TN 12 (01-24)

GN 02615.120 Title II Clark Court Order Manual Processing

A. Processing Center (PC) Clark manual relief

1. Clark manual relief workload

After releasing the Clark Informational Notice on December 11, 2012, we forwarded the records selected for manual processing directly to the PC. The PCs will administer Clark relief for Class Members whose records have:

  • A 10/24/2006 or later pending administrative appeal on either probation or parole violation (PPV) suspensions or overpayments, or

  • An overpayment history exists that prohibits the system from automatically calculating paid versus payable correctly without manual review and processing, or

  • Multiple warrants that require review of each warrant and subsequent manual relief processing.

In addition, if a record has a Central Office Message (CO MSG) of CLARK COURT ORDER—CASE SELECTED FOR CLARK RELIEF AND MEDICARE REVIEW, the technician will review the case to determine if the beneficiary is eligible to receive Clark relief and subsequently determine if Medicare relief is also appropriate. For instructions on processing Clark Medicare relief, see GN 02615.140.

The Social Security numbers and names of the Class Members who received the informational notices are on the Civil Action Tracking System (CATS) with a Court Case Identifier (CCID) of C2.

2. Processing Center Action Control System (PCACS) Clark manual workload identification

The Clark relief cases will have a Processing Center Action Control System (PCACS) issue to alert the technician that the case is available for processing. The PCACS for the Clark cases will contain the following information to identify the case.

TOEL1: STATUS TOEL2: FELRESU TOEL3: ALERT TOEL4: CLARK

3. Record review to determine relevant warrants and overpayments

All single warrant cases have a PPV suspension or overpayment initial determination dated 10/24/2006 or later, or have a PPV administrative appeal request pending 10/24/2006 or later. All multiple warrant cases require a review of each warrant to determine if that warrant meets the requirements for Clark relief. The chart below provides information on our records and data elements that you must review to determine the PPV suspension period and correctly process the Clark relief.

Payment record

Review of payment record

Result of Review

Master Beneficiary Record (MBR) query

CO MSG1 line will include information about the type of Clark relief that the beneficiary is due.

Confirm that the special message data line states: “CLARK COURT ORDER — CASE SELECTED FOR CLARK REVIEW.”

If the Class Member may qualify for Medicare relief, the CO MSG1 will state: “CLARK COURT ORDER — CASE SELECTED FOR CLARK RELIEF AND MEDICARE REVIEW.”

FUGITIVE line will show warrant information.

Check the data entries in this data field to determine for each warrant the:

Warrant date and Originating Agency Indicator,

warrant type: Felon Status = VIOLATION, and

current warrant status.

If the warrant is actionable (i.e., not satisfied), there is no MBR WARRANT SATISFY field. If the warrant is closed, there are data entries in the WARRANT SATISFY and SATISFIED RSN fields.

NOTE: If the beneficiary is deceased (i.e., LAF T1) or in terminated status (e.g., T4, T6, etc.), the WARRANT SATISFY date entry and SATISFIED RSN entry will remain blank. Do not closeout the warrant as “satisfied” when the beneficiary’s status terminates. For information on multiple warrant processing, see GN 02615.120C in this section.

O/U PAY line shows the most recent overpayment occurrence on the record and the reason for the overpayment.

Check the data line to confirm a PPV suspension overpayment.

The Due Process Overpayment Type (DPOT) T2 FF/SUS/VIO, (Type of Event (TOE 74), will show if this is a PPV overpayment. The Due Process Overpayment Amount (DPO) should be identical to the amount that appears on the ROAR record PPV overpayment event.

NOTE: In some instances, Beneficiary Overpayment/Underpayment Data (BOUD) may not show a TOE 74 even though there is a TOE 74 event on ROAR. If the BOUD TOE is not 74 or your estimate of the PPV suspension overpayment amount does not equal the overpayment posted in BOUD, check ROAR to see if BOUD may contain multiple overpayments.

HISTORY line will reflect a history of payment changes to the record.

Check the data entries in this line to determine the S9 period(s) with an HRFST of FUGFEL between 01/05 – present.

Check the following fields in the HISTORY data line:

STATUS CODE--Position 3, Benefit Paid Designation (BPD) of this entry shows if the monthly benefit was paid, code “1;” or, not paid, code “0.”

Reason for Suspension or Termination (SUS/TERM)--The code will be “9” with an HRFST of “FUGFEL.”

