Effective Dates: 04/21/2026 - Present Previous | Next

TN 9 (04-26)

PDB) Offset

Citations: Social Security Act Section 224(a), 20 C.F.R. Section 404.408.

The Processing Center (PC) encounters cases involving WC/PDB offset in a variety of ways, including:

•

awards with WC/PDB involvement at the Disability Adjudication -Hearings Administrative Law Judge (ALJ) level or higher;
•

certain initial disability insurance benefit (DIB) claims and other subsequent claims;
•

correspondence received from beneficiaries that require obtaining missing proof or verification of alleged WC/PDB events;
•

exceptions and alerts resulting from Modernized Claims System (MCS) and Interactive Computations Facility (ICF) inputs;
•

WC/PDB Regular Transcript Attainment and Selection Pass (RETAP) alerts;
•

Triennial Redetermination alerts; and
•

post-entitlement (PE) adjustments, redeterminations, and lump sum (LS) settlements not completed in the field office (FO).

Technicians should exercise caution when attorneys, non-attorney representatives, or claimants seek assistance in preparing a WC settlement and asks what effect, if any, such a settlement would have on the number holder’s (NH) benefits. If an attorney or non-attorney representative asks for specific advice regarding proration terms used to avoid possible offset, see the note to exercise caution in DI 52140.001G.

A. PC responsibilities for WC/PDB offset

The PC is responsible for:

•

identifying any potential WC/PDB offset situations as outlined in DI 52140.001B;
•

considering the Retirement Insurance Benefit (RIB) option as required in DI 52150.030;
•

documenting all allegations and obtaining all WC/PDB rates, dates, LS settlements, and any subsequent changes as outlined in DI 52145.001 and DI 52145.015;
•

developing for proof of any alleged WC/PDB events as outlined in DI 52145.001;
•

using the most expeditious means available to obtain proof concurrently, such as direct contact with the NH, attorney, or other appropriate sources and utilizing online sources. For instructions regarding the requirement to obtain updated proofs prior to adjudication in appeals-level allowance cases see DI 52140.010B.1 in this section.
•

securing an SSA-795 (Statement of Claimant or Other Person) repayment statement when necessary as outlined in DI 52140.010B.1.a;
•

imposing, adjusting, or terminating offset data for WC/PDB events through MCS and ICF as outlined in DI 52165.001;
•

prorating LS settlements and adjudicating through MCS and ICF as outlined in DI 52150.060;
•

annotating the special message field of the Master Beneficiary Record (MBR) regarding attempts to obtain proof or the inability to obtain proof;
•

annotating ICF screens WC/PDB Offset - Enclosure Notice Block - Primary (WCEP) with specific WC/PDB paragraphs and notices as outlined in DI 52155.035. It is the Claims Specialist’s (CS's) responsibility to provide WC paragraphs. The paragraphs must adequately explain the reason for the change in benefit amounts. For Workers' Compensation (WCP) paragraphs, see NL 00720.395. When necessary, provide a due process notice per instructions mentioned in Notices Required Before and After Taking a Title II Adverse Action in GN 03001.015;
•

preparing any necessary diaries, controls, and listing codes to help explain actions taken to expedite future processing as outlined in DI 52155.005;
•

retaining all WC/PDB proof for permanent retention by faxing or scanning the proof into the Paperless folder (selecting long retention) and retaining a copy of the source document in the official disability file (EF), eView, or the Evidence Portal (EP). For retention of WC/PDB Proofs, see DI 52145.015; and
•

ensuring that a certified electronic folder (CEF) is established and always faxing documents into the CEF, if applicable. For paper folders, retain the proof in the paper folder (if it is available), and fax any new documentation into the EP as outlined in DI 52145.015.

NOTE: Technicians must permanently retain WC/PDB proof. This allows for the review of the original document to verify whether the interpretation and input of the WC/PDB proof was correct.

B. Developing for proof of WC/PDB concurrently and establishing diaries for DIB awards processed in the Processing Center (PC)

Most claims initially adjudicated in the PCs by the CS are favorable decisions made at the Disability Adjudication ALJ hearing level or higher. The PC occasionally processes initial or reconsideration claims that the CS adjudicates.

1. Developing for proof prior to adjudicating the award

When processing an award at the appeals, ALJ, Appeals Council (AC), and Federal Court level, check for current WC/PDB payment information. Review the claim folder (paper or electronic), the MCS screens, and the EP to determine if a request for proof was already done or to check that proof may already be in the file. Proof should be current. We consider WC/PDB evidence of periodic payments as current at the pre-adjudicate state if the proof is no more than one year old. To count this period, review the date posted on the WC/PDB evidence in the file as a starting point. Therefore, if the proof in the file is more than one year old, you must obtain current proof.

