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M21-1, Part X, Chapter 15 – Social Security Administration (SSA) Prison Match

Overview

In This Section

This section contains the following topics:
Topic
Topic Name
1
2
3

1.  SSA Prison Match Worksheets


Introduction

This topic contains information on the SSA Prison Match worksheets, including

Change Date

April 4, 2016

X.15.1.a.  SSA Agreement with VA for Information on Prisoners

The Department of Veterans Affairs (VA) has a Memorandum of Understanding (MOU) with the Social Security Administration (SSA) under which SSA provides VA with information on prisoners whose VA benefits may be subject to reduction or termination.
References:  For more information on
  • imprisonment in penal institutions, see M21-1, Part III, Subpart v, 8
  • compensation for incarcerated Veterans, see 38 CFR 3.665
  • payment of pension during confinement in penal institutions, see
  • payment of disability compensation or Dependency and Indemnity Compensation (DIC) to persons convicted of a felony, see 38 U.S.C. 5313.  Note that under 38 U.S.C. 5313, the DIC rate is reduced to one half of the 10-percent compensation rate, not one half of the DIC rate.

X.15.1.b.  Ongoing Operation for SSA Prison Matches

Periodically, data from VA compensation and pension records are run against SSA’s inmate database.  For every match, VA generates an SSA Prison Match worksheet.  Each month, regional offices (ROs) receive listings showing the cases for which worksheets were issued.
  • If a worksheet is lost, the listing may be used in lieu of the worksheet.  The listing contains
    • information identifying the incarcerated individual,
    • information on the place and date of incarceration, and
    • sometimes the release date and the prisoner’s identification number.
  • If an RO does not receive a worksheet for a particular month, or if questions arise about the Prison Match, send an e-mail toVAVBAWAS/CO/212A.
Important:  The monthly SSA Prison Match worksheet or listing must be uploaded into the Veteran’s electronic claims folder (eFolder).
Reference:  For information on redacting documents containing personally identifiable information (PII) for multiple individuals, see M21-1, Part III, Subpart ii, 4.G.3.d.

X.15.1.c.  RO Responsible for Action on Listed Compensation Prison Match Cases

Refer to the table below to determine which RO is responsible for working an SSA Prison Match case for a Veteran in receipt of compensation.
If the Beneficiary Identification and Records Locator Subsystem (BIRLS) shows the claims folder location is …
Then …
any RO
the RO of record in BIRLS is responsible for the case.
the Records Management Center (RMC) (376)
the station of jurisdiction in the Hines’ master record or corporate record is responsible for the case.
Note:  Do not permanently transfer a claims folder solely because the beneficiary resides in the jurisdiction of another RO (unless it is a foreign case or other special circumstances apply).

Reference:  For more information on the conditions under which it is proper to permanently transfer a claims folder, see M21-1, Part III, Subpart ii, 5.D.1.a.


X.15.1.d.  PMC Jurisdiction Over SSA Prison Match Cases

The pension management center (PMC) of jurisdiction is responsible for resolving the prison match issue if
  • the beneficiary is in receipt of pension or DIC, or
  • Veteran is entitled to compensation but is receiving pension as the greater benefit.
Reference:  For more information on the jurisdiction of each PMC, see M21-1, Part V, Subpart iv, 1.2.b.

2.  Review of SSA Prison Match Worksheets


Introduction

This topic contains information on the review of SSA Prison Match worksheets, including

Change Date

June 5, 2017

X.15.2.a.  EP Assignment for SSA Prison Match Worksheets

End product (EP) 290 applies to each SSA Prison Match worksheet reviewed or related 800 series work item identified.
  • When establishing EP 290, use
    • the “run date” that appears in the upper, right-hand corner of the SSA Prison Match listing as the date of claim, and
    • Social Security Prison Match as the claim label.
  • Clear the EP 290 when
    • it has been determined that the award is not subject to adjustment, or
    • all development action has been completed and, except for the issuing of advance notice of adverse action, the award is ready for adjustment.
Important:  Follow the instructions in M21-1, Part III, Subpart ii, 1.C.7 if
  • action on the worksheet cannot be taken immediately, and
  • the action involves an award of disability compensation or DIC.
Reference:  For more information on due process and the issuing of notice of proposed adverse action, see M21-1, Part I, 2.A and  B.

