1. General Information on the Social Security Verification Match
Introduction |
This topic contains general information on the Social Security verification match, including the
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Change Date |
July 23, 2004
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2. Calculation of VA -Computed Social Security Rate
Introduction |
This topic contains information on the calculation of VA-computed Social Security rate, including
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Change Date |
July 31, 2015
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X.2.2.a. Estimated Post-COLA Rate |
If a COLA is authorized, VA pension and Parents’ DIC benefits are increased by the same percentage and at the same time as the Social Security benefits. Therefore, VA estimates a joint VA/Social Security post-COLA Social Security rate for each beneficiary.
Estimated Income for VA Purposes (IVAP)
The estimated Social Security rate is used to determine the VA beneficiary’s IVAP until VA processes the extract tape with the actual post-COLA SSA rate. Social Security Rates Differ by $10 or More
When exact rates are processed, VA compares them to the estimated rates. If the monthly Social Security rates differ by $10 or more, the pension management center (PMC) of jurisdiction must resolve the discrepancy. A write out is created to inform the PMC that a review of the income is required. Note: This is a systematic review. Review all discrepancies in income, regardless of the amount of deficiency.
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X.2.2.b. No SMIB Deduction |
If there is no Medicare or supplementary medical insurance benefit (SMIB) deduction in the master record, multiply the verified Social Security monthly amount in the master record or the monthly Social Security amount, in unverified cases, by the COLA factor.
Example: If the COLA is 4%, multiply the monthly Social Security amount by 1.04.
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X.2.2.c. New Monthly Social Security |
Use the table below to understand how VA calculates the new monthly Social Security payment for verified and unverified cases if there is no SMIB deduction.
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X.2.2.d. Post-COLA Social Security IVAP |
Use the table below to understand how VA calculates the post-COLA Social Security IVAP for a verified or unverified case.
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X.2.2.e. Standard SMIB(Medicare) Deduction |
The standard SMIB deduction amounts will be provided to PMCs annually. The COLA amount will also be provided at that time.
If the master record contains a standard SMIB deduction the
Follow the steps in the table below to calculate the Social Security rate with a standard SMIB deduction.
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X.2.2.f. Nonstandard SMIB Deductions |
If the pre-COLA SMIB is other than the current standard amount, the post-COLA Social Security monthly amount is estimated using the pre-COLA SMIB.
The assumption is made that there would be no change in the SMIB deduction because there is no way to estimate the post-COLA nonstandard SMIB deduction.
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X.2.2.g.
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The standard SMIB deduction increase can be more than the COLA. As a result, Social Security recipients at the lower end of the benefit scale would see their benefits increase less than the amount of the increase in the SMIB deduction and would end up with a net reduction in benefits. The law includes a provision that Social Security recipients will not be reduced solely because of the COLA.
Therefore, in cases where the newly increased SMIB deduction would be greater than the COLA increase, the Medicare deduction is automatically reduced to the extent necessary to prevent a reduction in the beneficiary’s monthly rate of Social Security.
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X.2.2.h. Example: Determining SMIB Deduction |
Situation:
Result: Since the payment amount cannot be reduced, the SMIB deduction must be reduced to $58.50 to continue paying $272 ($330.50 – $58.50 = $272.00).
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3. Processing Verified Social Security Amounts
Introduction |
This topic contains information on processing verified Social Security amounts, including
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Change Date |
August 8, 2016
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X.2.3.a.
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After matching VA extracts against their files, the SSA returns the files with current Social Security payment information to VA.
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X.2.3.b. Verification Attempts |
For each pension record, verification is attempted for
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X.2.3.c. Survivors Pension and Parents’ DIC Cases |
For Survivors Pension and Parents’ DIC cases, verification is attempted under the Veteran’s SSN and the payee’s SSN.