EXCEPTIONS: Technicians must re-verify the WC/PDB proof in the file at the time of adjudication regardless of the date of the WC/PDB proof in the following three situations:

•

State or Federal WC is readily available online;
•

Payment involves a known yearly WC/PDB cost of living adjustment (COLA) which would be paid at a date between the date last proven and date of adjudication; or
•

Appeal or claim was pending at last verification and expected date of decision has passed.

IMPORTANT NOTE: To expedite case processing, technicians should utilize concurrent development efforts by contacting both the beneficiary or their representative, the WC payer, insurance carrier, or WC attorney to obtain WC/PDB proof. Technicians should contact the NH first for WC/PDB verification per DI 52145.001. If proof is readily available online, it should be requested. There is no need to wait until you have exhausted one source of WC/PDB information before contacting another after attempting to contact the NH. This means calling the NH directly, calling their attorney, calling the WC attorney, and calling the WC carrier. You may need to get permission from the beneficiary to receive any information from another appropriate source. When contacting a beneficiary, advise them which other source you will be contacting for WC/PDB proof and obtain permission when applicable when the NH cannot or will not provide proof. Always verify the WC/PDB amount prior to adjudication to avoid payment errors. Use direct contact (DIRCON) procedures when contacting all available WC sources in GN 01070.305 through GN 01070.305 to obtain allegations of WC/PDB payments, or to find out what proof is readily available from WC/PDB sources. Make two contact attempts per source and document all calls each time using a Report of Contact (RPOC), whether the contact was successful or unsuccessful, or if the outcome resulted in leaving a voicemail message.

Take the appropriate actions based on the situation, as follows:

a. The WC/PDB claim is still under appeal

1.

If the NH requests full benefits pending resolution of the WC/PDB claim, obtain an SSA-795 repayment statement, if not already in file, and an expected decision date of any WC/PDB claim still under appeal per DI 52140.001F. A repayment statement is a statement that holds the NH liable for recovery of any overpaid amount(s) for benefits that should have been offset. The repayment statement on the SSA-795 form must be a completely dictated, free form statement from the NH.
2.

Annotate MCS or ICF as appropriate, with any new WC/PDB claim information that you received.
3.

Adjudicate the claim consistent with DI 52140.001F; and
4.

Establish a diary control (e.g., diary code 42) to follow-up on the status of the appeal. For Processing Center Action Control System (PCACS) diaries, provide contact names, telephone numbers, and any necessary WC/PDB claim information in the narrative portion of the diary.

NOTE: If the NH requests, in writing, not to receive their full disability benefits pending resolution of the WC/PDB claim or appeal, apply the State maximum WC rate in DI 52150.045. If the State maximum rate does not result in a full offset of benefits, use an alleged rate higher than the weekly maximum to impose full offset per DI 52140.001F.

NOTE: The PC cannot pay the full DIB payment without the attested language on the initial claim, a signed repayment statement, or documentation that the NH refuses to sign a repayment statement.

b. Worker has proof of WC/PDB

1.

Ask the NH to fax the proof directly to you or take it to their local FO as soon as possible; and
2.

hold the case no longer than five business days before follow-up.

c. Worker does not have acceptable proof or you are unable to contact the worker by phone

1.

Check eView and the EP to determine if the FO already obtained a signed SSA-1709 (Request for WC/PDB Benefit Information) for authorization to obtain WC/PDB proof.
2.

Simultaneously attempt to contact the WC carrier, PDB payer, or the WC/PDB attorney by phone per DI 52140.010B.1.
3.

Request that the carrier or other appropriate source submit WC/PDB proof to SSA by faxing it directly to you or mailing it to the applicable PC address.

NOTE: The NH is always the first contact for securing verification of WC/PDB. If the NH does not have verification, they should provide contact information and give SSA permission to contact the employer or insurance carrier. Technicians should contact the NH to obtain authorization to contact other appropriate sources. For more information on developing WC/PDB proof, see Verification/Proof of WC/PDB in DI 52145.001F and Obtaining Verification/Proof from Outside Sources in DI 52145.005.

d. You cannot obtain proof within 10 business days

1.

Adjudicate the claim using the State maximum WC rate at the time of the WC/PDB injury or illness. See DI 52150.045.
2.

The technician should include Manual Adjustment Credit and Award Processes (MADCAP) paragraph WCPR27 in the award notice or use dictated language that asks the beneficiary to provide proof of WC/PDB. Refer to NL 00720.395.
3.

