TN 20 (06-10)

GN 02610.050 Complex Offset Situations with Case Examples

This section provides instructions for computing windfall offset for certain complex windfall offset cases.

A. Types of windfall offset cases in this section

This section covers the following complex windfall offset cases:

Case Type

See …

Recomputing windfall offset when the Title II date of entitlement (DOE) or the Title II benefit amount changes due to an amended Title II award

 

GN 02610.050B

 

Recomputing windfall offset when the recipient dies and nobody is eligible to receive the Title XVI underpayment

 

GN 02610.050C

 

Determining the windfall offset end date (WOED) when the windfall offset period covers more than one period of Title XVI eligibility

 

GN 02610.050D

 

Processing cases when Title II retroactive benefits are released erroneously before applying offset

 

GN 02610.050E

 

Computing windfall offset with an authorized representative fee when the PMA is less than the windfall offset amount plus the fee amount

 

GN 02610.050F

 

Computing windfall offset when the Critical Payment System (CPS) has paid Title II benefits in the windfall offset period

GN 02610.050G

 

Determining Type A and W income amounts for windfall offset computations when CPS has paid Title II benefits in and outside the windfall offset period (detailed case example)

 

GN 02610.050H

 

B. Case type: recomputing windfall offset when the Title II date of entitlement (DOE) or the Title II benefit amount changes due to amended Title II award.

Due to an amended award which changes the Title II DOE or benefit amount, a recomputation of windfall offset may be needed.

Do not change the windfall offset end date (WOED) when recomputing windfall offset due to a Title II amended award. Any additional Title II benefits for months later than the original WOED are countable Title II income when received. Input this income as type A unearned income on the SSR in the month paid.

When providing offset information to each other, the processing center (PC) and field office (FO) must clearly communicate what the amounts represent; e.g., whether the offset is recomputed for the entire period or only for additional Title II benefits due. The e4345 is used to communicate and exchange information. For instructions on completing the e4345 see Field Office User's Guide and Program Center User's Guide .

Location of specific instructions and examples for cases with amended Title II awards:

  • For examples for recomputing the offset in these cases, see GN 02610.050B.1 through GN 02610.050B.2 in this section.

  • For an example of when a recomputation is not needed, see GN 02610.050B.3 in this section.

  • For instructions about applying administrative finality when a recomputation is required, see GN 02610.050B.4 in this section.

  • For processing center (PC) instructions after the FO has completed the recomputation, see GN 02610.036B.

  • For processing center (PC) instructions on completing the e4345, see e4345 PC User Guide.

  • For field office (FO) instructions on completing the e4345, see the e4345 FO User Guide.

  • If a recomputation causes an overpayment or underpayment, see SM 01320.400A and SI 02006.010

1. Title II DOE changes to a later date than the MBR DOE and the Title II benefit amount does not change or it decreases.

Adjust the windfall offset begin date (WOBD) if the month after the Title II amended DOE is later than the month of eligibility for Title XVI and recompute the offset. Do not adjust the WOBD if the Title II amended DOE is prior to the month of eligibility for Title XVI. The WOED does not change. Recompute the offset using the unchanged or lower Title II benefit amount by triggering an automated recomputation if possible.

EXAMPLE 1: DOE changes to later date and Title II benefit amount does not change within the offset period.

In this example the Title II DOE changes from 03/08 to 07/08. Adjust the offset period to 08/08- 11/08. Recompute the offset using the unchanged Title II benefit by triggering an automated recomputation if possible.

SSR shows:

WOBD: 4/08

WOED: 11/08

WIN: F

WPA: $1104.00

SSI payment data: 4/08 - 11/08: $637.00

SSI payment data: 12/08-12/08: $473.00

SSI payment data: 1/09 on: $504.00

NOTE: The acronyms “WOBD” and “WOED” do not appear on the SSR. They will be used throughout the examples in this section to identify the windfall offset begin dates and the windfall offset end dates that are on the SSR.

Social Security unearned income is posted as follows:

Type W: 04/08-09/08 $184.00

             10/08-11/08 $0.00



Type A: 10/08-12/08 $184.00

            01/09- $190.00

MBR Shows:

2008 Title II MBP: 4/08 - 12/08: $184.00

2009 Title II MBP: 1/09 on: $190.00

Amended Award received in 11/09 shows:

Title II DOE: 7/08

MBP remains unchanged

PC procedure for EXAMPLE 1:

  1. 1. 

    Using an e4345, the PC requests the FO complete an offset recomputation for the new period 8/08 through 11/08.

  2. 2. 

    Show $0.00 as the amount paid and $184.00 as the amount due for 07/08-08/08.

  3. 3. 

