Effective Dates: 9/18/2026 - Present

Identification Number:
RS 02801 TN 21
Intended Audience:See Transmittal Sheet
Originating Office:LP ISP
Title:Critical Cases
Type:POMS Full Transmittals
Program:All Programs
Link To Reference:
 

PROGRAM OPERATIONS MANUAL SYSTEM
Part RS – Retirement and Survivors Insurance
Chapter 028 – Sensitive/Critical Cases
Subchapter 01 – Critical Cases
Transmittal No. 21, 09/18/2026

Audience

PSC: BA, CA, CRT, CS, DC, DE, DEC, DPS, DS, DT/ER, ICDS, ICTU CA, ICTU SCPS, IEBA, IECA, IES, ILPDS, IPDS, ISRA, LCRT, PETE, RAC, RECONR, SCPS, TS, TSA, TST;
OCO-OEIO: BIES, BTE, CR, CTE, FCR, FDE, PETL, RECONE, RECONR;
OCO-ODO: BTE, CR, CST, CTE, CTE TE, DE, DEC, DS, PETE, PETL, RECONE;
FO/TSC: CS, CS TII, CS TXVI, CSR, CTE, FR, OA, OS, RR, TA, TSC-CSR;

Originating Component

ISP

Effective Date

Upon Receipt

Background

The agency may issue an immediate payment (IP) to beneficiaries who demonstrate a dire need and meet other criteria, including the critical case criteria. In the past, we issued these payments via paper check. Effective March 2025, Executive Order (EO)14247 Modernizing Payments To and From America's Bank Account and EO 14249 Protecting America's Bank Account Against Fraud, Waste, and Abuse require the Department of Treasury to issue all federal payments electronically. In compliance with the EOs, the agency began issuing IPs via a United States Debit Card (USDC), effective 02/09/2026. This transmittal incorporates Financial and Management's implementation of the USDC. This transmittal also clarifies existing critical case and IP policies and procedures.

Summary of Changes

RS 02801.001 Critical Case Criteria and Exclusions

We updated this section to:

Add an "Introduction."

Streamline the "Policy" subsection.

Streamline the procedural guidance in subsection C and retitle "Procedure-applying the critical case criteria."

 

RS 02801.010 Immediate Payment (IP) Criteria and Process

We re-titled the section, "Title II Immediate Payments" and updated it to:

Subsection A - Add an "Introduction"; formerly titled "Background."

Streamline the "Policy" subsection.

Streamline and incorporate procedural guidance for a payment determination and issuing a Title II IP into subsection C.

RS 02801.001 Critical Case Criteria and Exclusions

A. Introduction

This section provides information and guidance on Title II critical cases. When a beneficiary is adversely affected because payment is not made timely, a case will be treated as critical if it meets the requirements in this section. A critical case, requires priority handling and must be developed and processed expeditiously. For information about other types of cases identified for priority handling, refer to DI 23020.001.

B. Policy

A Title II critical case exists when:

  • •

    a beneficiary who is entitled to benefits has not received a due payment;

  • •

    there is a dire need or adverse public relations potential; and

  • •

    an exclusion outlined in RS 02801.001B2 does not apply.

For the definition of dire need, refer to DI 23020.030.

IMPORTANT: Cases that meet the terminal illness (TERI) criteria are also considered critical. For information on TERI cases, refer to DI 11005.601.

1. Situations in which a critical case may exist

A critical case for Title II may exist for situations in which there is:

  1. a. 

    an initial claim for benefits, where all factors of entitlement are met;

  2. b. 

    a reinstatement of payment for benefits that were in a suspense status and evidence has been submitted to prove the suspense no longer applies;

  3. c. 

    a delayed or interrupted payment due to a processing error;

  4. d. 

    an adverse determination has been reversed on appeal;

  5. e. 

    an alleged non-receipt of an issued payment. Refer to RS 02801.001B.2.c in this section for the critical case non-receipt exclusions;

  6. f. 

    a disability to survivor conversion case that has not successfully processed through the Manual Adjustment Credit and Award Process (MADCAP) after two attempts; or

  7. g. 

    a MADCAP adjustment action for nonpayment to payment status that has not successfully processed after three attempts.