If the beneficiary has an attorney or non-attorney representative, send neutral language paragraphs in GN 03940.075.
4.

Establish a 30-day diary to follow up on the response to our request for proof.
5.

If there is no response or no WC/PDB proof is received from any source, including the NH, continue development on a post-adjudicative basis even if the State maximum WC rate is applied to the claim. Refer to DI 52145.001 for what is considered acceptable proof.

NOTE: If there is prior evidence in the file that is older than one year, use the most recent available evidence in lieu of the State maximum WC rate.

e. Discrepant WC/PDB answers

If the work-related question on the DIB application and related forms (refer to DI 52140.001B) is answered "yes" but the filing question is answered "no":

1. Obtain an explanation of the discrepancy from the NH or employer, as necessary.

2. Determine if a claim will be filed if the NH has not filed a WC claim.

3. Document the Modernized Claims System (MCS) RPOC screen or the electronic file (EF)/eView/EP, with the response(s). Technicians may also use an SSA-795 to document the NH's or employer's response(s).

2. Developing for proof after adjudicating the award

When the 30-day diary alert matures, the PC should do the following:

a.

Check Paperless, eView, and the EP to determine if the beneficiary or other appropriate source (see DI 52145.001F) submitted proof of the WC/PDB payments while the follow-up diary was pending.
b.

If there is no proof in Paperless, eView, or the EP, attempt to verify the WC/PDB payments via State or Federal WC online access. Check the Workers’ Comp Resource Page, found in DI 52140.020, for a list of individuals in each PC with online access to individual State WC records.
c.

If the initial contact with the NH is unsuccessful, follow concurrent development instructions in DI 52140.010B.1 in this section to make contacts with all WC/PDB sources to obtain WC/PDB proof. Send a DIRCON letter to the NH to give us permission to obtain proof directly from the WC/PDB payer, carrier, or WC attorney, if applicable. Enclose Form SSA-1709 to the NH if not in the file. See Direct Mail Contact (DIRCON) in GN 01070.320.
d.

Send the action control record (ACR) to the development hold file (DHF) for 30 days from the date you sent the DIRCON letter.

If you do not receive WC/PDB proof within the 30 days from the date you sent the DIRCON letter, telephone the beneficiary to determine if they received the WC/PDB proof, send one follow-up request, and set a follow-up diary for an additional 30 days.

At the same time, when telephone contact is unsuccessful, simultaneously follow-up with any other appropriate WC/PDB source, as indicated directly below.

3. Obtaining proof from other appropriate sources

If the NH does not have their WC/PDB proof, but gives permission to contact all other appropriate sources or entities that require the NH's authorization, simultaneously do the following:

•

If there is no proof in Paperless, eView, or the EP, attempt to verify the WC/PDB payments via State or Federal WC online access. Check the Workers' Comp Resource Page in DI 52140.020 for a list of individuals in each PC with online access to individual State WC records per DI 52140.010B.3.a;
•

Call the insurance carrier directly. If unsuccessful or requested by the carrier, fax or mail the direct contact letter to the insurance carrier and enclose the SSA-1709 or other release signed by the NH, and
•

Attempt simultaneous contact with the WC/PDB attorney, per DI 52140.010B.3.c.

For specific guidelines on contacting WC/PDB insurance carriers, see Obtaining Verification/Proof from Outside Sources in DI 52145.005F.

In post-adjudicative cases, set up a PCACS diary for 30 days pending the initial request for information from the other appropriate source.

If you do not receive the requested information:

1.

make one follow-up request;
2.

set a follow-up diary for an additional 30 days; and
3.

document the electronic or paper folder with Reports of Contact and record all attempts to obtain WC/PDB proof.

As a last resort, when you still have not received proof after exhausting all WC/PDB sources and have documented all unsuccessful attempts, see DI 52140.010B.4 in this section for contacting the FO.

a. Obtaining evidence via State or Federal online access

Once you are certain the evidence is not already in the file, check the State POMS or the Workers' Comp Resource Page in DI 52140.020 to see if that State is one that provides SSA with online access to its WC records. The value of the online records can vary from state to state, and some development may still be required. However, the sites usually provide contact information for the employer, WC carrier, or the WC attorney, which can help with the development process. Check for a list of individuals in each PC with online access to individual State records.

b. Obtaining evidence from WC/PDB insurance carriers or other appropriate sources

Do the following:

•

Check online for WC/PDB proof, if applicable, for the employer, WC carrier, and WC attorney information, as outlined in DI 52140.010B.3.
•

Review all existing evidence for pertinent information, such as the WC/PDB claim number, WC/PDB carrier name, WC/PDB carrier phone number, and date of injury, etc. This also includes medical documentation in the WC/PDB record.
•