Monthly Benefit Credited (MBC) – MBC is the monthly title II benefit due after any appropriate dollar rounding (considering a deductible of supplementary medical insurance (SMI) premium), but prior to the actual collection of any obligation of the beneficiary (including SMI premium). Determine any overpayment or underpayment amount and check amount based on the MBC amount.

Recovery Overpayment Accounting Record (ROAR)

BENEFIT line

Identify the total current balance due for all overpayments for the beneficiary stated on the BBAL-$$$$$ data line.

EVENT line

Find the Event Identifier (EI) for the PPV overpayment (e.g., 01, 02, etc.).

Find the Type of Event (TOE) for the PPV overpayment on the EVENT data line, (e.g., T2 FF SUS/VIO WAR, T2 FF SUS/FEL WAR, PRIS SUS NON-MENT, OTHER OR CONSOLIDATED LDO, etc.).

Find the STATUS for the PPV overpayment. Determine from the STATUS code entry the current PPV overpayment recovery effort (e.g., BEN ADJ, DUE PROCESS, etc.).

HISTORY line

Identify the entries in the data line to determine when ROAR established the PPV overpayment amount.

RUN DATE

TRAN

AMOUNT

NOTE: If the PPV suspension caused an overpayment, the ROAR HISTORY RUN DATE entry for the PPV overpayment event establishment is important when determining the initial determination date for applying Clark relief. The establishment event transaction code (TC) is generally a TC12, but sometimes ROAR establishes the event as a TC 10.

Fugitive Felon System Control File (FFSCF)

Fugitive Felon Warrant Data (FFWQ) Screen

Review the following data fields on this screen to determine if you need to distinguish the suspension for this warrant from other warrants that the beneficiary may have.

WARRANT DATE

OFFENSE CODE (PPV warrants =5011, 5012, 8101, or 8102)

OFFENSE CHARGE SYMBOL (PROBATION/PAROLE VIOLATION)

WARRANT NUMBER

NCIC NUMBER

WARRANT FILE REPORT DATE

NOTE: For specific PPV warrant data codes applicable to Clark class members, see GN 02615.100B.1.

Fugitive Felon Warrant Status (FFSQ) Screen

Review the OIG SUBJECT STATUS DATE. If it is blank, it means that the Office of the Inspector General (OIG) did not verify the warrant nor refer it for PPV suspension.

Payment History Update Query (PHUS)

TRANS line

The PHUS retains the entire Transaction line as a permanent record of actual payment history. Review the transaction on PHUS to see what we actually paid the beneficiary.

If you need more information on the TRANS data line of the PHUS query, see SM 00545.275.

4. Determining the initial PPV suspension date for a multiple warrant case

For multiple PPV warrants, determine the PPV initial suspension determination date for each warrant by using the following chart.

Steps

Actions

1

Review the PPV warrant on FFSCF. Go to the Fugitive Felon Warrant Status Query (FFSQ) screen and find the OIG SUBJECT STATUS DATE: MM/DD/CCYY. This data represents the date that OIG referred the PPV warrant to us for review and suspension processing. Use this date as the beginning reference point for searching for the PPV suspension determination date. Benefit suspension always occurs after this date, if appropriate. Go to step 2.

If there is no OIG subject status date, search the Online Retrieval System (ORS) for title II PPV initial suspension and or overpayment determination notices dated 01/01/05 and later.

2

After determining the FFSQ beginning month and year reference point, review the MBR HISTORY PPV period of S9 FUGFEL. Find the posted MBR PPV suspension processing transaction. Use this date to search ORS for the notice, go to step 3.

If this warrant does not have a MBR PPV suspension processing transaction, stop. Go back to step 1 and start over with the next warrant.

NOTE: If the PPV suspension caused an overpayment, review the ROAR HISTORY data line. Check the ROAR PPV suspension overpayment posting date (i.e., RUN DATE and TC12 T2 FF/SUS/VIO). The ROAR PPV overpayment posting date corresponds with the POS FFEL or MACADE/MADCAP action date that processed the PPV suspension. Use this date to search for the notice on ORS, go to step 3.

3

Locate the beneficiary’s ORS PPV initial suspension notice and any related overpayment notice. Obtain the mailing date of the beneficiary’s PPV initial suspension and any overpayment determination notice, and go to step 5.

If the PPV suspension and any overpayment notice is not in ORS, go to step 4.

