Social Security

A. Purpose:

This EM provides new and updated instructions for controlling Decision Effectuation (DECEFFECT) issues in eWork. The instructions supersede existing policy found in DI 13010.025.B.4.

B. Background:

There are times when decisions made in eWork cannot update the Master Benefit Record (MBR) automatically. When that happens, eWork generates a DIB Cessation Exclusion document for upload to the Processing Center (PC) of jurisdiction via the Evidence Portal (EP) and creates a DECEFFECT issue on the Development Worksheet.

Note: There are situations where eWork generates a DECEFFECT issue, but PC involvement is not necessary. For example, eWork will not attempt to push the decision to the Post-entitlement Online System (POS) when a prior decision was reopened. Many of these cases can be resolved with a manual push to POS.

C. Prioritizing DECEFFECTs:

Effective immediately, DECEFFECTs will be broken into two priority groups:

· Priority 1: Current pay status is incorrect
· Priority 2: Current pay status is correct, but other MBR corrections are needed

· Step 1:
o If the eWork decision directs ongoing suspension or termination:
§ Make a POS input to impose suspense (S0). See MSOM 00705.008
§ Select 8 = CDR Suspend/Resume from the PESL screen
§ Select Y = Suspend Benefits with Current Month, and Reason for Suspension 1 = Work
§ Add a Special Message to the MBR indicating the reason for the suspense
§ On the next business day, check that the input worked. If the input failed, follow up using regular local procedures.
o If the eWork decision directs reinstatement of benefits, consider CPS payments in accordance with RS 02801.001.
· Step 2:
o Route the DECEFFECT document to the PC of jurisdiction using Document Type: “E-WORK-eWork Decision Effectuation Docs.”
o Refer to the KCNet DECEFFECT Tickle Guide and the eWork-Processing the Decision Effectuation Electronically Automation in Motion (AIM) VOD for detailed instructions on how to electronically route a DECEFFECT case to the PC. Add an Evidence Portal comment that states, “Priority 1 DECEFFECT”


· Step 3:
o eWork sets a 5-day tickle on the Development Worksheet.
o When the tickle matures, review PCACS to ensure the coversheet was received and is correctly indexed. PCACS should show the STATUS DIBCESS case pending in BA PROC.
o If there is no STATUS DIBCESS case reflected in PCACS, re-send the coversheet to the PC. Wait one day and check again. Contact your Regional Office (RO) Coordinator from the list on this site if there is still no STATUS DIBCESS case reflected in PCACS.
o If the STATUS DIBCESS case is pending in BA PROC, set the DECEFFECT tickle in eWork to 30 days from the date of the decision.
o When the tickle matures, review the MBR to ensure accurate processing. If all actions have been taken and the record is correct, receipt the DECEFFECT tickle.

· Step 4:
o If the decision is not complete and/or accurate, follow local procedures to contact your Area Work Incentive Coordinator (AWIC) or RO Coordinator via email using Subject Line: “Priority 1 DECEFFECT” followed by the Decision Date, and Claim Number.
§ In the body of the email, state “Please update the MBR with the most recent eWork decision.”
o Extend the DECEFFECT tickle 30 days.
o The RO coordinator will take the necessary action to follow up with the PC. The RO coordinator may advise you to set a longer tickle time depending on the circumstances. For RO coordinator instructions, see section D of this EM.
o If the issue is not resolved when the tickle matures, follow up with the RO coordinator again and extend the tickle by 30 days.
o Once the issue has been resolved, receipt in the DECEFFECT tickle.

· Step 1:
o Route the DECEFFECT document to the PC of jurisdiction using Document Type: “E-WORK-eWork Decision Effectuation Docs.”
o Please refer to the KCNet DECEFFECT Tickle Guide and the eWork-Processing the Decision Effectuation Electronically Automation in Motion (AIM) VOD for detailed instructions on how to electronically route a DECEFFECT case to the PC. Add an Evidence Portal comment that states, “Priority 2 DECEFFECT.”
· Step 2:
o eWork sets a 5-day tickle on the Development Worksheet.
o When the tickle matures, review PCACS to ensure the coversheet was received and is correctly indexed PCACS should show the STATUS DIBCESS case pending in BA PROC.
o If there is no STATUS DIBCESS case reflected in PCACS, re-send the coversheet to the PC. Wait one day and check again. Contact your RO Coordinator if there is still no STATUS DIBCESS case reflected in PCACS.
o If the STATUS DIBCESS case is pending in BA PROC, set the DECEFFECT tickle in eWork to 60 days from the date of the decision.
o When the tickle matures, review the MBR to ensure accurate processing. If all actions have been taken and the record is correct, receipt the DECEFFECT tickle.


· Step 3:
o If the decision is not complete and accurate, follow local procedures to contact your Area Work Incentive Coordinator (AWIC) or RO Coordinator via email using Subject Line: “Priority 2 DECEFFECT” followed by the Claim Number. In the body of the email, state “Please update the MBR with the most recent eWork decision.”
o Extend the DECEFFECT tickle 30 days.
o The RO coordinator will take the necessary action to follow up with the PC. The RO coordinator may advise you to set a longer tickle time depending on the circumstances. For RO coordinator instructions, see section D of this EM.
o If the issue is not resolved when the tickle matures, follow up with the RO coordinator again and extend the tickle by 30 days.
o Once the issue has been resolved, receipt in the DECEFFECT tickle.

· The subject of the email should contain the following:
o Priority of the DECEFFECT,
o Decision Date,
o Claim Number – If dual entitlement is involved include both claim numbers, and
o Type of Case – this should be Reinstatement, Cessation, Suspension, or MBR Correction.

· The Body of the email should contain:
o “Please update the MBR with the most recent eWork decision.”

o Additional comments if there are unusual circumstances such as decision outside of eWork, documents in EP; overlapping medical and work cessations; dual entitlement, etc.

· eWork-Processing the Decision Effectuation Electronically VOD for detailed instructions on how to electronically route a DECEFFECT case to PC.
· eWork-Processing the Decision Effectuation Electronically
· KCNet DECEFFECT Tickle Guide
· RO Coordinator List