If the WC/PDB carrier has gone out of business, merged with another carrier, or the carrier's records were destroyed or modified due to storage limitations, try to locate the current WC/PDB carrier by contacting the former WC/PDB carrier, the employer, or the WC attorney. When locating the WC/PDB carrier, you may receive a reply after tracking down the current owner of the record(s). The record(s) may be in a form of a total amount paid on the policy with an end date of their payments.
•

Phone contact is the preferred method for the quickest results. Document all phone contact attempts using a Report of Contact. When unable to obtain information, statements for clarification, or required WC/PDB evidence over the phone or via fax, a direct contact letter will be sent by the PCs and FOs to request WC/PDB evidence. For the PCs, see DIRCON guidelines in GN 01070.300-GN 01070.330. For the FOs, see GN 00301.150.

NOTE: Review State-specific procedure for the requirements regarding contacting other appropriate sources. Refer to DI 52120.000. For specific guidelines on contacting carriers, see DI 52145.005F.

c. Obtaining proof from NH's attorney

The NH's attorney may submit the following as verification:

•

a statement of the amount of legal fees, unless it exceeds the amount provided by the award;
•

approved copies of award notices or settlement agreements; and
•

Form SSA-1709 signed by the attorney retained by the insurance carrier or self-insured employer is acceptable proof.

NOTE: A Form SSA-1709 signed by the worker's attorney is not acceptable proof.

4. Obtaining evidence by contacting the FO

Do not refer WC/PDB development to the FO. If you are unable to obtain proof through direct contact by phone or mail and attempts to other appropriate sources, contact the FO only as a last resort if one of the special circumstances listed below applies. You must exhaust all other attempts to obtain proof and fully document your attempts.

PCs must only contact an FO when the following special circumstances occur:

•

Face-to-face contact with the NH is required (i.e., medical expenses noted in the award that seem unreasonable).
•

The need arises to make a final determination on an issue that is typically determined by the FO, such as a representative payee determination.
•

Some agencies would normally charge SSA for searching and providing information, but they have an arrangement with the local FO that allows them to obtain the information free of charge. For example, requests requiring information from the Alabama Department of Industrial Relations should be made via the servicing FO per DI 52120.005E.2.
•

A state agency refuses to provide information to any SSA component other than a specific FO.

If the case meets any of these special circumstances:

a.

Input a development request through the Request for Assistance (RQFA) Paperless system or a PCACS RQFA if the case is a paper file.
b.

Advise the FO that you attempted to obtain all WC/PDB proof by DIRCON contacts to the NH by phone and mail and concurrent development requests to all WC/PDB sources.
c.
Request and state clearly what information is needed and provide the following information to the FO:
- •
  
  List every attempt made to obtain the WC/PDB proof and document all unsuccessful attempts;
- •
  
  Provide the name of the insurance company, agency, or public entity making the WC/PDB payments, if known;
- •
  
  Provide the WC/PDB claim number, if known;
- •
  
  List the date of the WC/PDB injury or illness (which is not necessarily the DIB onset date); and
- •
  
  Provide the name of the workers' employer at the time of the injury or illness.

If you need the FO to verify excludable medical expenses, include the following:

•

the nature of WC/PDB injury or illness, and
•

the names and addresses of the sources of medical treatment.

Take the following actions to strictly control these cases by diaries and avoid costly delays in development:

1.

Send the ACR to DHF in Paperless for 60 days. Annotate the ACR with the development actions taken. If a paper case is involved, set a PCACS diary.
2.

Send a follow-up to the FO only once and set another diary for an additional 30 days;. Send the ACR to DHF.
3.

If you do not receive a response from the FO or receive the evidence after a reasonable effort to secure proof of WC/PDB, the PC should fully document the record of all unsuccessful attempts.
4.

If the claim or appeal was pending and there was no prior proven WC/PDB rate, send an advance due process notice informing the NH that we will impose offset at the State maximum rate, per DI 52150.045, unless we receive the requested WC/PDB evidence, per GN 03001.015.
5.

Establish a 30-day diary from the date the advance due process notice was sent. If you do not receive a response, take action to adjust the record using the State maximum rate effective with the current operating month (COM), per GN 02407.010A.1.

C. Systems processing of cases with WC/PDB offset

There are three ways to process and annotate WC/PDB information to the MBR:

a.

Modernized Claims System/Earnings Computation (MCS/EC). For instructions on systems processing of initial claims involving WC/PDB, see DI 52155.000.
b.

Title 2 Redesign (T2R) Interactive Computation Facility (ICF). For instructions, see DI 52165.000, and
c.

