Identification Number:
GN 02610 TN 26
Intended Audience:See Transmittal Sheet
Originating Office:ORDP OISP
Title:Title II/Title XVI (Windfall) Offset
Type:POMS Transmittals
Program:
Link To Reference:
 

PROGRAM OPERATIONS MANUAL SYSTEM
Part GN – General
Chapter 026 – Posteligibility
Subchapter 10 – Title II/Title XVI (Windfall) Offset
Transmittal No. 26, 08/20/2019

Audience

PSC: BA, CA, CCRE, CS, ICDS, IES, ILPDS, IPDS, ISRA, PETE, RECONR, SCPS, SPIKE, TSA, TST;
OCO-OEIO: BIES, BTE, CR, CTE, FCR, PETL, RECONR;
OCO-ODO: BTE, CR, CST, CTE, CTE TE, PETE, PETL;
FO/TSC: CS, CS TII, CS TXVI, CSR, CTE, DRT, DT, FR, OA, OS, RR, TA, TSC-CSR;

Originating Component

OISP

Effective Date

Upon Receipt

Background

This is a Quick Action Transmittal. These revisions do not change or introduce new policy or procedure. Added a sentence to remind technicians of the instructions in EM-19010 SEN. Cleaned up the policy a bit.

Summary of Changes

GN 02610.018 Applying Title II Offset to Concurrent Cases

Changed "title" to "Title" throughout the document to comply with the QUICC handbook.

Added citations to the relevant law and regulations before subsection A.

Subsection A

Clarified the effective date of the policy as the date AR 92-1(3) was published.

Removed unnecessary language in the second sentence.

Subsection B

Added a reference to EM-19010 SEN to ensure technicians consider the affect of fees when processing a concurrent award.

Subsection D

Added relevant references.

GN 02610.018 Applying Title II Offset to Concurrent Cases

A. Policy for applying Title II offset to concurrent awards

For claims adjudicated on or after January 10, 1992, windfall offset applies to the retroactive Title II benefits first even if we paid the Title II current monthly accrual (CMA) before the Title XVI benefits. Paying the Title XVI first will ensure that we protect a claimant’s Medicaid eligibility for months in the retroactive period. If the claimant insists payment of retroactive Title II benefits immediately, and understands the potentially adverse effect on Medicaid eligibility, obtain a withdrawal of the Title XVI application. For policy and procedures for withdrawal of a Title XVI application, see SI 00601.050.

B. Field Office (FO) procedures for processing Title II offset in concurrent awards

Apply Title II windfall offset in all concurrent awards.

NOTE: The system will control the release of Title II retroactive benefits until after payment of the Title XVI benefits.

  • Complete the non-medical development of the Title XVI claim as quickly as possible to avoid undue delay in paying any retroactive Title II benefits remaining after offset. If the claimant has at least one representative who has not waived his or her fee for services, follow the instructions in EM-19010 SEN. For additional information about adjudicating Title XVI awards in Title II offset cases, see SI 02006.005B.

  • For information about how to process windfall offset diaries, if the FO determines the individual is not eligible for Title XVI benefits because we denied the Title XVI claim, see SM 01320.010. For specific information about the 8W and 9W diaries, see SM 00815.600 and SM 01320.016, respectively.

  • When the action to pay the retroactive Title II benefits is complete, the supplemental security record (SSR) will post the retroactive Title II benefits as type W unearned income.

C. Title II retroactive benefits released without applying offset

For processing instructions for cases where we released the Title II retroactive benefits before applying offset, see GN 02610.050E.

D. References

EM-19010 SEN Field Office Processing Instructions for Concurrent Cases Involving Unknown or Unresolved Representative Fees

GN 02610.064 Acquiescence Ruling (AR) On Offset (Mazza)

SI 00601.050 Withdrawal of Supplemental Security Income (SSI) Application

SI 02006.005 Adjudicating SSI Claims in Title II Offset Cases

SM 00815.600 Processing Diary Alerts

SM 01320.010 Windfall Offset Diaries and Alerts - W1, 3W, 4W, 5W, 6W, 7W, 8W, 9W

SM 01320.016 9W Diary Procedure


GN 02610 TN 26 - Title II/Title XVI (Windfall) Offset - 8/20/2019