Effective Dates: 09/27/2024 - Present Previous | Next

TN 20 (09-24)

SI 02006.100 Excluding Title II Offset Cases from Underpayment Review

A. Introduction

1. SSI Underpayment (UP) Review

The FO generally must conduct a prepayment review of an SSI UP if the UP equals or exceeds a “review threshold” (currently, $15,000). The FO generally authorizes release of the prospective SSI benefits and the UP at the same time. See SI 02101.025. Note also installment payment (SI 02101.020) and dedicated account requirements (SI 02101.010) for large SSI underpayments.

2. Two-Input Process

However, the FO can decide to release prospective benefits and delay release of the UP. See SI 02101.025E.2. Some of these cases will be subject to title II offset because SSI benefits are due for one or more months in the Title II retroactive period. As a result of systems changes made to implement the 9W diary procedure, release of the prospective SSI benefits will trigger automated offset.

3. Exclusion from UP Review

By excluding certain title II offset cases from review, we speed up issuance of SSI retroactive benefits.

B. References

  • •

    Title II Offset Criteria, GN 02610.005

  • •

    Systems Offset Processing, SM 01320.005

C. Policy

1. Calculation of UP “At Risk”

The UP is only “at risk” to the extent that it exceeds the title II offset amount. We risk an OP by eliminating the review. The amount “at risk” is the UP minus the potential title II offset for the underpayment period.

  •  

      SSI UP

    - Offset amount in UP period

      Amount at risk

2. Exclusion Decision

Exclude a case from UP review if the amount “at risk” is less than the review threshold.

3. Relationship to Other Case Review Requirements

  1. a. 

    Exclusion of a case from UP review does not remove the UP period from subsequent review and correction by the FO. For example, the FO must review that period during the next redetermination under the rules and selection criteria in SI 02305.001.

  2. b. 

    There are two reasons for this:

    • •

      the FO may discover that the amount at risk is in fact an overpaid amount; or

    • •

      an additional UP may exist.

  3. c. 

    If any factor used to compute the UP and the title II offset amount are incorrect, see SI 02006.010 for computing the true OP or UP.

D. Examples

1. Case Excluded From Review - Amount At Risk = 0

a. Facts: SSI UP Computation

  • •

    UP period = February 2023- July 2024;

  • •

    UP for February - December 2023 = $914 per month;

  • •

    UP for January 2024 - July 2024 = $943

  • •

    Total UP = $16,655;

  • •

    FO decides to issue SSI benefits prospectively and withhold the UP pending completion of its review. SSI benefits for August 2024 are issued.

b. Facts: Offset

  • •

    Title II benefit starting January 2023: $950;

  • •

    Benefits due $950 title II income in February -December 2023, $979 January- July 2024;

  • •

    Retroactive title II benefits are not paid until the FO resolves the SSI UP.

  • •

    If we had paid the title II income due each month on time, they would have been due $0 SSI. The offset amount would be $914 from February 2023 - December 2023 and $943 from January 2024 - July 2024. .

c. Risk Computation

Underpayment Months

SSI underpayment per month

Potential offset per month

At Risk amount
February - December 2023:

$914.00

$914.00

$0

January-July 2024:

$943.00

$943.00

$0

Summary:

 
$16,655.00 SSI UP
- $16,655.00 Potential offset

$0

At Risk

d. Exclusion Decision

Amount at risk is less than review threshold. Case is excluded from UP review and the UP is released.

2. Case Excluded From Review - Amount At Risk is Less Than Review Threshold

a. Facts: SSI UP computation

  • •

    UP period = February 2023 -July 2024;

  • •

    UP for February - December 2023 - $914 per month;

  • •

    UP for January - July 2024 - $943 per month;

  • •

    Total UP = $16,655.00;

  • •

    FO decides to issue benefits prospectively and withhold the UP pending completion of its review. SSI benefits for August 2024 are issued.

b. Facts : Offset

  • •

    First title II benefit: $320 in January 2023;

  • •

    Due $320 title II income in February -December 2023;

  • •

    Due $340.00 title II income January 2024- July 2024;

  • •

    Retroactive title II benefits are not paid until the FO resolves the SSI UP;

  • •

    If we had paid the title II income due in February 2023 through July 2024 on time, they would have been due $614.00 per month for February through December and 634.00 from January 2024 on. The offset amount would be $300 per month for March on.

c. Risk Computation

SSI Underpayment Months

SSI underpayment amount per month

Potential offset amount per month

At Risk per month

February 2023- December 2023

$914.00

$300.00

$614.00
January 2024 - July 2024

$943.00

$320.00

$634.00

Summary

 
$16,655.00 SSI UP
- $5,540.00

Potential offset

$11,115.00

At risk

d. Exclusion Decision

Amount at risk is less than review threshold. Case is excluded from UP review and the UP is released.

E. Process - Interaction of Underpayment and Offset

1. Case Under Review

When a case is under review, and SSI benefits are issued prospectively while SSI benefits for prior months are withheld, the system posts UP's for prior months.

2. Title II Offset Computation

The system is able to perform the title II offset computation when there is an SSI UP as long as there is an SSI payment due for a month in the windfall period.

F. Procedure

 

1. Excluding a Case From Review

The FO compares the UP to the potential offset amount for the months in the UP period. If the amount at risk is below the review threshold, it ceases its review and releases the UP as appropriate given any installment or dedicated account requirements.

2. Documenting the Exclusion

Do the exclusion computation on an SSA-5002 (“Report of Contact”). If you can determine that there is no money at risk, or that the risk is low, without writing down a month-by-month computation, state why you are excluding the case from review on an SSA-5002. In either case, put the SSA-5002 in file.

To Link to this section - Use this URL:
http://policy.ssa.gov/poms.nsf/lnx/0502006100
SI 02006.100 - Excluding Title II Offset Cases from Underpayment Review - 09/27/2024
Batch run: 12/03/2024
Rev:09/27/2024