ICF calculations processed via Online Records Entry Operation (OREO) and transmitted through MADCAP. For processing instructions, see DI 52165.020.

NOTE: For instructions regarding obtaining proofs prior to adjudication, see DI 52145.000.

1. MCS/EC processing

The FO processes most initial and reconsideration level claims via MCS/EC. MCS/EC is able to process most disability claims involving WC/PDB.

The PCs are responsible for MCS processing of all ALJ-level awards and some subsequent claims.

To process through MCS, follow these steps:

a.

Review all MCS/EC WC/PDB screens input by the FO.
b.

Check the electronic folder (EF), eView, or EP for proofs. If a paper folder is involved, review for any missing information.
c.

Attempt to adjudicate the ALJ claim or subsequent claim through MCS/EC. The MCS/EC trigger adjusts WC data on the Shared Process screens and codes offset to the MBR.
d.

Finally, prepare notices to advise the beneficiaries of our decisions. For notice instructions, see Initial Determination Workers’ Compensation/Public Disability Benefit (WC/PDB) Notices in DI 52155.035.

2. Processing claims by T2R ICF and MADCAP

If you encounter an MCS/EC limitation:

a.

Input the WC/PDB information into ICF to compute offset and adjudicate the claim. For WC/PDB Data Computation Results Screens, see MS 02432.001 through MS 02432.008.
b.

Prepare an A101 or EF101. For A101 processing, see DI 52155.025 and for EF101 processing, see DI 52155.030.

Both T2R and MADCAP utilize a Datasheet produced from the ICF computation action. For Datasheet information, see MS 02435.001 and MS 02435.002.

The Benefit Technical Examiner (BTE)/Benefit Authorizer (BA) can key only limited WC data into MADCAP. WC data propagates into MADCAP from the data the CS adjudicated.

The CS does the following:

a.

Completes the WRAC screen with a “Y” in “USE THE RESULTS IN ICF?”
b.

Provides all pertinent WC/PDB paragraphs for a complete award notice.

NOTE: In MADCAP, the BTE/BAs input determines the type of notice that goes to the NH. Providing the BTE/BA with the correct paragraphs is crucial in getting your message across and creating a complete, accurate notice.
c.

Routes the case to the BTE/BA for MADCAP processing.

You may partially adjudicate the award based on the NH’s allegations and secure proof on a post-adjudicative basis. For partial adjudication, see procedures in GN 01010.110.

If an attorney or representative represents the NH and the case involves a fee agreement, refer to instructions in GN 03940.036.

3. WC/PDB verification is received and differs from the alleged WC/PDB

Adjust all offset through ICF if a new proven rate differs from the alleged WC/PDB rate.

For partially adjudicated ALJ cases with attorney or representative involvement:

•

Recalculate the attorney or representative's fee based on the proven rate (if necessary).
•

Add a special message on the MBR explaining that the attorney or representative's fee is ready for calculation since WC/PDB rates are now proven.

NOTE: Provide appropriate language regarding the established fee amount. ICF Function 32 input will except because of the attorney or representative fee coding on the MBR. Therefore, code "Y" on the WCPA screen in ICF 32 as if you will be completing an A101. Send the case to the BTE/BA to recalculate the attorney or representative's fee. The BTE/BA will then pay the correct amount to the attorney or representative using the Single Payment System (SPS).

IMPORTANT: If we obtained the WC/PDB information through other appropriate sources, follow due process procedures in GN 03001.025.

D. Establishing a diary control in the PC

Create a diary for a future WC/PDB action when no system output or alert will generate to notify the PC of the future action. For example, create a diary to notify the PC of the future action for known COLA increases of the WC/PDB benefit amount.

Take the following steps, as appropriate, to establish a diary control in the PC:

1.

MCS - When processing an approved hearing decision, establish the diary using the DECI and DIAR clearance screens. The MCS diary establishes a diary control in PCACS. For instructions on establishing diary control for WC/PDB, see DI 52155.005.
2.

Non-MCS - Establish the diary through PCACS. For PCACS instructions, see Diaries and Development Overview in MS 04909.001 through MS 04909.013.

E. Post-entitlement (PE) action when the case involves WC/PDB offset

Post-adjudicative receipt of information from beneficiaries, insurance carriers, etc., indicating a change in the WC/PDB rate, dates, or LS settlement requires a review of the MBR offset data and possibly a recomputation of the offset.