X.15.2.b.  Comparing the Prison Match Worksheet With the Corporate Record for Possible Erroneous Identification

Before taking any action based on an SSA Prison Match, compare the information on the worksheet or listing with information VA maintains in its corporate record.
  • Compare the name in the Prisoner’s Name field on the worksheet with the beneficiary’s or dependent’s name in the corporate record.
  • If the names are not close, check the date in the Date of Birth field on the worksheet against the date of birth in the corporate record and, if applicable, BIRLS.
Notes:
  • The Social Security number (SSN) that appears on a worksheet does not always belong to the corresponding prisoner.  In many instances, the system that runs the match associates a prisoner with a VA beneficiary on the basis of other criteria, such as name and date of birth.  When this occurs, the system makes an assumption that because the VA beneficiary and the prisoner are the same person, they share the same SSN that VA has of record for the beneficiary.
  • Based on the explanation provided in the preceding paragraph,it would be improper to assume that a prisoner is illegally using a VA beneficiary’s SSN simply because the system that runs the match associated the prisoner with a VA beneficiary.
Follow the instructions in the table below if there is no clear match between the prisoner identified on the worksheet and a VA beneficiary or dependent.
If …
Then …
the prisoner is clearly not a VA beneficiary or dependent
take no further action, other than to
  • undertake development for the VA beneficiary’s or dependent’s correct SSN under 38 CFR 3.652 (if the VA beneficiary or dependent appears to be the individual with the erroneous SSN), and
  • annotate the worksheet with the words “erroneous match.”
it is unclear whether the prisoner is a VA beneficiary or dependent
undertake development action to determine whether the VA beneficiary or dependent and the prisoner are the same person.

X.15.2.c.  Official Nature of an SSA Prison Match

If comparison of the worksheet or listing with the corporate record (and, if necessary, the claims folder) reveals that a VA beneficiary or dependent is the prisoner identified by the match, consider the worksheet or listing official notice of imprisonment in a penal institution.
References:  For more information on handling notice of imprisoned

X.15.2.d.  Caveat About SSA Prison Match Findings

The SSA Prison Match was designed to meet the needs of SSA, not VA.  Accordingly, the appearance of a VA beneficiary or dependent on an SSA Prison Match worksheet or listing does not always necessitate a corresponding award adjustment.
Based on the explanation provided in the preceding paragraph, take no action on a match if the prisoner is/was incarcerated in a facility that does not hold
  • sentenced offenders, such as a city jail, or
  • sentenced felons, in a compensation/DIC case.
Note:  Many facilities that house prisoners have web sites that provide information about the categories of prisoners the facility holds.

X.15.2.e.  Information Required to Determine What Award Adjustment Is Necessary

SSA Prison Match worksheets do not provide all of the information VA requires to determine what adjustments should be made to a beneficiary’s award.  Accordingly, VA must obtain the information listed in M21-1, Part III, Subpart v, 8.A.3.d from the facility where the beneficiary or dependent is/was incarcerated prior to sending advance notice of adverse action to the beneficiary.
References:
  • Follow the instructions in M21-1, Part X, 15.2.f for obtaining the information required to determine what award adjustment is necessary based on a beneficiary’s or dependent’s incarceration.
    • more information about the effect of a primary beneficiary’s incarceration on his/her VA benefits, and
    • the definition of “incarceration” (for the purpose of determining entitlement to VA benefits).
  • For more information about

X.15.2.f.  Obtaining the Information Required to Determine What Award Adjustment is Necessary

Use any of the following methods to obtain the information listed as required inM21-1, Part III, Subpart v, 8.A.3.d from the facility where the beneficiary or dependent is/was incarcerated.
Notes:
  • Information that VA uses to adjust a beneficiary’s award based on incarceration must originate with an official source at some level of government.
    • Uncorroborated statements by the beneficiary, a family member, or a private attorney concerning incarceration status are notacceptable.
    • Statements by prison or law enforcement authorities, prosecutors, and parole officers are acceptable.
  • Do not infer that an individual identified through the SSA Prison Match was never incarcerated simply because he/she does not appear on a prison web site.  Many web sites list only currently incarcerated individuals.  In every case, contact with the facility shown on the SSA Prison Match listing is required to establish that a person was notincarcerated.
Reference:  Follow the instructions in M21-1, Part III, Subpart v, 8.A.3.e for documenting information obtained from the sources referenced in this block.

