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Old 11-16-2008, 09:38 AM
Janke Janke is offline
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Join Date: Sep 2008
Posts: 686
15 yr Member
Janke Janke is offline
Member
 
Join Date: Sep 2008
Posts: 686
15 yr Member
Default Long, technical answer

I assume you are receiving monthly benefits and have been doing so for seven months. If I am incorrect in this assumption, my answer may not be correct.

My guess is that you DID file a claim for SSI benefits at the time you filed a claim for SSDI benefits because it is the agency's policy to take concurrent claims for all claimants. SSA has not always been consistent in obtaining claims for potentially eligible SSI recipients and a few people lost potential benefits. There are good reasons to take SSI claims in many cases. Although that is commendable, the policy to obtain SSI applications for all claimants creates new problems and also takes employee time to process these claims and deal with the potential after effects.

I am going to get pretty technical here. You could jump to the last paragraph for my suggestions.

When an SSI claim is taken concurrently with an SSDI claim, a computer record is set up and the SSDI computer record includes an indicator that an SSI claim was taken. That indicator puts an automatic "hold" on the payment of retroactive SSDI benefits until a subsequent action is taken by another employee. That indicator is generally established EVEN IF the SSI claim was initially denied for excess income or excess resources. The purpose of the hold is so that windfall offset can be performed on any retroactive SSDI benefits. Windfall offset is the amount of SSI that would not have been paid had the SSDI benefits been paid on time. If zero SSI is paid or due, then there is zero windfall offset, BUT since an SSI claim was filed, an employee or several employees in different components need to take the correct action.

There are electronic controls set up to automate this process. But the automated process does not work 100% of the time, for a variety of reasons, and so various electronic lists and electronic diaries are created. Most of the time, when there is an exception to automated windfall offset processing, the first action needs to be taken by an SSI claims rep in the local office. The list of cases is assigned to one or more SSI claims reps, in addition to their other duties such as taking initial applications, interviewing all day, other workloads as assigned. Most offices will assign windfall offset workloads to a highly skilled SSI CR, called the Technical Expert, since many of these cases can be extremely complicated.

Even the simple windfall offset diaries need an action taken first by the local office and then either an automated or manual action by the payment center to release the hold on the retroactive benefits.

The workload is monitored by the office manager and his/her boss. The goal is to resolve all of these diaries within 120 days. After 120 days, a report has to be made about the old cases and no one likes to be making reports about old windfall offset cases. Looks bad for the office manager since it affects his/her performance awards. It is one of many, many statistical reports that is used to measure an office's performance.

Occasionally, with all the electronic controls, there are cases that don't get on a list, and are not monitored by anyone except the claimant who is waiting for money. A frequent scenerio is an SSI claim is taken concurrently with an SSDI claim and the SSI claim is immediately denied for excess income (pension?) or excess resources (too much savings). 90 days after that SSI claim is formally denied, the computer record (SSID) goes from an active record (PS N01 RIC G) to a terminated record (PS T51 RIC T). Once the SSI record is in terminated status, no diaries are set, no electronic controls, no action can be taken in the field office to the SSI record. This means no employee is assigned to take the action in either the local office or the payment center, and the release of retroactive benefits grinds to a halt.

As a claimant, when you call the 800# or your local office or go into your local office, your first line employee is generally a lower grade service rep who does not always understand the complexities of windfall offset processing so you don't always get satisfaction or correct action taken. SSA is woefully understaffed for the amount of work that Congress expects to be done, and the employees can only do so much work in an 8 hour day. Most employees don't like that situation either, but it is out of their control. As an employee, there is a tendancy to work on the higher profile cases, the ones your supervisor asks you to report on each week, than the workload no one monitors. Human nature.

Since you have waited seven months, it sure sounds like the automated process has failed. I would contact your local office again. Ask if there was an SSI claim filed concurrently with your SSDI claim (you should also have received an SSI denial notice). The employee will look at an SSID. Is the PS code T51? If there was an SSI claim, the employee should then look at an AACT to see if the retroactive SSDI benefits are being held up because of windfall offset (several codes will indicate this). If so, you need to ask for the SSI CR in your local office you works windfall offset or talk to the SSI supervisor. The windfall offset person can access an electronic message system called the e4345 that sends an appropriate message to the payment center that generally gets worked on more quickly than other electronic messages, like an email or MDW (another communication system). Your local office may decide to issue some of the retroactive benefits themselves using a manual process called Critical Payment System, CPS. Anytime the automated process is circumvented, there is more likelihood of error, and takes employee time away from other workloads, but it can be done and when there is a PR problem and you have waited a reasonable amount of time, the supervisors will generally approve it.

It can still be a month before the payment center's action processes fully.

If you manged to read all of this and understand it, congratulations. These programs are more complicated that the claimants realize (it is not just pushing a few buttons) and understaffing in SSA makes it even harder to get work done timely and good service provided to the claimants.

Last edited by Janke; 11-16-2008 at 09:40 AM. Reason: Additional information
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finz (11-22-2008)