4

If you cannot find the beneficiary’s ORS PPV suspension and overpayment notice, recheck the beneficiary’s MBR and locate the MADCAP/MACADE PPV suspension action. This processing action will provide the beneficiary’s notice information that we included on the PPV suspension and overpayment notice. Add five days to the processing date and use this date as the PPV suspension and overpayment initial determination date, and go to step 5.

If MACADE/MADCAP did not process the PPV suspension, go to the MBR DED/ADD line and review the transactions to locate the system that processed the PPV suspension. Find the UPDATED field for the transaction and use the UPDATED date entry plus 5 working days as the initial PPV suspension determination date, and go to step 5.

5

If the initial PPV suspension determination is 10/24/2006 or later, the PPV warrant qualifies for Clark relief, process the reinstatement action. For reinstatement instructions, see GN 02615.120E.2 in this section.

NOTE: The title II PPV suspension and related overpayment determinations are contained in the same initial determination notice.

If the initial PPV suspension determination is earlier than 10/24/2006, the PPV warrant does not qualify for reinstatement unless the beneficiary has a pending administrative appeal. This warrant requires no further action. Go to step 1 to review the next warrant until you review all of the beneficiary’s PPV warrants.

If there is a 10/24/2006 pending administrative appeal on the PPV suspension or overpayment action on the record, process the record following instructions in GN 02615.130.

5. Clark relief processing actions

After reviewing the payment records, determine how you will process the relief for each warrant.

a. Administrative appeal

The ROAR review reveals that there was a PPV suspension or overpayment (e.g., T2 FF SUS/VIO WAR, T2 FF SUS/FEL WAR, or Consolidated LDO) with a TC 23 protest (e.g., WAIVER, RECON, HEARING, etc.) and, there is:

  • No further indication of a decision on the protest (i.e., administrative appeal request), or

  • A 10/24/2006 or later unfavorable PPV decision on ROAR (e.g., event TC 27, TC 41, TC 43 or TC55 following the TC 23).

If you have this situation, the instructions for processing pending administrative appeals are in GN 02615.130.

b. Overpayment adjustments necessary before relief processing

Your review of the ROAR record reveals that we adjusted the PPV overpayment amount to a different amount by imposing partial recovery on an incorrect PPV overpayment amount, or on multiple combined overpayment events; or, we used MACADE/MADCAP to force a correct balance which mistakenly reduced or removed the PPV overpayment amount that is due Clark relief.

For instructions on processing overpayment adjustment cases, see GN 02615.120B in this section.

c. Multiple warrants

The MBR FUGITIVE line review shows that there is more than one PPV warrant entry in the line. FFSCF review also shows warrant information for more than one PPV warrant.

For multiple warrant processing instructions, see GN 02615.120C in this section.

NOTE: After Clark relief processing, evaluate the beneficiary’s potential Medicare relief if the record has the CO MSG: CLARK COURT ORDER—CASE SELECTED FOR CLARK RELIEF AND MEDICARE REVIEW. For Medicare review instructions, see GN 02615.140.

B. Overpayment adjustments

1. Overpayment relief processing

a. Review payment records and determine the PPV overpayment amount

To remove or reduce a beneficiary’s PPV overpayment when processing relief take the following actions.

  • Review the MBR, ROAR, FFSCF, and PHUS records to determine the correct PPV overpayment balance. For instructions for reviewing the MBR, ROAR, FFSCF and PHUS records, see GN 02615.120A.3 in this section.

  • Consider any previously waived overpayment amounts. For instructions on reviewing and calculating overpayments where we waived a prior overpayment, see GN 02615.115C.3.

  • Compare the PPV overpayment balance to the existing ROAR overpayment events and the MBR BOUD line. For instructions for comparing the PPV overpayment balance to the ROAR record, see GN 02615.120B.3 in this section.

  • Input the ROAR overpayment removal or reduction amount to eliminate the remaining PPV suspension overpayment and have ROAR generate an explanatory beneficiary notice. For instructions for removing the beneficiary’s PPV overpayment, see GN 02615.120B.2 in this section.

NOTE: There is a priority order for applying terminations and nonpayment, reduction, deduction, and withholding events to monthly title II benefit amounts. For more information on the priority of applying terminations and nonpayment, reductions, and withholding events, see GN 02602.025

After completing your review of the MBR, ROAR, FFSCF and PHUS, determine the PPV overpayment amount to remove from the beneficiary’s BOUD/ROAR record. For instructions on adjusting benefits due the overpaid beneficiary, see GN 02210.006. For instructions on preparing a Payment Worksheet (PWST) to determine the actual remaining PPV overpayment amount, see MSOM QUERIES 006.017.

