TN 105 (08-23)

GN 00301.288 What Information is Needed on EVID and the Report of Contact page in the Consolidated Claims Experience (CCE) in PE Situations to Identify the Type of Evidence Submitted

A. General

Use EVID or the Report of Contact page in CCE to record identifying information about documents presented to prove an issue or a factor of entitlement/eligibility.

Refer to MS 01701.003 for instructions on how to complete the EVID and MS 08122.010 for the Report of Contact page in CCE.

When establishing EVID, be extremely careful about keying the client's name and all SSNs. There is no SSN interface with the NUMI to ensure that the information entered is correct.

B. Event Date

1. EVID

“DOCUMENT EVENT DATE” is the only mandatory date field. Since all documents should have at least one date, enter that date in the “DOCUMENT EVENT DATE” field. “DATE RECORDED” and “DATE ISSUED” should only be completed if they appear on the document. When the document has a start and end date (e.g., opening and closing date on a bank statement), always record the end date in the “DOCUMENT EVENT DATE” field. Annotate the start date in the “COMMENTS” field. If there is no date on the document, enter the date the document was received.

2. Report of Contact page in CCE

Always show an event date. If there is only one date, show that date as the event date. If there is no date, enter the date the document was received. If there is a start date and end date, record both but the end date will always be the event date. Include the issue and recorded date, if available.

C. Recording the Document Type on EVID/Report of Contact page in CCE

1. Procedure

Use the codes appearing in the charts in GN 00301.288C.2. and GN 00301.288C.3. to record the type of document. However, the type of document may be spelled out, if it is uncommon or does not appear in the chart.

In addition to the type of document, always code the name(s) shown on the document if different from the name shown in the “NAME” field on EVID or the “CLAIMANT/PERSON” field on the Report of Contact page in CCE. If the name is too long for the space provided, code the name(s) in the “COMMENTS” field on EVID or in the “REPORT TEXT” field on the Report of Contact page in CCE.

For SSA forms other than the ones listed in GN 00301.286D.4.d., show the form number.

2. Chart 1 - Document Type and Code Listed Alphabetically By Document Type

Document Type

Code

Document Type

Code

Account Statement (Financial)

ACCT STMT

Birth Certificate -Delayed State/ County/City

DBC

Adoption Records

ADOPT REC

Birth Certificate - Pre-Age 5 State/County/ City

BC

Affidavit

AFFDVT

Bris (Religious) Record

BRIS

Agency Statement

AGY STMT

Burial Agreement

BURIAL AGMT

 

 

Cancelled Check

CAN CK

Annulment Record

ANNUL REC

Census Record (Federal)

FC REC

Appraisals - Car/Real Estate/Other Property

APPRSL&type (e.g., car)

Census Record (State)

SC REC

Award Letter/Notice (except WC/PDB)

AWD LTR

Certificate

CERT

Bank Statement

BNK STMT

Certificate of Service - U.S. Armed Forces

DD-217N

Baptismal (Religious) Record

BAPT

Check

CK

Birth Certificate - Amended State/County/City

ABC

Check Register

CK REG

Birth Certificate - Child's

CBC

Child Support Stubs

CHLD SUPP STUBS

Certificate of Election

CE

 

 

Court Order of Legitimation

CT LEG

Funeral Contract

FUNERAL CNTRCT

Court Order - Name Change

CT NAME CHG

Guardian/Conservatorship Papers

GDN /CONSERV

Court Order of Paternity

CT PAT

Hospital Birth Record

HBR

Court Order of Support

CT SUP

Health Record

HR

Credit Card

CR CRD

Immigration Record/BCIS

INS &form No.

Death Record - State/County

DTH REC

Insurance Policy

INSUR POL

Deposit Slip

DEPST SLP

Indian Tribal Record

IT

DEQY

DEQY

IRA Statements

IRA STMT

Driver's License

DRV LIC

Marriage Certificate

MC

Disability, RR, MS &Alien Deportation File

DRAMS

Marriage License

MR LIC

Divorce Record

DV

Master Beneficiary Record

MBR

Equitable Adoption Agreement

EQUIT ADOPT

Military Casualty/Wounded Warrior Record – U.S. Govt.

DD-1300

Electronic Stock Verification

ESV

Military Record -U.S. Govt.

DD-214

Employment Record

EMP REC

Military Record - U.S. Govt.

NOAA-56-16

Factual Precedent

PRCDNT

Military Record - U.S. Govt.

