Past-due benefits equal to or greater than $5,000 - If the underpayment or past-due benefits due the claimant are equal to or greater
than $5,000, the CR must complete the underpayment review and enter the appropriate
code on the Underpayment Processing (UOUP) screen (see
MS
00304.018, Underpayment Processing (UOUP)) to show that the prepayment review is complete.
The system will generate an online build transaction SSR alert message: I9 ALERT –
REQUIRES IAR TO BE PAID BY OTP. When the CR receives the message, the CR continues
with the transaction. The system will set the underpayment verification code to “V,”
(UPV:V), withhold 100% of past-due benefits, and send an automated notice to the State
to request the IAR amount. In these cases, when the response is received from the
State, take the actions in the bullets below.
Past-due benefits less than $5,000 - If the underpayment is less than $5,000, the system will set the underpayment verification
code to “V,” (UPV:V), withhold 100% of past-due benefits, and send an automated notice
to the State to request the IAR amount. (See SI 02003.025, IAR Payment Processing for Exception Cases and Proration Cases.) In these cases,
when the response is received from the State, take the actions in the bullets below.
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•
If the IAR is less than 75% of the past-due benefits:
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–
Input a U TAC to the SSR to continue withholding 100% of past-due benefits (U TAC
replaces UPV:V).
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–
Input an A-OTP to pay the State the IAR amount. This also produces an automated notice
to the State.
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–
On the next workday, A-OTP to pay the claimant the difference between 75% of past-due
benefits and the IAR amount, or the first installment payment if required. (Past-due
benefits that are being withheld by U TAC minus IAR minus 25% of past-due benefits
[if concurrent case, as defined in GN 03920.031B.2. = benefits due claimant in one payment or installments.)
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–
Establish for resolution the FEE PETITION issue on the appropriate claims Development
Worksheet and set a follow-up date. Counting from the date of the FO action, set a
60-day follow-up in a case resolved by SSA or a 120-day diary for a case resolved
in Federal court proceedings.
-
•
If the IAR is equal to or greater than 75% of the past-due benefits, there are no
benefits due claimant at this time.
-
–
Input a U TAC to the SSR to continue withholding 100% of past-due benefits (U TAC
replaces UPV:V).
-
–
Input an A-OTP to pay the State the IAR amount. This also produces an automated notice
to the State.
-
–
Establish the FEE PETITION issue on the claims Development Worksheet for resolution
and set a follow-up date. Counting from the date of the FO action, set a 60-day follow-up
for a case resolved by SSA or a 120-day diary for a case resolved in Federal court
proceedings.
-
•
If past-due benefits minus IAR equals zero, there are no benefits for direct fee payment
and no past-due benefits due the claimant.
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–
Input an A-OTP to pay the State the IAR amount. This also produces an automated notice
to the State.
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–
Send a manual notice to the claimant and representative to advise that payment of
any fee SSA authorizes is between the claimant and the representative.
NOTE: In a concurrent claim, refer to the NOTE in GN 03930.030C.3.a.
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–
If the FEE PETITION issue follow-up date arrives before fee petition or authorization
is received, go to GN 03930.030C.6. When fee authorization is received, go to GN 03930.032.