Child Payees
Records for child payees receiving pension are included in the procedure, but no attempt is made to verify the entitlement of a dependent child on a Veteran’s or surviving spouse’s record. |
X.2.3.d. Corrective Award Action Necessary Based on SSA Matches |
Depending on the discrepancies found between the SSA information and VA computed post-COLA Social Security rate and on the type of VA benefits payable, the VA systems either
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4. Processing Verified Social Security Amounts: Old-Law and Section 306 Cases
Introduction |
This topic contains information on processing verified Social Security amounts in Old-Law and Section 306 cases, including
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Change Date |
August 8, 2016
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X.2.4.a.
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In all Old-Law and Section 306 cases for which verified Social Security data are available, The VA system
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X.2.4.b. Audits of Protected Pension Cases After SSA Matches |
The VA system does not generate review messages in protected pension cases merely because there are discrepancies between the Social Security amounts returned by the SSA and the existing amounts in the master record (the amount in the master record is the VA computed post-COLA Social Security rate).
Reported Death of Beneficiary or Spouse
The only other review messages issued during initial processing of SSA returns for protected pension cases are related to the reported death of a beneficiary or spouse. |
5. Processing Verified Social Security Amounts: Current-Law Pension and Parents’ DIC Cases
Introduction |
This topic contains information on processing verified Social Security amounts for curent-lae pension and Parents’ DIC cases, including
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Change Date |
August 8, 2016
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X.2.5.a. Current-Law Pension and Parents’ DIC |
In each curent-law pension and Parents’ DIC case for which verification is possible for a payee and/or spouse, the system compares the monthly Social Security income computed from the returned SSA data with the existing monthly Social Security income of record.
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X.2.5.b.
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If the post-COLA Social Security monthly amount equals the master record monthly amount, no further action is taken except to update the verified monthly rate and smib deduction fields, if necessary.
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X.2.5.c. Legend for Payee/Spouse Discrepancy |
The legend for a payee’s discrepancy is SSA REPORTS, or spouse’s discrepancy is SSA RPTS SPOUSE, or both, if applicable.
The amount shown is the monthly Social Security income computed from the SSA verified monthly entitlement amount.
This monthly Social Security income is
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X.2.5.d.
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When there is a SMIB deduction, the actual amount is also shown on the INCOME/NET WORTH Screen in the SMIB field.
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X.2.5.e.
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When there is no Medicare deduction in a verified case, the SMIB field is blank.
Therefore, if the INCOME/NET WORTH screen shows a positive entry in the VER RATE field for Social Security and a blank in the SMIB field, the SMIB deduction amount for that SSA beneficiary was verified as none.
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X.2.5.f. Verified Rate |
The verified rate is the amount called MBA (monthly benefit amount) by the SSA and represents the gross entitlement (unrounded) amount.
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X.2.5.g.
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The SMIB field represents the SMIB deduction. The verification program also computes a verified post-COLA monthly Social Security income amount.
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X.2.5.h. Example: Determining Verified Monthly Social Security Amount |
Situation:
Result: Adding the SMIB ($58.70) to $327 gives $385.70 as the verified monthly Social Security amount.
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X.2.5.i. Verifying Monthly Social Security Amount |
Check Share or call SSA to verify the monthly Social Security amount. Unless it is known that SMIB is paid by a state or organization, use the amount in the message legend.
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X.2.5.j.
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If the verified computed monthly Social Security income is within $10 of the amount in the INCOME/NET WORTH RATE field
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X.2.5.k.
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If the verified computed monthly Social Security income exceeds or is less than the amount in the INCOME/NET WORTH RATE field by $10 or more check the Share system or call SSA for the correct rate.
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X.2.5.l. Developing for Date of Rate Change |
Initiate development with the payee to determine the commencing date of the SSA rate change.
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X.2.5.m. Informing the Payee |
Tell the payee he/she has been identified by SSA through the matching program as receiving SSA benefits at a rate which differs from the rate on which his/her VA benefits are paid.