1. Use the following ICF functions for post-adjudicative offset calculations and updates to the WC/PDB MBR data:

•

ICF Function 32 (Adjudicate WC/PDB Claim (WCDA)) propagates certain data from the MBR, propagates data from one ICF screen to another, and computes offset. T2R processes the offset unless there is an exception, which would then go to a BTE/BA for MADCAP processing. See MS 02434.004.
•

Use ICF Function 34 (WC/PDB Offset - OREO) screens to input manual WC/PDB computations to create an electronic version of the offset computation. For additional information on ICF WC/PDB Computations, see DI 52165.000. For an overview of OREO, see MS 02436.001.

ICF creates a Datasheet that is available for view/print via ICF - “WCPDB: DATASHEET/QUERY MENU” Function #33 or through the Online Retrieval System (ORS) in the EP or Master File Query Menu (MFQM) Function #25. The Datasheet contains all WC/PDB information from the ICF action, including offset computation results, special instructions, and notice information.

2. Reviewing for proof as a PE action

Search all available internal resources to determine if WC/PDB verification has been previously secured (e.g., paper file, Paperless completed side of the folder, EF, EP, MBR special message field, Shared Process evidence screens, and MCS development screens). Take note of the following reminders:

•

In Paperless, use the “Get Folder” feature on every case and review the entire list of active and archived ACRs before taking your action. The necessary WC/PDB proof may already be available in Paperless.
•

We consider WC/PDB evidence of periodic payments as current in PE actions if it is no more than one year old. To count this period, we review the date posted on the WC/PDB evidence in the file as a starting point. Therefore, if proof in the file is more than one year old, you must obtain updated proof. See DI 52145.001G for the re-verification rule and two exceptions to the rule.
•

If you find no WC/PDB proof, initiate the direct contact procedures previously mentioned in DI 52140.010B.1.
•

Retain the oldest active ACR until the action is complete. When initiating direct mail development, be sure to keep the oldest ACR in DHF, document what you are requesting, and keep the ACR open until you receive WC/PDB proof. Close any other WC/PDB-related ACRs, adding a comment that the ACR is cross-referred to the oldest ACR.

3. Re-imposing offset after reverse offset ends

To re-impose offset after reverse offset ends, use the most recent periodic payment rate to adjust the benefits and develop on a post-adjudicative basis for current proof of WC/PDB payments. Carefully review reverse offset instructions and examples in:

•

DI 52105.001G Reverse Offset Plans
•

DI 52150.020E WC/PDB Offset First Considered Date and Offset Effective Date

4. Taking non-WC/PDB-related PE actions

When non-WC/PDB-related PE actions (such as Automatic Earnings Reappraisal Operation (AERO) or earnings enforcements) are involved, we do not require re-verification of proof of the WC/PDB periodic payments unless there is knowledge that a WC/PDB event occurred and is material to current processing of the action. Use the quickest means available (online access, DIRCON, etc.) to obtain WC/PDB verification/proof, if needed.

5. Deleting the WC/PDB data from the MBR

It may be necessary to delete WC/PDB data previously established on the MBR. This situation can occur if all the WC/PDB payments are repaid as the result of a third-party settlement or if a pending WC claim is subsequently denied and there is no request for appeal. Per DI 52165.015, deleting the WC/PDB data is appropriate if the WC/PDB data was added erroneously to the record and WC/PDB is not involved in the disability claim, i.e., if the WC/PDB periodic payments and/or lump-sum settlement ended prior to the date of entitlement. T2R Release 3 and the expansion of the MBR make the deletion process more complicated, but you can still delete WC/PDB data using ICF. Annotate the special message field on the MBR of the deletion of previous WC/PDB data and state the reason.

Be sure to review the MBR the next day to verify that all WC/PDB data fields were removed and to check that any process to correct payment is complete. For deleting WC/PDB data through ICF, see DI 52165.015.

Specific instructions on how to delete the data are also available using the following link: Interactive Computations Facility (ICF) Resource Page for WC/PDB Offset Computations.

F. Handling WC/PDB-related alert and exception output received in the PC

1. Output from inputs made in the FO

Some FO actions using ICF #32 (Adjudicate WC/PDB Claim (WCDA)) create a system exception that requires final processing in the PC. Other FO actions process, but produce an alert in the PC if T2 identifies an MBR inconsistency or other issue that requires attention. An FO input using ICF #34 (OREO) produces output in the PC for processing to completion via MADCAP.

In most instances, T2R exceptions and alerts initially go to the BTE/BA for processing via MADCAP. The BTE/BA may forward the output to a CS if they believe there is a problem with the input data or the ICF result is something that the BTE/BA is unable to resolve.

If the BTE/BA forwards the case to the CS, the CS must then review the alert or exception and make the correction needed to complete processing. The CS should review the EF(eView), EP, or the completed side of the Paperless folder for prior WC/PDB information or proof that might be available to resolve the alert or exception before returning the case to the BTE/BA for final processing.