NOTE: Compute PPV overpayment amounts only for warrants that have an offense code of 5011, 5012, 8101 or 8102.

b. No PPV overpayment exists

If no PPV suspension overpayment currently exists (e.g., all previously withheld PPV suspension benefits were released to the beneficiary and the PPV suspension overpayment balance is now $0.00, or the PPV overpayment was waived and no additional PPV suspension benefits are payable, or the beneficiary’s PPV suspension period was replaced by their prisoner suspension period, etc.) after completing your review of the MBR, ROAR, FFSCF, or PHUS records, add the following special message to the MBR: CLARK COURT ORDER - CLARK REVIEW COMPLETED. For instructions for adding a special message to the MBR, see MSOM QUERIES 006.026.

If there is no further case processing needed (e.g., correction of the MBR to remove the S9 FUGFEL history, the ROAR record does not need correction, etc.) except for updating the FFSCF database with the GOOD CAUSE: CRT (i.e., good cause of Court), send the beneficiary a notice to explain your review of the PPV suspension and overpayment and that there is no additional relief payable. For an example of the notice and the paragraph to include in your notice, see GN 02615.160B.4.

c. Adjusting the ROAR record

If the PPV overpayment should remain on the record after you complete your MBR, ROAR, FFSCF, or PHUS records review (e.g., the PPV suspension overpayment balance is due to a pre-10/24/2006 PPV initial suspension or overpayment determination with no pending appeal on or after 10/24/2006), annotate your review results to the Special Message data field on the MBR (SP MSG). Add the following special message to the MBR: CLARK COURT ORDER - CLARK REVIEW PROCESSED.

EXAMPLE:

The beneficiary had two closed periods of PPV suspension, one closed period occurred in 1/05 to 05/05. We notified the beneficiary of their PPV suspension and overpayment of $1900.00 in our notice to them dated 12/30/2005. The beneficiary neither protested nor appealed our PPV suspension or overpayment decision. In 11/2006, we received another closed period PPV warrant that caused us to suspend the beneficiary’s benefits for 05/2006 through 07/2006. We notified the beneficiary of this closed period suspension and overpayment of $900.00 in our notice to the beneficiary dated 12/23/2006. The beneficiary neither protested nor appealed the second closed PPV suspension period or their overpayment of $900.00. We posted the beneficiary’s overpayment for the first period of suspension to BOUD/ROAR with a TOE of “74” representing the PPV suspension overpayment. The beneficiary requested that we withhold the $1,900.00 using partial recovery at the rate of $10.00 per month. When the beneficiary incurred the second period of PPV suspension, ROAR added the additional $900.00 to the existing TOE 74 overpayment event on ROAR. The combined balance for the PPV overpayment amounts on ROAR in 01/2013 is $1480.00. The second period of closed PPV suspension for 05/2006 through 07/2006 qualifies for Clark relief. We took a MACADE/MADCAP action to correct the MBR HISTORY field to remove the second S9 FUGFEL period. A processing exception caused the action to incorrectly adjust the ROAR record. We subsequently prepared a Debt Management System (DMS) action to reduce the existing ROAR by $900.00 (the amount of the PPV overpayment for the Clark relief period) to $580.00, the remaining balance due for the first period of PPV suspension. DMS issued a letter explaining the removal of the second PPV overpayment of $900.00 to the beneficiary. The technician added the Special Message to the MBR showing, “CLARK COURT ORDER—REVIEW PROCESSED.”

2. Removal of remaining PPV overpayment balance from ROAR (TOE 74- T2 FF SUS VIO/WAR Overpayment)

Review the MBR and determine the following:

  • If you must correct the PPV suspension MBR HISTORY line (i.e., remove S9 HRFST of FUGFEL), pay relief for Clark PPV suspension periods, and correct (e.g., reduce or remove) the existing PPV overpayment amounts, use MACADE/MADCAP to process the Clark relief. For MACADE/MADCAP processing instructions, see GN 02615.120C in this section.

  • If you do not need to correct the HISTORY line on the MBR or pay past PPV suspension periods and your only processing action is to remove or reduce the PPV overpayment, take the actions outlined in the chart.