    Explain in remarks that the change is based on an amended award to a later month of entitlement. The breakdown represents the new total retroactive benefits subject to offset.

  4. 4. 

    When the PC receives the e4345 from the FO, compare the old and new offset amounts and follow instructions in GN 02610.036.

FO procedure for EXAMPLE 1:

  1. 1. 

    When the FO receives an e4345 from the PC, recompute the offset using 08/08, (the month after the month of the revised DOE) as the WOBD. The WOED (11/08) does not change.

  2. 2. 

    Complete the e4345 with the recomputation results and return the e4345 to the PC.

  3. 3. 

    Do not recompute the months from the DOE on the MBR to the revised DOE since those months are no longer within the offset period and do not affect SSI eligibility.

Based on the amended award the SSR will show:

WOBD: 08/08

WOED: 11/08

WPA: $368.00

Type W: 08/08-09/08 $184.00

             10/08-11/08 $0.00

 

Type A: 10/08- $184.00

             01/09- $190.00

NOTE: Type W amounts in the original offset period from the DOE on the MBR to the revised DOE are no longer included in the total Title II retroactive amount or the windfall period of the recomputed offset.

EXAMPLE 2: DOE changes to later date and Title II benefit amount decreases.

The amended award changes the Title II DOE from 03/08 to 07/08. The new offset period will be from 08/08 through 11/08:

SSR shows:

WOBD: 4/08

WOED: 11/08

WIN: F

WPA: $2400.00

Social Security unearned income is posted as follows:

Type W: 04/08-09/08 $400.00

             10/08-11/08 $0.00

Type A: 10/08-12/08 $400.00

MBR shows:

2008 Title II MBP: $400.00

Amended award shows:

Title II DOE: 07/08

MBP: $370.00

PC procedure for EXAMPLE 2:

  1. 1. 

    Request a recomputation from the FO of the revised offset period using an e4345. Provide a breakdown showing new MBP beginning with new DOE.

  2. 2. 

    When the FO returns the e4345 with the new figures, the PC compares the old and new offset amounts and follows instructions in GN 02610.036.

FO procedure for EXAMPLE 2:

  1. 1. 

    Recompute the revised offset period of 8/08 - 11/08 using the MBP of $370.00.

  2. 2. 

    The FO sends the results to the PC using the e4345.

Based on amended award the SSR will show:

WOBD: 08/08

WOED: 11/08

WPA: $740.00

Revised Social Security unearned income is postedby CR as follows:

Do not overlay the current type A income with the revised type A income.

Type W: 08/08-09/08 $370.00

               10/08-11/08 $0.00

Type A: 10/08-12/08 $400.00

              01/09- 02/09 $420.00

              03/09-on $380.00

CMA paid in 04/09 for 03/09- The correct Title II benefit amount is posted since the Title II system processed the action in time to reduce the 03/09 benefit.

NOTE: Type W amounts in the original WP from the DOE on the MBR to the revised DOE are no longer included in the total Title II retroactive amount or the windfall period of the recomputed offset.

2. Title II DOE changes to an earlier month than the MBR DOE and Title II benefit amount increases, decreases, or stays the same

EXAMPLE 1: Title II DOE changes to an earlier month and the Title II benefit amount increases

In this example the Title II DOE changes from 11/03 to 12/02. Adjust the offset period and recompute the offset using the earlier WOBD (01/03) and the increased Title II benefit amount. The WOBD is the month after the revised earlier DOE or the month of Title XVI eligibility, whichever is later. The WOED does not change.

SSR shows:

Current Title II offset information for the completed windfall offset period

Title XVI DOE 05/1999

WOBD: 12/03

WOED: 01/05

WPA: $2390.00

Social Security unearned income posted as follows:

Type W: 12/03 $190.00

              01/04-11/04 $200.00

              12/04-01/05 $0.00

Type A: 12/04- $200.00

              01/05-on $210.00

MBR shows:

2003 Title II MBP: $190.00

2004 Title II MBP: $200.00

2005 Title II MBP: $210.00

CMA paid in 12/04 for 11/04: $200.00

Amended award shows:

DOE: 12/02

2003 Title II MBP: $200.00

2004 Title II MBP: $210.00

2005 Title II MBP: $220.00

CMA paid in 12/04 for 11/04: $200.00

PC procedure for EXAMPLE 1:

  1. 1. 

    Request a recomputation from the FO of the revised offset period (01/03 – 01/05) using an e4345. Provide a breakdown showing new MBP beginning with new DOE through 10/04. Enter the CMA paid amount as the original 11/04 paid in 12/04.

  2. 2. 

    In remarks provide amount of increases withheld for months after the CMA paid month. The FO may need this information to ensure there are sufficient retroactive benefits to cover the revised offset.

