Retention Date: March 10, 2018
|Intended Audience:||All RCs/ARCs/ADs/FOs/TSCs/PSCs/OCO/|
|Originating Office:||ORDP OISP|
|Title:||Policy and New Procedures for Processing Paper Applications Associated with Third-party iClaims - Instructions Will Follow Shortly|
|Type:||EM - Emergency Messages|
|Program:||Title II (RSI); Title XVI (SSI); Disability; All Programs|
|Link To Reference:||See References at the end of this EM.|
This emergency message (EM) provides the policy and procedures for processing the paper SSA-16 Application for Disability Insurance Benefits (DIB) and paper SSA-8000/8001 Application for Supplemental Security Income (SSI), when submitted in conjunction with a third party internet claim (iClaim) pending in the Modernized Claim System (MCS).
A third party can help a claimant file for disability benefits by completing an iClaim for DIB or DIB/SSI. Once the third party submits the iClaim, the claimant receives an Internet Application Summary by mail to review, sign, and return to a field office (FO) or workload support unit (WSU). Prior to obtaining the claimant’s signature for the Internet Application Summary, FOs and WSU’s may receive a completed paper application with the claimant’s signature. The current procedure for processing these paper applications includes manually clearing the MCS claim when the information on the paper application does not exactly match the information in MCS.
C. Valid application policy requirements
A claimant must file a valid application to become entitled to benefits, except in those situations where automatic conversions apply. To determine if an application for benefits is valid, you must verify that it meets the following criteria:
1. on a prescribed application form GN 00204.002;
D. Protective filing policy for third-party iClaims
2. signed beneath the penalty clause by a proper applicant GN 00204.003 and SI 00601.012;
3. filed with SSA GN 00204.006; and
4. The claimant must be alive when the application is filed, unless:
· before death, there was a written statement of intent to claim benefits GN 00204.005A and SI 00601.020;
· before death, SSA received an SSI oral inquiry SI 00601.025; or
· within 3 months after the month of death, a proper applicant filed a Title II disability application GN 00204.005A.
· A third party may establish a protective filing date for a claimant by initiating or submitting an iClaim.
IMPORTANT: An iClaim that is completed and submitted by a third party is a protective filing. It does not become a valid application until the claimant reviews the benefit application, affirms under penalty of perjury that information provided is correct, and signs the application.
E. Procedure for processing a paper SSA-16 application when a third-party iClaim is pending in MCS
The current procedures for a third-party iClaim have not changed. Technicians should continue to import the iClaim into MCS within five business days and try to contact the claimant by phone to:
· A third party initiates an iClaim when he or she completes the iClaim Applicant Identification screens and receives the application number.
· A third party who completes and submits an iClaim for a claimant is not a proper applicant and cannot sign the online application.
· review the application that is stored in the Online Retrieval System (ORS) with the claimant;
If the technician receives a paper SSA-16 prior to contacting the claimant and it meets the definition of a valid application, he or she must:
· update MCS with any additions or changes;
· confirm his or her intent to file; and
· read the attestation script affirming under penalty of perjury that the information provided is correct and agreeing to sign the application for benefits.
· update MCS with the information from the SSA-16; and
If the FO or WSU receives more than one valid application, (e.g., paper SSA-16 and Internet Application Summary) treat the additional application as a duplicate per GN 00204.028.
F. Procedure for processing a paper SSA-8000/8001
When a third party submits a paper SSA-8000/8001 with the claimant’s signature in addition to submitting an iClaim for DIB or DIB/SSI:
· store the updated MCS claim in ORS before entering any other updates in the MCS application path. This will secure the integrity of the information provided by the claimant on the paper application.
· Follow the witnessed signature procedure in GN 00201.015H.2.
· Establish the SSI claim in the Modernized Supplemental Security Income Claims System (MSSICS) with the information from the paper application; or
An application for SSI is also an application for Title II benefits per SI 00601.010D. However, a claimant is required to file a separate Title II application unless he or she meets one of the exceptions listed in SI 00601.035B.2.
Exception applies - Separate Title II application is not required
If the claimant meets one of the exceptions in SI 00601.035B.2, send the SSI claim to DDS.
· Update the pending deferred application in MSSICS with the information from the paper application if the iClaim includes an SSI application;
· Store the application in ORS before entering any other updates in MSSICS. This will secure the integrity of the information provided by the claimant on the paper application; and
· Follow the witnessed signature procedure in GN 00201.015H.
· Do not solicit a separate Title II application.
Exception does not apply – Separate Title II application is required
If the claimant is required to file a separate Title II application, delay sending the claim to DDS:
· Follow the normal procedures for adjudicating the Title II claim in SI 00601.035C.5.
· Attempt to contact the claimant once by phone to review the Internet Application Summary and obtain his or her signature.
Direct all program-related and technical questions to your Regional Office (RO) support staff 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.
GN 00201.015 Alternative Signature Methods
GN 00204.001 Valid Application
GN 00204.013 Third Party Non-proper Applicant and Protective Filing
GN 00204.020 Scope of the Application
GN 00204.028 Duplicate Applications
SI 00510.001 Overview of the Filing for Other Program Benefits Requirement
SI 02301.215 Summary of Posteligibility (PE) Suspension, Stop Payment and Termination Events by Payment Status Code (PSC)
· If contact is unsuccessful, issue the SSA-8051 and monitor for compliance.
· If the claimant does not file for Title II benefits, deny the SSI claim for failure to pursue (N06). For additional information on the payment status code N06, see SI 02301.215.
EM-17032 - Policy and New Procedures for Processing Paper Applications Associated with Third-party iClaims - Instructions Will Follow Shortly - 10/11/2017