PHS-1867

Family Bible

BIBLE

Military Service Record - Other

MS REC Form No.

 

 

Report of Contact

RC

Modernized Claims System

MCS

 

 

Modernized SSI Claims System

MSSICS

 

 

Mortgage/Rent Receipts

MORT/RENT RECPT

 

 

Mutual Fund Statement

MUTL FUND

 

 

Naturalization Certificate

NAT CERT

 

 

Notification of Birth

NB

State ID

STATE ID

Numident

NUMI

Stock Certificate

STOCK CERT

Passbook

PASS BK

Supplemental Security Record

SSR

Passport

PASSPORT

Tax Return - Personal

TAX RTN

Pay Stubs

PAY STUB

Tax Return - Corporate

TAX RTN -CORP

Payment History Update System

PHUS

Tax Return -Partnership

TAX RTN - PARTNER

Personal Letter

LTR

Tax Return - Self-Employment

TAX RTN - SE

Public Disability Benefit Document

PDB

Unemployment Statement

UNEMPLY STMT

Rental Agreement

RENT AGRMT

Vehicle Registration

VEH REG

Rent Receipts

RENT RECPT

Voting Record

VOTE REC

SAVE Query

SAVE

W-2/W-2c

W-2/W-2c

Savings Bonds

BOND

 

 

School Records

SCH REC

401K Statements

401K

Separation Decree

SEP DECREE

 

 

3. Chart 2 - Document Type and Code Listed Alphabetically By Code

Code

Document Type

Code

Document Type

ABC

Birth Certificate (Amended)

BOND

Savings Bond

ACCT STMT

Account Statement (Financial)

BRIS

Bris (Religious) Record

ADOPT REC

Adoption Records

BURIAL AGMT

Burial Agreement

 

 

CAN CK

Cancelled Check

AFFDVT

Affidavit

CBC

CE

Birth Certificate - Child's

Certificate of Election

AGY STMT

Agency Statement

CERT

Certificate

 

 

CHLD SUPP STUBS

Child Support Stubs

ANNUL REC

Annulment Record

CK

Check

APPRSL &type

Appraisals - Car/Real Estate/Other Property

CK REG

Check Register

AWD LTR

Award Letter/Notice (except WC/PDB)

CR CRD

Credit Card

BAPT

Baptismal (Religious) Record

CT LEG

Court Order of Legitimation

BC

Birth Certificate - Pre-Age 5 State/County/City

CT NAME CHG

Court Order - Name Change

BIBLE

Family Bible

CT PAT

Court Order of Paternity

 

 

CT SUP

Court Order of Support

BNK STMT

Bank Statement

DD-1300

Military Casualty Record - U.S. Govt.

DCB

Birth Certificate-Delayed State/County/City

 

 

DD-217N

Certificate of Service - U.S. Armed Forces

HBR

Hospital Birth Record

DD-214

Military Record - U.S. Govt.

HR

Health Record

DEPST SLP

Deposit Slip

INS &Form No.

INS/Immigration Record

DEQY

DEQY

INSUR POL

Insurance Policy

DRAMS

Disability, RR, MS, Alien Deportation File

IRA STMT

IRA Statements

DRV LIC

Driver's License

IT

Indian Tribal Record

DTH REC

Death Record - State/County

LTR

Personal Letter

DV

Divorce Record

MBR

Master Beneficiary Record

EMP REC

Employment Record

MC

Marriage Certificate

EQUIT ADOPT

Equitable Adoption Agreement

MCS

Modernized Claims System

ESV

Electronic Stock Verification

MORT/RENT RECPT

Mortgage/Rent Receipts

FC REC

Census Record (Federal)

MR LIC

Marriage License

FUNERAL CNTRCT

Funeral Contract

MS REC Form No.

Military Service Record - Other

GDN/CONSERV

Guardian/Conservator-

Ship Papers

MSSICS

Modernized SSI Claims System

MUTL FUND

Mutual Fund Statement

STATE ID

State ID

NAT CERT

Naturalization Certificate

STOCK CERT

Stock Certificate

NB

Notification of Birth

TAX RTN

Tax Return -Personal

NOAA-56-16

Military Service Record - U.S. Govt.