  3. 3. 

    When the FO returns the e4345 with the new figures, compare the old and new offset amounts following the instructions in GN 02610.036 and determine the net underpayment due, including the increases due for the CMA paid month and later.

FO procedure for EXAMPLE 1:

  1. 1. 

    The FO adjusts the offset period to 01/03 – 01/05 using the revised MBP for 2003 and 2004.

  2. 2. 

    The FO sends the results to the PC using the e4345.

Base on the amended award the SSR will show:

CMA paid in 06/05 for 5/05: $220.00

Revised WOBD: 01/03

Unchanged WOED: 01/05

WPA: $4710.00

Total retroactive Title II benefits used to recompute the offset: $4710.00

$200.00 x 12 months (01/03 through 12/03) = $2400.00

$210.00 x 11 months (01/04 through 11/04) = $2310.00

Social Security unearned income posted as follows:

Type W: 01/03-12/03 $200.00

             01/04-11/04 $210.00

              12/04-01/05 $0.00

 

Type A: 12/04-12/04 $200.00

              01/05-05/05 $210.00

              06/05- on $220.00

Increased Title II CMA amount paid in 06/05 for 05/05: $220.00

Title II increase payable from 12/04-05/05 is counted as Type A income

when received. The increase from 12/04-05/05 is $10.00 for each month. Type A income counted when received is $60.00 ($10 x 6 months)

EXAMPLE 2: DOE changes to an earlier month and the Title II benefit amount decreases.

Adjust the offset period and recompute the offset using the earlier WOBD and the reduced Title II benefit amounts. The WOBD is the month after the revised Title II DOE, or the month of eligibility for Title XVI, whichever is later. The WOED does not change.

SSR shows:

Current Title II offset information for the completed offset period:

WOBD: 6/08

WOED: 11/08

WIN: F

WPA: $1600.00

Title XVI DOE: 04/08

Social Security unearned income is posted as follows:

Type W: 06/08-09/08 $400.00

              10/08-11/08 $0.00

Type A: 10/08-12/08 $400.00

             01/09-on $420.00

MBR shows:

Title II DOE: 05/08

2008 MBP: $400.00

2009 MBP: $420.00 (amount paid prior to amended award)

Amended award shows:

Title II DOE: 3/08

2008 MBP: $380.00

2009 MBP: $400.00

PC procedure for EXAMPLE 2:

  1. 1. 

    Request a computation of the revised offset period (04/08-11/08) using an e4345. Provide a breakdown showing the new MBP beginning with the new DOE through 08/08. Enter the CMA paid amount as the original 09/08 CMA paid in 10/08.

  2. 2. 

    In remarks explain that a revised computation is needed due to an amended award with decreases in benefit amount. The breakdown represents the revised amounts subject to offset.

  3. 3. 

    When the FO returns the e4345 with the new figures, compare the old and new offset amounts as instructed in GN 02610.036.

  4. 4. 

    The PC must determine the net amount due or overpaid and take into account the total decreases for the CMA paid month and later.

FO procedure for EXAMPLE 2:

Adjust the offset period and recompute the offset using the reduced Title II amount ($380.00) and the Title II DOE (3/08). Return the e4345 to the PC with the required results.

Based on the amended award the SSR will show:

CMA paid in 03/09 for 02/09: $410.00

WOBD - 4/08

WOED - 11/08

2008 MBP: $380.00

2009 MBP: $400.00

WPA: $2280.00

Total retroactive Title II benefits used to recompute the offset: $2280.00

NOTE: Based on the amended award the MBR will show Title II overpayment for 10/08- 01/09.

Type W: 04/08-09/08 $380.00

               10/08-11/08 $0

Type A: 10/08-12/08 $400.00

                01/09- $410.00

EXAMPLE 3: Title II DOE changes to an earlier month, but the Title II benefit amount stays the same.

Adjust the offset period using the earlier WOBD and unchanged Title II benefit amount. The offset period begins with the month after the revised earlier Title II DOE or the month of Title XVI eligibility whichever is later. The windfall end date does not change.

SSR shows:

Title XVI DOE 02/08

WOBD: 5/08

WOED: 11/08

WPA: $2000.00

Social Security unearned income is posted as follows:

Type W: 05/08-09/08 $400.00

              10/08-11/08 $0.00

Type A: 10/08-12/08 $400.00

              01/09-on $420.00

MBR shows:

Title II DOE: 4/08

2008 MBP: $400.00

2009 MBP: $420.00

Amended award shows:

DOE: 2/08

MBP: $400.00

PC procedure EXAMPLE 3:

  1. 1. 

    Request a recomputation of the revised offset period 03/08-11/08 using an e4345. Provide breakdown beginning with new DOE through 08/08.

