Effective Dates: 01/23/2023 - Present Previous | Next

TN 15 (01-23)

GN 01701.305 Recomputations Involving Totalization and the Windfall Elimination Provision (WEP)

A. Introduction to recomputations involving Totalization benefits

If a number holder (NH) receiving a Totalization benefit continues working and later earns additional U.S. quarters of coverage (QC), they may become insured based on U.S. coverage alone. If so, we generally recompute the benefit and convert the NH to a non-Totalization benefit because the non-Totalized benefit is generally greater than the Totalization benefit.

However, if the NH also receives a pension based on non-covered employment, WEP may apply to the non-Totalized benefit, because the NH no longer receives a Totalization benefit. Therefore, in some situations the non-Totalization benefit with WEP would be less than the Totalization benefit when WEP does not apply.

NOTE: WEP does not apply when the NH receives a pension based only on non-work-related factors, such as residency and citizenship.

B. Policy on recomputations involving Totalization benefits

1. General policy on recomputations when the Totalization benefit is greater than the non-Totalization benefit subject to WEP

Continue to pay the Totalization benefit if the non-Totalization benefit with WEP is less than the Totalization benefit. However, do not use earnings and QCs in the year the NH meets insured status based on U.S. coverage alone or in subsequent years, to recompute the Totalization primary insurance amount (PIA). For information on how to process cases where insured status is acquired based on U.S. coverage only, see GN 01703.270

2. Effect on premium-free hospital insurance when the Totalization benefit is greater than the non-Totalization benefit subject to WEP

If the NH receiving a Totalization benefit would be entitled to premium-free hospital insurance (HI) by gaining insured status based on U.S. coverage alone but continues to receive a Totalization benefit because it is greater than the non-Totalization benefit, technically entitle the beneficiary to the non-Totalization benefit for entitlement to premium-free HI. For information on Hi in Totalization claims see GN 01701.140. Pay the Totalization benefit, so WEP does not apply.

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http://policy.ssa.gov/poms.nsf/lnx/0201701305
GN 01701.305 - Recomputations Involving Totalization and the Windfall Elimination Provision (WEP) - 01/23/2023
Batch run: 01/23/2023
Rev:01/23/2023