TAX RTN - CORP

Tax Return - Corporate

NUMI

Numident

TAX RTN - PARTNER

Tax Return -Partnership

PASS BK

Passbook

TAX RTN - SE

Tax Return - Self-Employment

PASSPORT

Passport

UNEMPLY STMT

Unemployment Statement

PAY STUB

Pay Stub

VEH REG

Vehicle Registration

PDB

Public Disability Benefit Document

VOTE REC

Voting Record

PHS-1867

Military Record - U.S. Govt.

 

 

PHUS

Payment History Update System

W-2/W-2c

W-2/W-2c

RC

Report of Contact

 

 

RENT AGRMT

Rental Agreement

401K

401K Statements

RENT RECPT

Rent Receipts

 

 

SAVE

SAVE Query

 

 

SCH REC

School Record

 

 

SEP DECREE

Separation Decree

 

 

SSR

Supplemental Security Record

 

 

 

D. Foreign Countries Whose Evidentiary Documents Can Be Certified Electronically For Domestic Claims

1. Procedure

Use the codes appearing in the charts in GN 00301.288D.2. and GN 00301.288D.3. to record the foreign country on EVID or Report of Contact page in CCE in PE situations. See GN 00301.286E.4. for foreign documents that do not appear in the charts.

 

2. Chart 1- Countries and Codes Listed Alphabetically By Country

Country

Code

Country

Code

AUSTRALIA

AS

LUXEMBOURG

LU

AUSTRIA

AU

MALTA

MT

BELGIUM

BE

MONACO

MN

CANADA

CA

NETHERLANDS

NL

CZECH REPUBLIC

EZ

NEW ZEALAND

NZ

DENMARK

DA

NORWAY

NO

FINLAND

FI

POLAND

PL

FRANCE

FR

PORTUGAL

PO

GERMANY

GE

SAN MARINO

SM

GREECE**

GR

SLOVAKIA

LO

HUNGARY

HU

SPAIN

SP

ICELAND

IC

SWEDEN

SW

REPUBLIC OF IRELAND

EI

SWITZERLAND

SZ

ISRAEL***

IS

UNITED KINGDOM (i.e., ENGLAND, SCOTLAND, WALES & NORTHERN IRELAND)

UK

ITALY

IT

 

 

JAPAN

JA

 

 

LIECHTENSTEIN

LS

 

 

*A list of all Country Codes are found in SM 01005.632D.

**Only documents secured by the Federal Benefits Unit (FBU) in Athens.

***Only documents for events after 1947.

3. Chart 2-Countries and Codes Listed Alphabetically By Code

Code

Country

Code

Country

AS

AUSTRALIA

LO

SLOVAKIA

AU

AUSTRIA

LS

LIECHTENSTEIN

BE

BELGIUM

LU

LUXEMBOURG

CA

CANADA

MN

MONACO

DA

DENMARK

MT

MALTA

EI

REPUBLIC OF

IRELAND

NL

NETHERLANDS

EZ

CZECH REPUBLIC

NO

NORWAY

FI

FINLAND

NZ

NEW ZEALAND

FR

FRANCE

PO

PORTUGAL

GE

GERMANY

PL

POLAND

GR

GREECE**

SN

SAN MARINO

HU

HUNGARY

SP

SPAIN

IC

ICELAND

SW

SWEDEN

IS

ISRAEL***

SZ

SWITZERLAND

IT

ITALY

UK

UNITED KINGDOM (i.e., ENGLAND, SCOTLAND, WALES&NORTHERN

IRELAND)

JA

JAPAN

 

 

E. Types of Information to Be Coded In The “Comments” Field On EVID Or Recorded In The “Report Text” Field On the Report of Contact Page in CCE

The “COMMENTS” field on EVID is a two-line free form field that appears at the bottom of EVID. This field and the “REPORT TEXT” field on the Report of Contact page in CCE should be used to record information about evidentiary documents that will be useful to subsequent reviewers.

The adjudicator should use their discretion in deciding what information should be captured. The following is a list of possible uses:

  1. 1. 

    To note the purpose for which the document is presented when “OTHER” is selected in the “DOCUMENT SUBMITTED AS PROOF OF THE FOLLOWING EVENTS/ISSUES:” field.

  2. 2. 

    To annotate the name(s) appearing on the document if different from the claimant's name:

    • in the “NAME” field on EVID;

    • in the “CLAIMANT/PERSON“ field on the Report of Contact page in CCE; or

    • used in the MCS or MSSICS claim (see GN 00301.288B.).

  3. 3. 

    To indicate whether other documents were presented to prove the same allegation/issue.