Provide notice of proposed adverse action as outlined in M21-1, Part I, 2.B.6, if the verified Social Security rate will result in a reduction or termination of benefits. Advise the payee of the monthly Social Security rate
Ask the payee to
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X.2.5.n. Monthly Entitlement Amount Is Erroneous |
If development or a review of the folder clearly establishes that a verified monthly entitlement amount is erroneous, process a correction of master record transaction of six zeros to the appropriate ver rate field.
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X.2.5.o.
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If the payee fails to respond or the response is inadequate, adjust the award under38 CFR 3.652.
Note: For purposes of 38 CFR 3.652(a)(1), the “month in which the eligibility factor was last shown by the evidence of record to have existed” is the last month in which it can be definitely be shown by the evidence that the payee’s income did not exceed the income limitation for payment of pension benefits.
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6. Action on Terminated SSA Accounts
Introduction |
This topic contains information on terminated SSA accounts, including
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Change Date |
July 31, 2015
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X.2.6.a. Beneficiary or Spouse Deceased |
Code 833 messages are also issued for cases in which the SSA records indicate that a VA beneficiary or the spouse of a VA beneficiary is deceased.
The following are the two code 833 messages that are issued for these cases:
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X.2.6.b.
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The message SSA RPTS PAYEE DECEASED is issued for a record that is in active payment status at the time of the verification run. This message is keyed to certain coded fields in the SSA record. It is possible that the codes are neither accurate nor current.
Notes:
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X.2.6.c.
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The message SSA RPTS SPOUSE DECEASED is issued for an appropriate record if there is a spouse indicated in the master record and there is no future award line on or before January, showing total dependency reduced to indicate loss of the spouse.
Note: Control such cases and take appropriate development action to determine current dependency status and the date of loss of the spouse. The effective date of award adjustment will be dictated by the end-of-month rule or end-of-year rule, depending on the type of VA benefits payable and the actual date of the spouse’s death.
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7. EP Credit, Reporting, and Cost Avoidance
Introduction |
This topic contains information on EP credit, reporting, and cost avoidance, including
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Change Date |
April 5, 2005
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X.2.7.a. EP Assignment |
EP 150
Cases which require development and/or award action because of an income adjustment are assigned EP 150. EP 130
Cases which require development and/or award action because of a change in dependency are assigned EP 130. Note: No separate end product credit is assigned to develop for or terminate an account based on the fact of a Veteran’s death, as appropriate credit is included in any subsequent death action.
Reference: For more information on EP credit, see M21-4 Appendix B.
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X.2.7.b. Report Format |
RCS 20-0846 reports are required in the following format:
Important: Negative reports are required.
Note: Regional offices (ROs) will be informed annually of the date this report is due and where to send the report.
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X.2.7.c. Determining Fiscal Year Cost Avoidance |
Fiscal year cost avoidance is calculated as follows:
The result is the fiscal year cost avoidance.
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X.2.7.d. Example: Determining Cost Avoidance |
Situation: The Social Security verification match indicates that a single Veteran’s monthly Social Security rate is $447.50 effective December 1, 1999. The Veteran is currently being charged with Social Security of $420.50 per month effective December 1, 1999.
After affording a notice of proposed adverse action, the RO determines that the award must be adjusted to charge SocialSecurity of $477.50 per month from July 1, 1999. The award making the adjustment is authorized on August 7, 2000. The difference between the monthly rate that would have been paid based on Social Security of $420.50 and the rate actually paid after the adjustment based on Social Security of $447.50 per month, is $27.00 per month.
Action: The lower rate will be paid for two months that remain in fiscal year 2000 (August and September). Therefore, fiscal year cost avoidance for this case for purposes of the RCS-20-0846 report is $54 ($27.00 x 2).
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Historical_M21-1X_2_07-31-15.doc | May 19, 2019 | 152 KB |
Historical_M21-1X_2_08-10-2005.doc | May 19, 2019 | 118 KB |
Change-July-31-2015-Transmittal-Sheet-M21-1MRX_2_TS.docx | May 19, 2019 | 40 KB |
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