X.15.2.g.  Processing the SSA Prison Match Case

If, after considering the principles discussed in M21-1, Part X, 15.2.b and d, it appears that adjustment of a beneficiary’s award due to incarceration (of the beneficiary or a dependent) might be necessary, follow the instructions in the table below after taking the action described in M21-1, Part X, 15.2.f.
Step
Action
1
Follow the instructions in the table below.
If VA …
Then …
requested the information listed inM21-1, Part III, Subpart v, 8.A.3.d (by letter, for example)
proceed to the next step.
obtains the information listed in M21-1, Part III, Subpart v, 8.A.3.d withoutissuing a request (through telephone contact or by accessing a correctional facility’s web site, for example)
proceed to Step 8.
confirms through official sources –without issuing a request – that the beneficiary or dependent is/was notincarcerated
2
Was VA able to obtain within 30 days of its initial request the information listed in M21-1, Part III, Subpart v, 8.A.3.d?
  • If yes, proceed to Step 8.
  • If no, proceed to the next step.
3
Make/send a follow-up request for the information and allow 30 days for a response.
4
Did the facility to which VA sent a follow-up request respond within the additional 30-day time period?
  • If yes, proceed to Step 8.
  • If no, proceed to the next step.
5
  • Clear the EP 290 that was established in accordance withM21-1, Part X, 15.2.a.
  • Establish EP 600, using
    • the current date as the date of claim, and
    • the Social Security Prison Match claim label.
Important:  Follow the instructions in M21-1, Part III, Subpart ii, 1.C.7 if no companion EP was established to run concurrent with the EP 290.
6
Send the beneficiary notice of proposed adverse action, using the sample language shown in M21-1, Part X, 15.3.
  • Inform the beneficiary that VA intends to reduce or discontinue his/her benefits effective the 61st day after the date of confinement printed on the Prison Match worksheet.
  • Include in the notice information about the right of eligible family members to
    • an apportionment of the beneficiary’s disability compensation or DIC, or
    • an allotment of the pension to which the beneficiary is otherwise entitled.
Important:
  • Send the notice of proposed adverse action to the primary beneficiary at his/her current address of record, regardless of whether the incarcerated individual is the beneficiary or a dependent.
  • Do not send the notice of proposed adverse action to the prison listed on the Prison Match worksheet unless the prison is the beneficiary’s current address of record.
  • If the address of family members that are eligible for an apportionment or allotment of the incarcerated beneficiary’s benefits is known, send VA Form 21-0788, Information Regarding Apportionment of Beneficiary’s Award, to them at the same time the notice described in this step is sent to the beneficiary.
Reference:  For more information about issuing notice of proposed adverse action based on incarceration, see M21-1, Part III, Subpart v, 8.A.3.f.
7
Proceed to Step 11.
8
Follow the instructions in the table below.
If information obtained in accordance with the instructions inM21-1, Part X, 15.2.f  shows …
Then …
  • the beneficiary or dependent was incarcerated for reasonsother than conviction of a
    • felony (if the beneficiary receives disability compensation or DIC), or
    • felony or misdemeanor (if the beneficiary receives pension), or
  • the beneficiary or dependent was incarcerated less than 60 days after conviction for a felony or misdemeanor
  • clear the EPs that were established in accordance with M21-1, Part X, 15.2.a, and
  • take no further action.
the beneficiary or dependent was incarcerated at least 60 days after conviction for a
  • felony (if the beneficiary receives disability compensation or DIC), or
  • felony or misdemeanor (if the beneficiary receives pension)
  • proceed to the next step.
9
  • Clear the EP 290 that was established in accordance withM21-1, Part X, 15.2.a.
  • Establish EP 600, using
    • the current date as the date of claim, and
    • the Social Security Prison Match claim label.
Important:  Follow the instructions in M21-1, Part III, Subpart ii, 1.C.7 if no companion EP was established to run concurrent with the EP 290.
10
Prepare notice of proposed adverse action, according to instructions in M21-1, Part III, Subpart v, 8.A.3.f, and send the notice to the beneficiary.
11
Did the beneficiary respond to the notice of proposed adverse action within 65 days of the date VA sent the notice?
  • If yes, proceed to the next step.
  • If no, proceed to Step 13.
12
Did the beneficiary submit evidence showing an adjustment of his/her award due to incarceration is not in order?
  • If yes,
    • clear the EP 600 and the EP that was established in accordance with the instructions in M21-1, Part III, Subpart ii, 1.C.7
    • notify the beneficiary that VA will not reduce or discontinue (whichever applies) his/her benefits, and
    • disregard the remaining steps in this table.
  • If no, proceed to the next step.
13
  • Reduce or discontinue benefits, under the EP 600, as proposed in the notice of proposed adverse action.
  • Clear the EP that was established in accordance with the instructions in M21-1, Part III, Subpart ii, 1.C.7.
Reference:  To execute the reduction or discontinuance in the claims-processing system, follow the instructions in M21-1, Part III, Subpart v, 8.A.3.g.
14
Notify the beneficiary of the action taken.
Reference:  For more information about issuing decision notices, seeM21-1, Part III, Subpart v, 2.B.