NOTE: The CS should verify that proper notice language is included per DI 52155.035 before returning the case to the BTE/BA for final processing.

2. Triennial redetermination alerts

Triennial redetermination alerts are a PC workload responsibility. For information regarding the triennial redetermination of the average current earnings (ACE) alerts received in the PC each year and re-verifying WC/PDB, refer to DI 52150.080.

G. Regular Transcript Attainment and Selection Pass (RETAP) alerts for WC/PDB events

The BTE/BA or CS process the following RETAP alerts in the PC. See the following applicable references for complete processing instructions:

RETAP Alerts for WC/PDB Events	Reference
Workers Comp Non-MEGACAP Alert (Code F) This alert is becoming rare. It identifies cases where offset ends at age 62 and needs a manual action to remove the offset.	SM 00619.056
Workers Comp MEGACAP Alert (Code G) This alert identifies disabled workers who are in offset at age 62 and who may benefit from filing a claim for retirement insurance benefits (RIB).	SM 00619.057
NH Age 65-Dev DIB Election This alert identifies disabled workers about to attain age 65 who had elected to receive RIB due to WC/PDB offset. Since offset ends at age 65 for beneficiaries that attain age 65 before December 19, 2015, it is probably to their advantage to consider receiving DIB again. NOTES: • Effective December 19, 2015 and later, WC offset based on receipt of periodic payments or newly prorated lump sums now extends from age 65 to full retirement age (FRA). • Since WC offset now continues to FRA for beneficiaries attaining age 65 on 12/19/2015 or later, there will be no need for comparison (reduced RIB to higher DIB). See 2015 amendment in DI 52101.005.	SM 00619.096
Calif PDB Offset Removal This alert generates 18 months after the periodic payment start date based on the receipt of California State Disability Insurance (SDI) payments, with no stop date posted to the MBR. NOTE: The MBR does not contain sufficient data to distinguish between California PDB offset cases based on SDI payments and those that are cases based on other types of California PDBs (for example, State disability pension). The RETAP will occasionally select records where offset is not based on SDI payments. If the offset is correct but not based on SDI, add a special message to the MBR indicating the source of the California PDB payments and add No Action Necessary (NAN) to the ACR for the alert.	SM 00619.098
Develop for Pending WC/PDB This alert generates when the disabled worker’s Title II application and resulting MBR data indicate one of the following: • An intent to file for WC/PDB; • A WC/PDB claim was filed but the decision is still pending; or • An appeal was filed on a previously denied WC/PDB claim and the appeal is still pending. NOTE: These alerts also generate when an appeal is filed on previously terminated WC/PDB payments and the appeal is still pending. Only offset data is present on the MBR with a STOP date and the INJURY (continued) data line shows APPEAL PENDING. These alerts will continue to generate at 6-month intervals until the MBR pending code is resolved.	SM 00619.099
Offset Workers' Compensation (WC) Federal Employees Compensation Act (FECA) This alert generates for NHs who are eligible to receive the FECA COLA. This alert generates annually on the second day of COM 4 (Generating in March for April COM).	SM 00619.117