  2. 2. 

    In remarks, inform the FO that a recomputation is needed based on amended award with earlier MOE and no change to original Title II monthly benefits amount.

FO procedure: Recompute offset and return the e4345 to the PC with the necessary information.

Based on amended award the SSR will show:

WOBD -- 3/08

WOED -- 11/08

2008 MBP-- $400.00

2009 MBP-- $420.00

WPA: $2800.00

Total retroactive Title II benefits used to recompute the offset: $2800.00.

($400.00x 7 months (03/08-09/08) = $2800.00

Type W: 03/08-09/08 $400.00

              10/08-11/08 $0

Type A: 10/08-12/08 $400.00

              01/09- on $420.00

3. The Title II DOE does not change and Title II benefit increases or decreases.

As explained in GN 02610.036, if the DOE does not change and the Title II benefit increases, do not recompute the offset period.

When the DOE does not change and the Title II benefit decreases, recompute the windfall offset using the decreased Title II benefit.

EXAMPLE 1: Title II DOE does not change and Title II benefit increases

In this example, the FO does not recompute the offset and takes no action in this situation. The PC will process the case using the increased Title II benefit. The PC will not send an e4345 to the FO.

SSR shows:

WOBD: 7/08

WOED: 11/08

WIN: F

MBR Shows:

2008 Title II MBP: $400.00

Amended Award shows:

Title II MBP effective 06/08: $410.00

PC procedure EXAMPLE 1:

  1. 1. 

    No recomputation is needed by the PC.

  2. 2. 

    The PC will process the Title II benefit increase.

  3. 3. 

    The PC does not send an e4345 to the FO.

FO procedure EXAMPLE 1:

  1. 1. 

    The FO does not recompute the months in the offset period -7/08 through 11/08.

  2. 2. 

    If the PC requests a recomputation, the FO should return the request.

  3. 3. 

    The FO will explain that no computation is required as described in GN 02610.036.

EXAMPLE 2: Title II DOE does not change and Title II benefit decreases.

In this example, the FO recomputes the offset using the decreased Title II benefit amount.

SSR shows:

WOBD: 7/08

WOED: 11/08

WIN: F

WPA: $1230.00

Social Security unearned income is posted as follows:

Type W: 07/08-09/08 $410.00

                0/08-11/08 $0.00

Type A: 10/08-12/08 $410.00

                 01/09- on $420.00

MBR shows:

2008 Title II MBP: $410.00

2009 Title II MBP: $ 420.00

Amended award shows:

2008 Title II MBP: $400.00

2009 Title II MBP: $410.00

PC procedure for EXAMPLE 2:

  1. 1. 

    Request a recomputation of the offset by providing the revised breakdown for the offset period 07/08-11/08.

  2. 2. 

    Provide a breakdown showing $0.00 paid and the new lower benefit due for the DOE through 08/08.

  3. 3. 

    In remarks explain that a revised offset computation is needed due to amended award with decrease in rates.

  4. 4. 

    The PC should determine the net overpayment after the FO returns the revised computation.

FO procedure for EXAMPLE 2: Recompute the months in the offset period and send the results using an e4345.

Based on the amended award the SSR will show:

WOBD: 07/08

WOED: 11/08

WPA: $1200.00

Total retroactive Title II used to recompute the offset: $1200.00 ($400.00x 3 months (07/08-09/08) = $1200.00.

Revised Social Security unearned income:

Do not overlay the current type A income with the revised type A income

Type W: 07/08-09/08 - $400.00

              10/08-11/08 - $0.00

Type A: 10/08-12/08 - $410.00 (amount paid before amended award received)

             01/09-02/09 - $420.00

03/09 on- $410.00-correct CMA paid and posted on the SSR because Title II system processed the action in time to reduce the CMA.

4. Applying administrative finality rules in windfall offset recomputations involving DOE changes

When evidence for a windfall offset case with an amended award shows that the FO/PC made a previous determination of Title II entitlement and Title XVI eligibility, see GN 02610.058 to decide which administrative finality rules will apply.

An application for Title XVI is an application for Title II benefits. If SSA did not make an initial determination of entitlement or close out the Title II application at the same time an individual filed for Title XVI, the rules of administrative finality do not apply. The program center reopens the claim and prepares an amended award with an earlier DOE and any necessary changes in Title II monthly benefit rates. The FO will recompute the offset from the revised DOE. The WOED does not change and any Title II received outside the windfall offset period is income in the month received.

C. Case type: Recomputing windfall offset when the recipient dies and nobody is eligible to receive the Title XVI underpayment.