References: 

 

2. Critical case exclusions

Some cases are excluded from Title II critical case processing because they are not considered critical payment situations. A critical case does not exist for situations in which there is:

  1. a. 

    an issue or discrepancy where no payment is due. For example, a Medicare issue with no Title II payment problem, Social Security Number (SSN) issues or earning discrepancies, requests for explanation of benefit or overpayment amounts;

  2. b. 

    a request for a recomputation, recalculation, and/or delayed retirement credits where only the amount of payment is in question;

  3. c. 

    an alleged non-receipt for a payment that represents only a retroactive cost-of living increase payable to all beneficiaries, a lump-sum death payment, or an underpayment due a deceased beneficiary;

  4. d. 

    a conditionally adjudicated or non-adjudicated claim;

  5. e. 

    payment of the family maximum; or

  6. f. 

    a tax refund offset.

References: 

 

C. Procedure-applying the critical case criteria

When applying the critical case criteria, technicians must consider the merits of each case and determine if the issue with the case can be resolved through routine processing, by using direct input in the applicable system. For cases that cannot be resolved using direct input, technicians will use the Critical Payment System (CPS) to replace the delayed payment. CPS is primarily used to:

  • •

    make Title II critical payments-a payment issued by the Treasury Department and received by the beneficiary in two-to-five days; and

  • •

    record Title II immediate payments (IP)-a debit card is issued immediately in the field office because of a dire need situation requiring payment faster than the two-to-five days of a Treasury issued payment. For more information on the criteria for an IP, refer to RS 02801.010.

For more information on CPS, refer to SM 00635.000 and MS 07901.001.

While most critical cases are identified and processed in the FO, these cases are also processed in the teleservice center (TSC) and the processing center (PC). For TSC instructions on processing critical cases, refer to TC 15001.040. For PC and FO instructions, refer to RS 02803.000.

NOTE: If the FO needs to transfer a critical case to the PC for necessary action, such as when a CPS exclusion exists or for certain appellate reversals, complete a Modernized Development Worksheet (MDW) 2560HP (High Priority Payment Center Request) request. For information about modes of requesting assistance, refer to GN 01070.228.

NOTE: For critical cases where benefit payment offset (BPO) applies, subtract any BPO amount before issuing a CPS payment. Additionally, CPS payments cannot be issued to pay back excess BPO payments. For more information, refer to GN 02410.300.

RS 02801.010 Title II Immediate Payments

A. Introduction

This section provides information and guidance on Title II immediate payments (IPs). An IP is a method of expedited payment made only in the field office (FO), within the Third Party Payment System (TPPS). Effective 02/09/2026, we issue these payments via a US Debit Card (USDC). For more information about TPPS and the USDC, refer to TPPS and GN 02402.021.

B. Policy

The Commissioner of Social Security (COSS) established the IP process to allow for beneficiaries demonstrating dire need to receive a payment immediately. The IP applies to both Title II and Title XVI cases, as well as concurrent cases (Title XVI eligibility and Title II entitlement). For information about Title XVI IPs refer to SI 02004.001.

1. Criteria

We make a Title II IP when a case meets these requirements:

  • •

    The case involves delayed payment of an initial claim or delayed or interrupted payments, or nonreceipt of issued payments; and

  • •

    We completed all development and established entitlement for payment; and

  • •

    The case meets the critical criteria outlined in RS 02801.001 and the beneficiary has an immediate financial need for payment that cannot be reasonably met through other resources available in the community.

References:

  • •

    GN 02406.201 Nonreceipt of Title II Critical Payment System (CPS) Checks

  • •

    GN 02406.004 Nonreceipt Desk Charts for Teleservice Center, Title II and Title XVI Field Offices

  • •

    GN 02406.700 General Information on Mass Loss of Checks and the Payment Delivery Alert System (PDAS)

2. Initial claims

In initial claims, do not make an IP without a valid Social Security number.

3. Concurrent cases

In concurrent cases where retroactive benefits are due and windfall offset applies, compute the windfall offset first. This computation determines the Title XVI and Title II amounts due. For more information about Title II/Title XVI Windfall Offset, refer to GN 02610.000.

Make the IP from the program which can pay the full IP amount. Use this chart as guide.

If...

Then...

Both Title II and Title XVI can pay the full IP amount

Pay the IP from Title II funds.

