ICF), and Informational/Certified Earnings Record (ICERS) to help identify an individual’s filing options.

    PCS combines features from many applications to streamline and standardize the pre-claim interview process. This reduces the chance of a technician missing potential entitlements and closeouts. It also documents the individual’s decision about filing (or not filing) for potential benefits.

    PCS generates a written “Summary of Potential Benefits” notice to the individual. This notice highlights potential entitlements at the end of the interview. The notice explains the advantages and disadvantages of filing an application for certain benefits and helps the individual make an informed decision.

    Technicians can print this notice locally and use it to discuss all potential benefits and next steps with the individual. The notice is saved and available in the Online Retrieval System (ORS). If the technician updates information in PCS, a revised version of the summary notice is also stored in ORS.

    NOTE: Technicians in non-beta offices or the National 800 Number Network (N8NN) should continue to follow the existing claims taking process if an individual has a PCS summary notice as detailed in GN 00201.005 .

    C. PCS functionality

    Technicians in beta offices will use a limited functionality version of PCS to conduct a pre-claim interview. The limited functionality version of PCS identifies potential benefits on an individual’s own record.
    In a future version, PCS will be able to identify additional potential benefit entitlements based on the individual’s relationships (e.g. marriage, child, and parent) for auxiliary or survivor’s benefits.

    PCS identifies potential eligibility on an individual’s own record for the following programs:
      · Retirement Insurance Benefits (RIB),

      · Disability Insurance Benefits (DIB),

      · Supplemental Security Income benefits (SSIDI, SSIBI, and SSIAI),

      · End-Stage Renal Disease (ESRD), and

      · Medicare Health Insurance (Part A) (based on insured status).


    1. When to use PCS

    Technicians can use PCS to conduct a pre-claim interview for legally competent adult individuals who:
    · have valid Social Security numbers, and
    · visit a field office inquiring about filing for benefits, or
    · have an appointment to file for benefits under Title II only, Title XVI only, or under both titles, and
    · is acting on his or her own behalf, and
    · does not have an existing SSA record or claim (e.g., MBR, SSR, pending internet claim or claim in MCS or the SSI Claims System.).

    2. Determining entitlement to auxiliary and survivors benefits outside of PCS

    After using PCS to identify potential entitlement on the individual’s own work record, technicians must identify the individual’s potential entitlement to auxiliary and survivor benefits (outside of PCS).
    Identifying all potential entitlements is necessary for explaining filing considerations that involve multiple benefits.

    For example:

    If the individual is potentially entitled to:
    · RIB and Husband or Wife’s Insurance Benefits (AUXSPO), the technician should explain deemed filing.
    · Widow(er) Insurance Benefits (WIB) and RIB, the technician should explain how the option to file for WIB only (restricting the scope of the application in order to file for RIB at a later time) can allow the individual to accumulate delayed retirement credits (DRCs).
    If an individual returns to the office later to file for benefits, the technician should go through PCS again. They need to ensure that all information is up-to-date, and then select “file now” at the end of the path. This action allows all updated information to propagate into MCS and the SSI Claims system.

    D. How to document protective filings and oral inquiries in PCS

    Technicians must continue to document the protective filing in the 800# system per GN 00204.010.

    If the individual does not wish to file or does not qualify, closeout the protective filing per GN 00204.012.

    1. Title II

    When technicians conduct a pre-claim interview with PCS, it establishes a protective filing date for Title II.
    After the pre-claim interview is complete, document the individuals’ filing decision in PCS.
    If the individual does not wish to file or does not qualify, closeout the protective filing per GN 00204.012.

    2. Title XVI

    When the individual is at least age 64 and 10 months or alleges a disability, PCS includes an explanation of Supplemental Security Income (SSI).

    When the technician provides the SSI explanation, PCS creates an oral inquiry. Immediately after the SSI explanation, obtain the individual’s intent to file for SSI.

    If the individual does not want to file for SSI, document and closeout the oral inquiry following SI 00601.030 and SI 00601.037.

    If the individual wants to file, document or closeout the protective filing per GN 00204.012.

    E. When PCS should not be used

    If an individual has an appointment to file or visits an office to file for Medicare only, do not use PCS. This functionality will change in a future release.

    For individuals who do not meet the PCS criteria, technicians should continue to follow the pre-application policy in GN 00203.002 and SI 00601.060D.

    F. Items to consider for non-beta offices

    PCS generates a written “Summary of Potential Benefits” notice for individuals at the end of the interview.

    Technicians can print this notice locally and use it to discuss all potential benefits and next steps with the individuals. The notice is also available in the Online Retrieval System (ORS).

    If the technician updates an individual’s information in PCS, a revised version of the summary notice is also stored in ORS.

    If an individual brings his or her PCS summary notice to a non-beta office or calls into the #800, technicians should proceed with the normal claims-taking process per GN 00201.005.

    G. Training

    A desk guide was provided to all beta office technicians to assist with navigating PCS. Additional training materials such as a user guide or Video on Demand will be available nationwide in the future.

    Direct all program-related and technical questions to your Regional Office (RO) support staff, who may refer questions or concerns to their Central Office contacts.

    References
    GN 00201.005 General Application Taking Practices
    GN 00203.002 Pre-Application Actions for Interviewing Claimants
    SI 00601.060D Supplemental Security Income (SSI) Interviewing
    GN 00204.010 Protective Filing
    GN 00204.012 How to Close a Protective Writing
    SI 00601.037 Closing Out Leads and Protective Filings


    EM-19020 - Preliminary Claims System (PCS) Beta Release - 07/26/2019