1. Determine the offset period when recipient dies

The offset period ends with the month of death unless the offset end date is earlier than the month of death. Apply offset only in those months that SSI payments were paid to the recipient or other authorized recipient, or to a state as an Interim Assistance Reimbursement (IAR), or to recover an overpayment, or to pay an authorized representative fee. SSA considers that the recipient was paid SSI money in these situations.

2. Recomputation of offset in situations with or without installment payments

Consider all SSI money issued as part of an installment payment before the recipient death as subject to offset if shown as paid on the SSR. Any SSI money still held as an underpayment based on installment rules is considered not paid to the recipient and is therefore not subject to offset.

Determine which months should not have been subject to windfall offset. See POMS GN 02610.022 and SM 01320.060 to determine the offset period. Adjust the offset using zeros for months before the DOD that should not be offset. Determine the amount of offset that should not have been deducted from the Title II PMA. Adjust the payments in the offset period so the correct amount of Title II benefits can now be paid on the Title II record.

In a situation where the offset amount on the SSR that was deducted from the PMA is larger than the recomputed offset, record the recomputed offset figures in the remarks section of the SSR rather than in the offset fields on the SSR. Do not post the figures in the offset field on the SSR.

Send an e4345 to the program center (PC) explaining why you recomputed and changed the offset period and what the results were. Explain that the excess amount of money deducted from the Title II PMA, is now due as a Title II underpayment.

3. Examples of recomputing windfall offset cases when the recipient dies

EXAMPLE 1: offset end date is later than date of death and IAR paid to a state.

Prior to learning of death, SSR and MBR show:

SSI DOE: 2/08 (E02 month)

Title II DOE: 2/08 (1st payment is made in 3/08 for 2/08)

WOBD: 3/08

WOED: 12/08

Regular monthly SSI payment amount: $443.00

Regular monthly Title II benefit amount: $214.00

Last month included in Title II PMA: 09/08

Title II CMA paid in 11/08 (for 10/08)

First regular monthly SSI payment paid in 11/08

Offset information:

Offset amount withheld from PMA: $1552.00 ($194.00 x 8 = $1552.00)

Amount of retroactive SSI after offset: $3544.00

IAR information used to determine amount paid to the state

IAR period: 3/08 through 10/08

State monthly interim assistance payment: $100.00

Amount of total interim assistance paid to recipient and amount of IAR due state: $800.00

Retroactive SSI information after IAR paid to state:

Amount of SSI retroactive payment remaining after IAR amount paid to state: $2744.00

Installment payment for 03/08 through part of 07/08 made in 11/08

First installment payment is $1911.00 ($637.00 x 3 = $1911.00) for 03/08 through part of 07/08

DOD: 11/19/08 (SSA learned of death on 12/20/08)—Revisions due to death:

Revised windfall offset period

WOBD: 03/08

WOED: 11/08 (due to death in 11/08)

Because recipient died in 11/08, the installment payment and first SSI monthly payment were returned.

 

The office (PC or FO) that first learns of the date of death, will prepare an e4345 with the date of death.

If the PC first learns of the date of death, the PC will send the e4345 to the FO asking for a recomputation of the offset.

 

If the FO first learns of the date of death, the FO will recompute the offset, and return the e4345 to the PC with the recomputation results.

Offset computation currently on the SSR

Type W: 03/08-10/08 $214.00

Type A: 11/08-on $214.00

Offset amount equals $194.00 for each month from 03/08-10/08.

Offset amount withheld from PMA: $1552.00 ($194.00 x 8 months =$1552.00)

  1. 1. 

    FO procedure for EXAMPLE 1 Recompute the offset using the WOED equal to the DOD

  2. 2. 

    Use the $100.00 IAR amount as the offset amount for 03/08-10/08

  3. 3. 

    Adjust the offset amounts to:

    03/08-10/08: $100.00

    11/08- $0.00

    Adjusted total offset amount: $800.00 ($100.00 x 8 months = $800.00)

  4. 4. 

    Post recomputed offset amounts in the remarks section than the SSR.

  5. 5. 

    Determine the amount of SSI money to be returned to Title II account based on the DOD and the amount of SSI money actually paid for 03/08-10/08.

    $1552.00- original total offset amount

    $800.00- adjusted total offset amount

    $752.00 amount returned to Title II account

EXAMPLE 2: Offset end date is earlier than date of death, one installment payment paid and no party eligible to receive the remaining underpayment

SSR shows:

Current Title II offset information for completed offset

SSI DOE: 10/07 (E02 month)

WOBD: 3/08

WOED: 04/09

First Title XVI installment paid 11/07 - 01/08

DOD: 05/09

Title XVI underpayment never released: 3/08 - 09/08

MBR shows:

Current Title II offset information for completed offset

Title II DOE: 02/08 (first payment due in 03/08 for 02/08)

Months no longer subject to offset: 03/08-09/08

PC procedure for EXAMPLE 2:

  1. 1. 