Steps

Actions

1

Remove or reduce the current PPV overpayment balance TOE 74-T2 FF SUS/FEL/VIO event on the ROAR/BOUD overpayment record using the DEBT MANAGEMENT SYSTEM (DMS) screens as instructed below:

Civil Action Screen (DRCA),

Choose “6” Debt Management from the SSA Main Menu screen.

Choose “2” Debt Resolution from the Debt Management Menu (DMMU). Enter the Social Security number (SSN) and beneficiary identification code (BIC).

On the Debt Resolution Menu (DRMU) enter the Debt Number. Enter “1” in SELECT for “Establish” mode. Then enter “20” for “Civil Action” in the SELECT THE DESIRED FUNCTION field.

On the Civil Action screen (DRCA), DECISION TYPE and DECISION REASON enter “2” – CLARK. Enter the APPROVAL AMOUNT that you previously determined from your review of our payment records based on the instructions in GN 02615.120B in this section and press enter.

An informational message will notify you that you must complete the Review Civil Action (DRWA) screen (you must do this for every case input on the DRCA). Press enter again.

Move the case to the selected reviewer’s paperless queue designated by your office to authorize the input action.

2

The designated approving reviewer will log into the Personal Communications software (PCOM) with a different personal identification number (PIN) than the one used to input the DRCA screen. If the reviewer is satisfied with the proposed ROAR transaction, process the approval as follows:

On the DRWA Screen,

Choose “6” for Debt Management from the SSA Main Menu.

Choose “2” for Debt Resolution from the DMMU screen. Enter the SSN and BIC.

On the Debt Resolution Menu (DRMU), enter the Debt Number. Enter “2” in SELECT for “Update” mode. Then enter “21” Review Civil Action in the SELECT THE DESIRED FUNCTION field.

On the DRWA screen, the DRCA information propagates to DRWA screen. Put a “Y” in the APPROVED BY REVIEWER FIELD and then press enter.

3

DMS sends an automated beneficiary notice to explain the PPV overpayment removal or reduction. For an illustration of the caption and paragraph that will appear on the notice, see GN 02615.160B.3.

NOTE: If the beneficiary is deceased (i.e., LAF T1), DMS will only send a PPV overpayment removal or reduction notice if the beneficiary had a representative payee on their record at the time of death. If a deceased beneficiary does not have a representative payee, that notice is not used. For information on processing Clark relief for a deceased beneficiary, see GN 02615.135A.4.

4

Reprocess the PPV overpayment Debt Management input exceptions using the screens in the DMS. For instructions for resolving debt management exceptions, see SM 00610.410 through SM 00610.420.

5

Add the MBR SP MSG: CLARK COURT ORDER—CLARK RELIEF PROCESSED to annotate that you completed your review and processing of the case.

If the record has the CO MSG: CLARK COURT ORDER—CASE SELECTED FOR CLARK RELIEF AND MEDICARE REVIEW, do not add the SP MSG to the MBR. Next, process a Medicare review following instructions in GN 02615.140.

NOTE: ROAR may have a fugitive felon Type of Event (TOE) 73 incorrectly entered instead of a PPV TOE 74. Examine the offense code on the FFSCF warrant record in conjunction with the ROAR TOE 74 record to make sure you are removing the correct overpayment balance for the matching warrant and that warrant’s corresponding overpayment period.

3. Removal or adjustment of a remaining PPV overpayment balance from ROAR/BOUD consolidated overpayment event

To determine the true remaining consolidated (i.e., combined) overpayment amounts, minus the benefits now payable for Clark relief and any previously waived overpayment amounts, you must compare all benefits paid on the record to those payable for the total consolidated overpayment period. Use a Payment Worksheet to determine the difference between what we actually paid a title II beneficiary and what we owe the beneficiary for the consolidated overpayment period. For instructions on processing a Payment Worksheet, see MSOM QUERIES 006.017.

After determining the remaining consolidated overpayment amount, including the benefits now payable for Clark relief and previously waived overpayment amounts, remove or reduce the current consolidated overpayment balance to the new overpayment balance computed on your Payment Worksheet. If it is not necessary to correct MBR History, or correct the FUGITIVE line on the MBR, process the consolidate overpayment adjustment using the instructions in GN 02615.120B.1.c. in this section. If a MBR HISTORY correction to remove an S9 FUGFEL period and correct the FUGITIVE line is necessary, follow the instructions in GN 02615.120B.2. in this section.