Title II equals or exceeds the IP amount

Pay a Title II IP.

Title II is less but Title XVI equals or exceeds the IP amount

Pay a Title XVI IP.

Both Title II and Title XVI are less than the IP amount

 Pay the Title II IP first and then the Title XVI IP up to the IP maximum or the amount of unpaid benefits, whichever amount is less.

4. Posteligibility - delayed or interrupted payment

In posteligibility (PE) cases, we make an IP if the recipient meets the criteria upon reinstatement. We will also make an IP if payments will be delayed or stopped due to a systems limitation or other systems problems.

5. Maximum IP amount payable

The maximum Title II IP for an individual, including dual entitlement or concurrent cases, is the lesser of $5,000 or the total unpaid benefits due at the time the field office issues the IP. Do not exceed this limit. If additional benefits are due, use another payment method (e.g., a one-time CPS payment) for the remaining balance.

C. Procedure

 

1. Making a Title II payment determination

Take these steps to make a Title II IP determination.

Step

Action

1

Does the case meet the critical criteria outlined in RS 02801.001 and is there an immediate financial need or potential public relations problem involved and all avenues to resolve the emergency have been exhausted?

If yes, go to step 2.

If no, STOP. Explain no IP can be paid.

2

Has Title II entitlement been established? For instructions on verifying entitlement for Title II immediate payments, refer to RS 02803.130A.

If yes, go to step 3.

If no, and if Title XVI eligibility is established and there is unpaid Title XVI funds due, evaluate for a Title XVI IP, refer to SI 02004.100.

If no, and Title XVI eligibility is not established, STOP. Explain no IP can be paid.

3

Is it an initial, delayed, interrupted payment or nonreceipt case?

If yes, go to step 4.

If no, explain why an IP cannot be made. Expedite the case to put into regular payment immediately.

4

Obtain approval for an IP from FO management. If making a determination for a concurrent Title II/Title XVI case, evaluate the case to decide from which program to issue the IP, refer to RS 02801.010B3 in this section.

Determine the maximum IP amount payable and refer to RS 02801.010C2 in this section to process the payment.

NOTE: The 30-day limit on issuing subsequent IPs no longer applies. However, beneficiaries must meet ALL criteria before we can issue a subsequent IP within 30 days.

NOTE: If the FO requires assistance before they can issue the IP, contact the processing center (PC) via fax, e-mail , or telephone. If after issuing the IP, the FO needs to transfer a case to the PC for necessary action, complete a Modernized Development Worksheet (MDW) 2560HP (High Priority Request) request. For information about emergency situations requiring telephone or email contact, refer to RS 02803.120. For information about modes of requesting assistance, refer to GN 01070.228.

2. Processing Title II immediate payments

Establish, approve and transmit the Title II IP in the critical payment system (CPS), per instructions outlined in SM 00635.000 and MS 07901.000. After the payment is established and approved on the applicable CPS screens, and transmitted to the TPPS system, the FO technician will complete Form SSA-8102 and the cashier will complete the issuance of the USDC payment in TPPS.

Before the cashier issues the USDC payment, the technician will:

  • •

    Complete the fillable Form SSA-8102, (Advance Payment or Immediate Payment Receipt and Notice) template by recording receipt of the IP. The SSA-8102 is also located in the inForm Library.

  • •

    Print all three copies of the SSA-8102.

  • •

    Obtain the beneficiary's or representative payee's signature on all 3 copies.

  • •

    Provide the copies of the SSA-8102 and CPS output to the cashier.

The cashier will:

  • •

    Review the SSA-8102 to ensure accuracy and that the recipient or representative payee signed all three copies.

  • •

    Issue the USDC to the beneficiary or their representative payee in TPPS. For more information about a cashier issuing USDC payments through TPPS, refer to GN 02402.021C, AIMS 03.05.07 and the TPPS User Guide.

  • •

    Give the copy of the SSA-8102 marked "Claimant" to the beneficiary or representative payee as a receipt and notice.

  • •

    Return the "File" copy to the technician to upload in the Claims Folder using the Evidence Portal (EP) per GN 00301.322.

  • •

    Retain the "Cashier" copy and the CPS output as documentation in the TPPS file as required for FO manager audit and review.


RS 02801 TN 21 - Critical Cases - 9/18/2026