    When the PC receives the e4345 from the FO, the PC will adjust the trust funds according to the instructions on the e4345.

  2. 2. 

    The PC will add the offset amount withheld from the Title II PMA to any retroactive Title II benefits on this account.

FO procedure for EXAMPLE 2:

  1. 1. 

    Determine the offset amount withheld from Title II PMA for 03/08-09/08 since these months are no longer subject to offset.

  2. 2. 

    Prepare an e4345 to the PC explaining the payments for 03/08-09/08 are no longer subject to offset because these payments were never issued.

  3. 3. 

    Include on the e4345 the offset amount withheld from Title II PMA.

  4. 4. 

    Instruct the PC to transfer the amount from the general trust fund to the Title II trust fund and include the offset amount withheld from the PMA in any retroactive Title II benefits on this account.

D. Case type: Determining the windfall offset end date when the windfall offset covers more than one period of Title XVI eligibility

1. Determining if there is more than one windfall offset period

If the Title II entitlement period covers more than one Title XVI eligibility period, treat the periods as separate windfall offset periods. The Title XVI periods of eligibility must be based on separate applications and awards. When completed, the total windfall offset results are reported to the PC on e4345 by adding the results of the two separate windfall offset periods together.

2. Counting Title II income when there is more than one windfall offset period

Deduct the separate windfall offset amounts from the retroactive Title II benefits due the beneficiary. The PMA amount is equal to the total retroactive Title II benefits. Benefits received for months outside the offset period and included in the PMA amount are type A unearned income counted in the month of receipt. Any Title II money used in either of the offset periods that is payable to the recipient is non-countable income for income purposes.

See GN 02610.005 C.12 for the definition of non-countable income.

3. Effect of termination event on windfall offset end date

When one of the periods of eligibility is terminated (payment status code N07, N08, N19, or T01), the offset end date is the month before the month of termination if no appeal is filed timely. See SI 02301.201 B. for explanations of terminations and suspensions. Do not use the thirteenth month as the end date.

4. Effect of ineligibility event on windfall offset end date

When Title II offset applies to a period of SSI suspension that is 12 consecutive months, the windfall offset end date is the 13th month after the suspension date.

See SI 02301.201B to identify a situation where the recipient stays in suspense for 24 consecutive months (military-related recipients). When Title II offset applies to a period of SSI suspension that is 24 consecutive), the windfall offset end date is the 25th month after the suspension date.

EXAMPLE: Effect of ineligibility event on the offset period

SSR shows:

SSI eligibility from 3/07 to 6/07

Ineligible (N01) beginning 7/07 (terminated in 7/08)

No windfall offset data

New SSR shows:

SSI DOE: 10/08 (E02 month)

Eligibility begins 10/08 and continues

Title II award received that shows:

DOE: 2/07

First month T2 retro due: 03/07 (02/07 due to be paid in 03/07)

Offset information:

First Title XVI eligibility period

WOBD: 3/07

WOED: 7/08

Second eligibility period

WOBD: 10/08

WOED: 01/09

CMA is posted as type A in 12/08.

02/09: first month that Title II income is shown as type A income

E. Case type: Processing cases when Title II retroactive benefits are released erroneously before applying windfall offset

1. If no retroactive Title XVI money has been released

When Title II retroactive benefits are released erroneously before the windfall offset amount is computed, apply Title XVI windfall offset by posting type G income to the SSR. Follow instructions in SI 02006.205B.1 for processing Title XVI offset cases and SM 01320.040 for inputting type G income.

2. If some retroactive Title XVI money has been released

When Title II retroactive benefits are released erroneously before the windfall offset amount is computed for all months of the windfall period and some retroactive Title XVI money was paid for some months in the offset period, apply Title II offset and post type W income in those months. Apply Title XVI offset for the months by posting type G income where the retroactive Title XVI money has not been paid.

3. If some retroactive Title XVI money has been released and remaining retroactive Title XVI money was withheld under the installment payment policy

When Title II retroactive benefits are released erroneously before the windfall offset amount is computed for all months in the windfall period, and the remaining retroactive Title XVI money is still withheld under the installment policy, apply Title XVI offset by posting type G income for the months where the retroactive Title XVI money has not been paid.

For the months the Title II money was released without offset that coincide with the months in the Title XVI installment payment already made to the recipient, Title II offset should be applied, and type W posted.. For example, when the SSI money included in an installment payment is for 03/08 through 07/08, the Title II money for 03/08 through 07/08 is subject to Title II offset. In this situation, the windfall offset period will include some months with Title II offset posted as type W income and some months with Title XVI windfall offset posted as type G income.