C. Multiple warrants

Review and process each PPV warrant independently. Use the chart’s steps to evaluate each PPV warrant to determine the beneficiary’s Clark relief eligibility.

Steps

Actions

1

Determine if the PPV warrant and the accompanying suspension period are eligible for Clark relief. For instructions on determining the initial PPV suspension and overpayment decision date, see GN 02615.120A.4 in this section.

You must review and evaluate each PPV warrant independently, go to step 2.

2

After review of each PPV warrant, review the beneficiary’s payment records following instructions in GN 02615.120A.3 in this section.

Go to step 3.

3

If your payment review reveals,

A 10/24/2006 or later pending administrative appeal on either PPV suspension or overpayment:

  • For reconsideration, process following instructions in GN 02615.130B

  • For Administrative Law Judge (ALJ) and Appeals Counsel (AC) appeals, refer the pending PPV administrative appeal to the Office of Hearings Operations (OHO). Do not continue processing Clark relief for any of the other PPV warrants. OHO must decide the pending administrative appeal issue before we process the Clark relief. For instructions on processing administrative appeals, see GN 02615.130.

or,

The PPV suspension and overpayment are eligible for Clark relief, but the beneficiary has an overpayment that prohibits the system from automatically calculating paid versus payable correctly without manual review and processing, go to step 4.

or,

The warrant and the PPV suspension and overpayment are not eligible for Clark relief, stop. You do not need to take further action on the warrant. Continue to process each actionable PPV warrant.

4

For instructions on processing relief for cases where you must review and process the PPV overpayment manually, see GN 02615.120B in this section.

D. Reinstating or resuming Title II benefits for the PPV suspension period

1. PC instructions for resuming or reinstating benefits from LAF S9 FUGFEL status using MADCAP/MACADE

Steps

Required Actions

1

Use MADCAP/MACADE to reinstate benefits. (For systems FFEL screen processing instructions, see MSOM COMMON 005.035.)

From the FFSCF:

Annotate the new warrant disposition to the PPV WARRANT DUE PROCESS/GOOD CAUSE (FFDG) screen.

In the update mode, enter the mandatory entries and then enter the: GOOD CAUSE DETERMINATION section of the screen:

GOOD CAUSE ESTABLISHED(Y/N): Y

IF YES, GOOD CAUSE REASON: CRT

GOOD CAUSE DECISION DATE (mmddccyy): 99999999 (place the current date in this date field)

REMARKS: CLARK COURT ORDER—CLARK RELIEF PROCESSED or CLARK RELIEF AND MEDICARE RELIEF PROCESSED, if your reinstatement action also includes processing Medicare relief.

NOTE: You must update the FFDG screen to avoid a processing exception of the FFEL reinstatement input. Instructions for updating the FFSCF are in PRISON 006.001.

2

From the MACADE path:

Select #6 (ENTITLEMENT AND ELIGIBILITY MENU) on the TRANS-TO MENU and select #31 FUGITIVE FELON (FFEL) on the ENTITLEMENT AND ELIGIBILITY MENU, or

Enter ENT in the TRANS- TO field and select #31 (FFEL).

3

On the MACADE FFEL screen:

a. LAF S9 FUGFEL status

In the update mode, enter the mandatory entries and then enter on the

RESUMPTION OF BENEFITS section the following:

RESUME BENEFITS EFFECTIVE WITH FIRST SUSPENSION MONTH: Y

ENTER RESUMPTION REQUEST REASON: 3 GOOD CAUSE

IF RESUMPTION REQUESTED FOR GOOD CAUSE, ENTER GOOD CAUSE REASON: CRT

b. Closed period suspension

Remove from the FFEL screen, the existing “WARRANT SATISFIED” date and “SATISFIED REASON” entries.

Enter on the RESUMPTION OF BENEFITS section the following:

RESUME BENEFITS EFFECTIVE WITH FIRST SUSPENSION MONTH: Y

ENTER RESUMPTION REQUEST REASON: 3 GOOD CAUSE

IF RESUMPTION REQUESTED FOR GOOD CAUSE, ENTER GOOD CAUSE REASON: CRT

4

Add a Payment History (HST) screen to the MACADE/MADCAP action to release the benefits that were in S9 FUGFEL for the PPV suspension period and to start continuing monthly benefit payment, if appropriate. For information on the summarization rules for post-adjudicative actions, see SM 00848.010B.2.