  4. 4. 

    To annotate that the allegation(s)/issue(s) was not proven by the document.

  5. 5. 

    To indicate that a material discrepancy exists between the allegation and the document.

  6. 6. 

    To indicate that the claim was taken on paper.

  7. 7. 

    To indicate, if needed, the time period covered by the document.

  8. 8. 

    To indicate if the document had a Raised seal.

  9. 9. 

    To indicate the month and year reduced spouse's or widow(er)'s benefits were elected.

EXAMPLE: Claimant signed (Form) dated (MM/DD/YY) electing to accept reduced benefits beginning (MM/YY).

F. Recording The Record Identification Number (RIN)

Use the “RIN” field on EVID or the “REPORT TEXT” field on the Report of Contact page in CCE to record any record number or identifying number on the document (e.g., account number from a bank statement, employer identification number from a W-2).

G. Recording Specific Evidence Types

1. W-2 Forms

When entering the event date in the “DOCUMENT EVENT DATE” field on EVID or “REPORT TEXT” on the Report of Contact page in CCE, enter the last day of the year as stated on the W-2.

Information about the amount of income may be shown in the “COMMENTS” field on EVID or the “REPORT TEXT” field on the Report of Contact page in CCE. The amount of income must be entered in the system for which the substantive information is being captured (e.g., MCS, MSSICS, etc.). Record the employer's EIN in the “RIN” field on EVID or the “REPORT TEXT” field on the Report of Contact page in CCE.

The date recorded and the date issued are not needed.

In an initial claims situation, when a claimant brings in two or more W-2s from different employers as proof of wages, complete two different EVID screens. Show all W-2's on one Report of Contact page in CCE. (If proof of prelag wages is presented, completion of the Earnings Modernization screens is sufficient to capture an audit trail about the employer.)

2. Tax Return Information

When coding tax return information on EVID or the Report of Contact page in CCE, show as the event date the last day of the tax year as stated on the tax return.

Show information about the amount of income in the “COMMENTS” or “REPORT TEXT” field. However, the amount of income must be entered in the system for which the substantive information is being captured (e.g., MCS, MSSICS, etc.).

The date the tax return was signed by the taxpayer (if shown) should be recorded in the “DATE RECORDED” field or “REPORT TEXT” field on the Report of Contact page in CCE.

3. Monthly Pay Stub Information

In title XVI PE situations where the local requirements call for SSI recipients to provide proof of income on a monthly basis, the FO can annotate EVID or the Report of Contact page in CCE with the first month reporting; do not code subsequent months. Record/store subsequent months' information according to SI 00820.141C.2.b. In the “COMMENTS” field of EVID or “REPORT TEXT” field on the Report of Contact page in CCE, include a statement “Future monthly income stored locally.”

4. Military Service

When coding military service (DD-214) information, show the discharge date in the “DOCUMENT EVENT DATE” field on EVID or “REPORT TEXT” field on the Report of Contact page in CCE. Show the active duty start date in the “COMMENTS” field on EVID or “REPORT TEXT” field on the Report of Contact page in CCE. If there are several periods of active military service with a break in service, show the very last discharge date as the event date. Enter the other periods in the “COMMENTS” field on EVID or “REPORT TEXT” field on the Report of Contact page in CCE.

If a person has multiple periods of active military service with no break in service, show as one period of service. You may annotate the fact that there were several DD-214s covering this period in the “COMMENTS” field on EVID or the “REPORT TEXT” field on the Report of Contact page in CCE. However, the military service periods must be entered in the system for which the substantive information is being captured (e.g., MCS). Neither the date recorded nor date issued is needed.

5. Veteran Administration Benefit Query

If VBAQ is used to prove a period of military service, annotate on EVID/Report of Contact page in CCE. When VBAQ is an issue, see MS 05203.020.

6. Online Evidence

When evidence certified by the custodian of record that is received via Online Data Exchange is being recorded, show that it is “Online” evidence. Record the date of access, name of the agency whose records were accessed, the name or number of screens accessed and data element used as evidence.

 


To Link to this section - Use this URL:
http://policy.ssa.gov/poms.nsf/lnx/0200301288
GN 00301.288 - What Information is Needed on EVID and the Report of Contact page in the Consolidated Claims Experience (CCE) in PE Situations to Identify the Type of Evidence Submitted - 08/15/2023
Batch run: 12/06/2023
Rev:08/15/2023