NOTE: Follow instructions in GN 02610.018C for the period when both Title II and Title XVI payments have been released. Follow instructions in SI 02006.205B.1 for the period where Title XVI offset will be applied.

F. Case type: Computing windfall offset with an authorized representative fee when the PMA is less than the windfall offset amount plus the fee amount

When the Title II PMA is less than the offset amount plus the attorney fee, there is an excess offset amount. If the PMA includes money outside the offset computation only use the Title II retroactive money in the windfall period.

We determine the excess offset amount by subtracting the Title II fee amount from the PMA to determine the maximum amount of Title II retro that can be offset. The maximum amount is subtracted from the total offset amount. The difference is the excess offset amount.

The excess amount is posted on the SSR in the excess offset field (WFX). If the offset period is recomputed for a reason other than offset, the excess amount can be recovered under Title XVI rules.

EXAMPLE: PMA amount is less than windfall offset amount plus fee amount

The combined attorney fee amount is $4,000.00.

The Title II fee amount is $3500.00 and the Title XVI fee amount is $500.00.

The offset amount is $6,000.00.

The PMA amount is $9,000.00.

The offset amount and the Title II attorney fee amount total is $9,500.00.

The excess offset amount is determined as follows:

$9,000.00 (PMA)

Minus $3,500.00 (Title II attorney fee)

Equals $5,500.00

 

$6,000.00 (offset amount)

Minus $5,500.00 (result of PMA less Title II attorney fee amount)

Equals $ 500.00 (excess offset amount)

G. Case type: Computing windfall offset when the Critical Payment System (CPS) has paid Title II benefits in the windfall offset period.

1. CPS payments paid in Title II/Title XVI windfall offset period do not affect windfall offset period.

Payments made through CPS do not affect the definition of a windfall period. CPS payments are shown on the SSR as type A unearned income. The offset period:

  • begins the later of the month of eligibility to SSI or the month after the month of entitlement to Title II; and

  • ends 2 months after the month the last Title II benefit included in the prior month accrual (PMA) payment would have been paid.

For more information about the windfall offset period, see GN 02610.022.

For more information about CPS payments, see SM 00635.001.

2. Income treatment of CPS payments

CPS payments are shown on the SSR as type A unearned income. When the FO issues CPS payments while windfall offset is pending, adjustments may be required to the:

  • total RSDI withheld (WPA);

  • type A income on the SSR; or

  • type W amounts used in the windfall offset computation.

3. When to process offset cases involving CPS payments

Process Title II or Title XVI offset cases when:

  • Title II payments have been established through regular current monthly accrual (CMA) payments; or

  • the appropriate suspense or termination code is input to the MBR; or

  • the FO is no longer paying CPS payments.

4. CPS payment equals the Title II monthly benefit payment (MBP) in a month in the windfall period

When a CPS payment equals the MBP, post the CPS payment as type A unearned income in the month received and post type W unearned income equal to zero for the same month. Subtract the CPS amount from the total retroactive Title II benefits in the windfall offset (WPA).

5. CPS payment is less than the monthly benefit payment (MBP) in a month in the windfall period

When a CPS payment is less than the correct Title II MBP, post the CPS payment as type A unearned income in the month received and post the additional monthly amount due as type W unearned income for the same month. Subtract the CPS amount from the total retroactive title II benefits withheld for windfall offset (WPA).

6. CPS payment larger than the monthly benefit payment for a month in the windfall period

When a CPS payment is larger than the MBP, post the CPS payment as type A unearned income in the amount of the MBP in the month received.

When the PC sends the CPS information on the e4345, the FO will:

  • post the amount of the type A unearned income equal to the MBP in the UMIH field on the SSR;

  • post the type W amount as $0 for the same month; and

  • subtract the CPS amount from the total retroactive title II benefits withheld for windfall offset (WPA).

The PC does not determine an underpayment or an overpayment until the FO completes the windfall offset computation.

7. CPS payment is issued in a month outside of the windfall period while windfall offset computation is pending

When a CPS payment is issued in a month outside the windfall period and the windfall offset computation is still pending, the PC does not determine an underpayment or an overpayment until the FO completes the windfall offset computation. The type A unearned income on the SSR should reflect only the MBP for that month. The type A unearned income posted may require an adjustment if the MBR interface has included the CPS payment in the type A unearned amount. Make no adjustment to the WPA for CPS payments issued in months outside of the windfall period.

H. EXAMPLE: Determining Type A and W income amounts for windfall offset computations when CPS has paid Title II benefits in the windfall offset period

This detailed example shows data from the MBR and SSR and completed e4345 screens with PC information used for the computation of windfall offset when the individual has received multiple CPS payments that are less than the monthly benefit payment (MBP) and greater than the MBP.