5

If the beneficiary is eligible for Medicare relief, see the instructions in GN 02615.140 for additional MACADE/MADCAP coding that is necessary for completion of this processing action.

6

Add additional notice information to the MADCAP notice regarding the Clark Class Order to the notice. Include paragraph FUG118 to the notice. For an exhibit of the Clark Court Order relief language, see GN 02615.160B. For information on processing requests for special notices for blind or visually impaired claimants, beneficiaries, and representative payees, see TC 00101.021.

Also take the following actions:

  • Add this SP MSG to the MBR: CLARK COURT ORDER--CLARK RELIEF PROCESSED or CLARK COURT ORDER--CLARK RELIEF AND MEDICARE RELIEF PROCESSED, as appropriate.

  • Release the Clark underpayment without regard to the presence of a Windfall Offset data (WOD) line on the MBR.

  • Do not prepare a PPV good cause determination.

  • If a suspended beneficiary has a representative payee, do not release retroactive benefits if the suspension was for three or more months. For instructions on continuing suitability payee development, see GN 02615.115D.

  • Do not pay retroactive payments to beneficiaries who are prisoners as defined in EM-10013 SEN or while they are subject to fugitive felon nonpayment. For instructions on processing retroactive payments, see GN 02615.115C.1.

2. Alternative processing for reinstating benefits when FFEL excepts—FO Instructions

Check the MBR to make sure the system reinstated the benefits effective with the first month the PPV warrant stopped the benefit. If the MBR indicates the reinstatement did not process, check the THIS query in MFQ. If THIS indicates a processing exception, follow instructions in GN 02613.500C and GN 02613.500D.

NOTE: In some instances, applying Clark relief to a record will not allow monthly benefits to begin because there is a higher priority suspension event that may supersede the PPV suspension (e.g., prisoner suspension LAF S7, no child-in-care suspension LAF S4, etc.). You must still close out the FUGITIVE line on the MBR for PPV warrants to ensure unauthorized future PPV suspensions actions will not occur. For more information about higher priority suspension actions, see the instructions in GN 02602.025.

E. Closed period case processing

1. Determining a closed period of Clark relief

For each closed period PPV warrant,

Steps

Actions

1

Check the PPV warrant data on the FUGITIVE data line on the MBR and on the FFSCF to determine the closed suspension period.

For a closed PPV warrant, the MBR FUGITIVE warrant entries contain the following:

WARRANT DATE = date the law enforcement agency (LEA) issued the PPV warrant

FELON STATUS = VIOLATION

WARRANT SATISFY= date the PPV warrant was satisfied

SATISFIED RSN – Apprehended or Dismissed

For a closed PPV warrant, the FFSCF Fugitive Felon Warrant Status (FFSQ) screen warrant entries contain the following:

WARRANT DATE = date the law enforcement agency (LEA) issued the PPV warrant

WARRANT STATUS = CLOSED

IF WARRANT CLOSED, WARRANT END DATE= date the warrant was satisfied

WARRANT ENDED REASON = Warrant Dismissed or Felon Apprehended

WARRANT SATISFIED INPUT DATE = date the FO or PC keyed the warrant satisfied action

2

After reviewing the MBR and FFSCF warrant data, determine the closed PPV warrant period. The period begins with the WARRANT DATE or 01/01/2005 if later than the WARRANT DATE, and ends with the MBR WARRANT SATISFY/WARRANT ENDED DATE entry.

NOTE: For computing the PPV closed period, remember that the earliest warrant date you can have is 01/01/2005 regardless of the actual PPV warrant date on FFSCF.

EXAMPLE:

Date of initial determination = 08/31/2008

MBR FUGITIVE line

DATE OF WARRANT = 02/05/2004 FELON STATUS = Violation

WARRANT SATISFY= 07/21/2008

SATISFIED RSN = Dismissed

The closed period for this example = 01/01/2005 through 07/21/2008.

3

Determine the PPV suspension and overpayment initial determination date and if the PPV closed period warrant is eligible for Clark relief following instructions in GN 02615.120A.4 in this section.

2. Reinstating benefits for a closed period of fugitive felon suspension

For processing instructions for reinstating benefits for open and closed PPV suspension periods, see GN 02615.120D.1. in this section.


To Link to this section - Use this URL:
http://policy.ssa.gov/poms.nsf/lnx/0202615120
GN 02615.120 - Title II Clark Court Order Manual Processing - 06/25/2013
Batch run: 01/04/2024
Rev:06/25/2013