X.15.2.h.  References to Other Relevant Information

The table below contains references to additional information that is relevant to the procedure described in M21-1, Part X, 15.2.g.
For more information about …
See …
due process and the issuing of notices of proposed adverse action
the amount to which VA must reduce disability compensation when a beneficiary is incarcerated
the amount to which VA must reduce DIC when a beneficiary is incarcerated
apportioning an incarcerated Veteran’s disability compensation to his/her dependent(s)
apportioning an incarcerated beneficiary’s DIC to other family members
allotting an incarcerated Veteran’s pension to his/her dependents
allotting an incarcerated beneficiary’s Survivors Pension to other family members

X.15.2.i.  Reporting SSA Prison Match Cases

ROs are responsible for reporting the following information on all BOP and SSA prison matches:
  • total number of prison match cases received from SSA and/or the Bureau of Prisons (BOP)
  • number of prison match cases that required no action
  • number of prison match cases that required development and/or adjudicative action (to warrant the establishment of an EP)
  • number of prison match cases that resulted in the creation of an overpayment
  • total dollar amount of overpayments created as a result of the match(es)
  • number of cases referred for fraud under M21-1, Part III, Subpart vi, 5.A
  • cost avoidance in prison match cases that required an award adjustment
  • number of separate batches of prison match cases received, and
  • number of agencies to report. (Only SSA or BOP.  Or both SSA andBOP).

Notes:

  • Prepare and submit reports containing the above information on a quarterly (October 15th, January 15th, April 15th, and July 15th) basis.
  • ROs must e-mail their reports to VAVBAWAS/CO/212A.
  • PMCs must also e-mail their reports to VAVBAWAS/CO/PENSION POL & PROC.

Important:  Negative reports are required.

Reference:  For information about computer matches with BOP, see M21-1, Part X, 12.

3.  Notices of Proposed Adverse Action – No Response From the Facility in Which the Benefiicary or Dependent Is/Was Incarcerated


Introduction

This topic provides the suggested language to use in notices of proposed adverse action when the facility in which a beneficiary or dependent is/was incarcerated does not respond to VA’s request for information regarding the incarceration, and the primary beneficiary is otherwise entitled to

Change Date

April 4, 2016

X.15.3.a.  Beneficiary Entitled to Disability Compensation or DIC

Use the language in the paragraphs below when
  • preparing a notice of proposed adverse action
  • the facility in which a beneficiary is/was incarcerated does not respond to VA’s request for information regarding the incarceration, and
  • the beneficiary is otherwise entitled to
    • disability compensation, or
    • DIC.
We are proposing to reduce your monthly rate of [disability compensation or Dependency and Indemnity Compensationto $[amount] per month effective [date] based on information we have received from a computer match with the Social Security Administration that indicates you have been incarcerated at [name of prison] from [date].
Under 38 CFR. 3.665, your VA award is subject to reduction as of the 61st day of incarceration after conviction for a felony.  If you were not convicted of a felony, or if you were incarcerated less than 61 days following conviction, your award should not be reduced.
We attempted to contact prison authorities to confirm your dates of incarceration and whether incarceration was for a felony.  However, authorities at [name of prison] have not responded to our requests for information.
If you believe that your award is not subject to reduction because you were not convicted of a felony, or because you were incarcerated less than 61 days, please furnish documentary evidence of that fact or provide us with the name and telephone number of a governmental official (for example, District Attorney, parole officer, and so forth) who can verify that you were not convicted of a felony or were incarcerated less than 61 days.

X.15.3.b.  Beneficiary Entitled to Pension

Use the language in the paragraphs below when
  • preparing a notice of proposed adverse action
  • the facility in which a beneficiary or his/her dependent is/was incarcerated does not respond to VA’s request for information regarding the incarceration, and
  • the beneficiary is otherwise entitled to pension.
We are proposing to [stop or reduceyour pension award effective [date]based on information we have received from a computer match with the Social Security Administration that indicates that [you have or your dependent has] been incarcerated at [name of prison] from [date].
Under 38 CFR. 3.666, your VA award is subject to being [discontinuance or reductionas of the 61st day of incarceration after conviction for a felony or misdemeanor.  If [you were not or your dependent was notnot convicted of an offense, or if [you were or your dependent wasincarcerated for less than 61 days following conviction, your award should not be adjusted.
We attempted to contact prison authorities to confirm the dates of incarceration and whether incarceration followed conviction for an offense.  However, authorities at [name of prison] have not responded to our requests for information.
If you believe that your award is not subject to adjustment because [you were not or your dependent was notconvicted of an offense, or because[you were or your dependent wasincarcerated for less than 61 days, please furnish documentary evidence of that fact or provide us with the name and telephone number of a governmental official (for example, District Attorney, parole officer, and so forthwho can verify that [you were not or your dependent was not] convicted of an offense or that [you were or your dependent wasincarcerated less than 61 days.
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