H. References

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DI 52101.005 Social Security Amendments with Workers’ Compensation/Public Disability Benefit (WC/PDB) Offset Provisions
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DI 52105.001 Reverse Offset Plans
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DI 52120.001 Introduction to State Specific Workers' Compensation (WC) Procedures
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DI 52120.005 Alabama Workers' Compensation (WC)
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DI 52135.001 Introduction to State Specific Public Disability Benefits (PDB)
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DI 52135.030 California Public Disability Benefits (PDB)
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DI 52140.001 Field Office (FO) Responsibilities for Workers' Compensation/Public Disability Benefit (WC/PDB) Offset
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DI 52140.020 Workers' Compensation Resource Intranet Page
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DI 52145.000 Verification of Proof of Workers' Compensation/Public Disability Benefit (WC/PDB) - Table of Contents
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DI 52145.001 Verification of Proof of Workers' Compensation/Public Disability Benefits (WC/PDB)
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DI 52145.005 Obtaining Verification/Proof from Outside Sources
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DI 52145.010 Completion and Receipt of Form SSA-1709 (Request for Workers' Compensation/Public Disability Benefit Information)
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DI 52145.015 Retention of Workers' Compensation/Public Disability Benefit (WC/PDB) Proofs
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DI 52150.020 Workers' Compensation/Public Disability Benefit (WC/PDB) Offset First-Considered (OFC) Date and Offset Effective Date (OED)
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DI 52150.030 Considering the Retirement Insurance Benefit (RIB) Option
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DI 52150.045 Chart of States' Maximum Workers' Compensation (WC) Benefits
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DI 52150.060 Prorating a Workers' Compensation/Public Disability Benefit (WC/PDB) Lump Sum Settlement
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DI 52150.080 Triennial Redetermination (Redet) of the Average Current Earnings (ACE)
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DI 52155.000 Initial Claims with Workers' Compensation/Public Disability Benefit (WC/PDB)
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DI 52155.005 Initial Claims and Appeals Requiring Diary Control for Workers’ Compensation/Public Disability Benefit (WC/PDB)
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DI 52155.025 A101 Processing Claims with Workers' Compensation/Public Disability Benefit (WC/PDB)
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DI 52155.030 EF101 Processing of Claims with Workers' Compensation/Public Disability Benefit (WC/PDB)
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DI 52155.035 Initial Determination Workers' Compensation/Public Disability Benefit (WC/PDB) Notices
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DI 52165.000 Interactive Computations Facility (ICF) for Workers' Compensation/Public Disability Benefit (WC/PDB) Computations
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DI 52165.001 Using the Interactive Computations Facility (ICF) to Compute Workers' Compensation (WC) Public Disability Offset (PDB) Offset and ICF Terms
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DI 52165.015 Deleting Workers' Compensation/Public Disability Benefits (WC/PDB) Data through Interactive Computations Facility (ICF)
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DI 52165.020 Use Interactive Computation Facility (ICF) Function 34 Online Record Entry (OREO) to Process ICF Problems and Limitations
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DI 81010.090 Faxing Documents into the Certified Electronic Folder (CEF) Using Barcodes
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GN 00301.150 Evidence of Mail Development
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GN 00301.322 Retention of Paper Material After Faxing into Either the eDIB Folder or Claims Folder using NDRed
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GN 01010.110 Partial Adjudication
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GN 01070.300 Payment Center (PC) Contact With Public (Direct Contact DIRCON)
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GN 01070.305 Use of Direct Contact (DIRCON)
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GN 01070.320 Direct Mail Contact
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GN 01070.330 Claimant Appointed Representatives - DIRCON
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GN 02407.010 Processing Post-Entitlement (PE) Events for Cycles 1, 2, 3, and 4 During a "Window" Period
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GN 03001.015 Notices Required Before and After Taking A Title II Adverse Action
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GN 03001.025 Processing Third Party Reports in Title II Adverse Action Situations
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GN 03910.050 Contacting a Represented Claimant
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GN 03920.051 Excess Fee Payments Made to Representatives and Entities
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GN 03940.036 Fee Agreement Process - Field Office (FO) and Processing Center (PC) Procedures - Partial Adjudication Involving Deferred Development, Including Workers' Compensation (WC) or Public Disability Benefit (PDB) Information
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GN 03940.075 Title II - Fee Agreement Process - Neutral Language Paragraphs - Fee Authorization Deferred
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MS 02432.001 Workers' Compensation/Public Disability Benefits Data Computation
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MS 02432.008 WC/PDB Offset - PIC Offset Data (WCPO)
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MS 02434.004 WC/PDB Offset - Disposition - Adjudicate WC/PDB Claim (WCDA)
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MS 02435.001 Workers' Compensation/Public Disability Benefits Datasheet - Overview
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MS 02435.002 WC/PDB Offset Datasheet (WCDS)
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MS 02436.001 Workers' Compensation/Public Disability Benefits Offset Online Record Entry Operation (OREO) - Overview
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MS 04909.001 Diaries and Development - Overview
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MS 04909.013 Request for Assistance (RQF2)
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NL 00720.395 Workers' Compensation (WCP)
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SM 00619.056 Workers' Comp Non-MEGACAP Alert (Code F)
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SM 00619.057 Workers' Comp MEGACAP Alert (Code G)
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SM 00619.096 NH Age 65 - Dev DIB Election
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SM 00619.098 Calif PDB Offset Removal
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SM 00619.099 Develop for Pending Workers' Compensation/Public Disability Benefit (WC/PDB) Alert
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SM 00619.117 Offset Workers' Compensation (WC) Federal Employee Compensation Act (FECA)

To Link to this section - Use this URL:
http://policy.ssa.gov/poms.nsf/lnx/0452140010

DI 52140.010 - Processing Center (PC) Responsibilities for Processing Workers’ Compensation/Public Disability Benefit (WC/PDB) Offset - 04/21/2026
Batch run: 04/21/2026
Rev:04/21/2026

Program Operations Manual System (POMS)