Case facts:

The PC sends the e4345 to the FO with the following information:

CMA amount: $1189.40 paid in 05/08 for 04/08

Retroactive Title II benefits withheld: $20,964.40 windfall total amount (WTA)

The monthly breakdown does not include the CPS payments paid. These amounts are included in the remarks field on the e4345.

Monthly breakdown of retroactive RSDI withheld:

Paid

 

MBR Month Due

 

Due

 

Net Due

 

Subtotal

 

SSI Month Received

 

 

$0.00

 

10/06 – 11/06

 

$1126.00

 

$1126.00

 

$2252.00

 

11/06 – 12/06

 

 

$0.00

 

12/06 – 11/07

 

$1163.00

 

$1163.00

 

$13,956.00

 

01/07 – 12/07

 

 

$0.00

 

12/07 – 02/08

 

$1189.00

 

$1189.00

 

$3567.00

 

01/08 – 3/08

 

 

$0.00

 

03/08 – 03/08

 

$1189.40

 

$1189.40

 

$1189.40

 

04/08 – 04/08

 

 

PC Contact/Remarks Section (e4345):

CPS Payments Paid

03/26/08: $ 999.00

05/15/08: $ 999.00

10/14/08: $2,000.00

The following breakdown of unearned income shows how the PC figures are reflected on the SSR. The FO will adjust these amounts to complete the windfall offset computation. After completing the offset computation, the FO will complete Section II of the e4345 and return the e4345 to the PC.

SSR UMIH field includes CPS payments

UMIH

T

 

UMP

 

UMS

 

UMA

 

F

 

UMI

 

PV

 

 

A

 

0308

 

0308

 

999.00

 

N

 

999999999A

 

71

 

 

A

 

0408

 

0408

 

.00

 

N

 

999999999A

 

71

 

 

A

 

0508

 

0508

 

2188.40

 

N

 

999999999A

 

71

 

 

A

 

0608

 

0608

 

1189.40

 

N

 

999999999A

 

71

 

 

A

 

0708

 

0908

 

1189.40

 

T

 

999999999A

 

71

 

 

A

 

1008

 

1008

 

3189.00

 

T

 

999999999A

 

74

 

 

A

 

1108

 

1208

 

1189.00

 

T

 

999999999A

 

71

 

 

A

 

0109

 

0000

 

1258.00

 

C

 

999999999A

 

72

 

 

 

FO adjustments to Type A Payment in UMIH field and of Type W unearned income for the same months:

03/08: CPS payment = $999.00 which is less than the MBP

03/08: Type A unearned income = $999.00

03/08: Type W unearned income = $190.00 (the difference between

the MBP of $1189.00 and the CPS payment of $999.00)

04/08: Type A unearned income = $0.00

04/08: Type W unearned income = $1189.40

05/08: MBP of $1189.40 and a CPS payment of $999.00

05/08: Subtract CPS payment ($999.99) from total Title II paid in 5/08

($2188.40) = $1189.40

The PC will not determine an underpayment or an overpayment on the record until the FO completes the windfall offset computation.

The FO adjusts the PC information and inputs the result to the SSR

WOBD: 11/06

WOED:: 06/08

05/08: Type A unearned income = $1189.40

05/08: Type W unearned income = $0.00

06/08: Type A unearned income = $1189.40

06/08: Type W unearned income = $0.00

07/08 - 09/08: Type A unearned income = $1189.40

10/08: MBP of $1189.00 plus a CPS payment of $2000.00

10/08: Subtract CPS payment ($2000.00) from total Title II paid in

10/08 ($3189.00) = $1189.00 – 10/08: Type A unearned income = $1189.00 11/08 - 12/08: Type A unearned income = $1189.00

01/09 continuing: Type A unearned income = $1258.00

The PC will not determine an underpayment or an overpayment on the record until the FO completes the windfall offset computation.

The FO uses these adjusted type W unearned income amounts, including 11/06 through 02/08, for the windfall offset computation.

Adjusted type W unearned income amounts including 11/06 through 02/08:

11/06 - 12/06: $1126.00

01/07 - 12/07: $1163.00

01/08 - 02/08: $1189.00

03/08 - 03/08: $190.00

In 03/08, the $190.00 is the difference between the MBP of $1189.00 and the CPS payment of $999.00.

04/08 - 04/08: $1189.40

05/08 - 06/08: $ 0.00


To Link to this section - Use this URL:
http://policy.ssa.gov/poms.nsf/lnx/0202610050
GN 02610.050 - Complex Offset Situations with Case Examples - 03/14/2013
Batch run: 05/14/2013
Rev:03/14/2013