Transcript Slide 1

Developing Past Work for
Title II Disability
Beneficiaries
July 2014
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VCU NATIONAL TRAINING CENTER
Learning Objectives
After this training, CWICs should be able to:
• Describe the CWIC’s role in developing past wages
and/or self-employment income;
• Identify and describe the steps CWICs must take in order
to recognize when past work has not been developed;
• Describe the process Social Security uses to collect and
verify past wages or self-employment income; and
• Describe the protocol CWICs should use for collecting
past earnings information and developing past work.
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The CWIC’s Role in Developing Past Work:
Supporting the Beneficiary to Report Work and
Earnings
• Explain the work CDR process and help the beneficiary
understand the importance of developing work since
entitlement.
• Teach the beneficiary what documents to save (or
retrieve) to verify wages or earnings from selfemployment.
• Support the beneficiary in retrieving past wage data.
• Support the beneficiary in reporting work and earnings
including completion of the SSA 820/821.
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The CWIC’s Role in Developing Past Work:
Helping Prepare for a Work CDR
• Evaluate wages or NESE to estimate if and when TWP
months were used and if the TWP has ended.
• If TWP has ended, estimate the beginning and end dates
of the Extended Period of Eligibility (EPE).
• Recognize when work incentives might apply and assist
the beneficiary with gathering necessary documentation
of work incentives usage.
• Estimate if gross earnings or self-employment income
might represent SGA and if/when monthly benefits should
have been ceased.
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Recognizing When Past Work Has Not Been
Developed
Step 1: Ask probing questions about past work during the initial
information gathering process.
– Start by explaining that you need to know about past work in order to
provide accurate advice about how future work will affect benefit.
– Stress that it is very important to be as accurate as possible about past
work.
– Ask if ANY work has been performed since entitlement – wage
employment, self-employment , paid internships or other.
– Gather dates of employment, hours worked and wage rates.
– Ask if an income tax return was filed indicating any earned income or
self-employment income.
– Ask if wages were reported and if so, how they were reported.
– Ask the beneficiary if they have ever completed an SSA 820/821.
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Recognizing When Past Work Has Not Been
Developed
Step 2: Check beneficiary reports of past work against BPQY
(version 5.2).
– Look at IRS wages from date of entitlement onward – watch for
missing years or years of earnings not reported by the beneficiary.
– Review 5 most recent years’ monthly verified earnings.
– Check TWP usage.
– Check last work review action.
– Compare the information provided on the BPQY with the
information provided by the beneficiary.
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Indicators that Past Work is Undeveloped
• IRS annual earnings are listed, but not all of these
earnings show in the 5 most recent years’ earnings.
• IRS earnings average over the applicable TWP guideline,
but no TWP usage is indicated on BPQY.
• Last work review action is prior to years with IRS earnings.
• IRS earnings average over the applicable SGA guideline,
but month of cessation is left blank.
• Beneficiary alleges earnings but nothing shows on the
BPQY or most recent IRS years are missing.
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Beneficiary’s Description of Past Work Does
Not Match BPQY
• Send beneficiary a copy of the BPQY and call or meet to
go over it together.
• Gently probe into discrepancies between beneficiary’s
allegation of work and what shows on the BPQY. Use a
non-judgmental approach and explain why you are asking
the questions.
• Ask permission to contact Social Security to investigate
discrepancies. Get a signed SSA 3288 and fax it to the CR,
WIL or AWIC.
• Ask specific questions to determine what has and has not
been developed through contact with CR, WIL or AWIC.
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Developing Past Work – CWIC Protocol
• Help the beneficiary document past earnings on a monthby-month basis if possible.
• Begin with Social Security’s “preferred” wage verification
sources and systematically work down to secondary
sources as needed.
• CWICs should actively support beneficiaries through the
process of collecting past wage data – help strategize on
ways to find wage information and check in frequently to
assess progress.
• If the beneficiary cannot find wage documentation, help
reconstruct monthly earnings estimates.
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Social Security’s Primary Sources
of Wage Verification
1. Pay Stubs (or equivalent) - Copies are permitted in most
cases.
2. Disability Control File (DCF) Verified Monthly Earnings – If the
wages were previously reported and are posted to the DCF
no further verification is needed.
3. Certified wage information provided by TTW Program
Manager.
4. Supplemental Security Income Record (SSR) Verified Monthly
Earnings – Be careful to count wages when EARNED, not
when received.
5. Monthly Wage Verification from Employer – This includes
direct contact with the employer or using The Work Number,
Verify Job System and Verify Direct.
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What to do when Preferred Sources of
Verification DO NOT Exist
• If the beneficiary has NO record of monthly wages and it is
not possible to get this information directly from the
employer, CWICs must work with Social Security to
develop secondary sources of wage verification.
• Secondary sources generally only provide ANNUAL
earnings figures instead of monthly amounts.
• Check first to see if Social Security has access to annual
wage information from within its own system.
• If nothing is available, the CWIC will need to work directly
with the beneficiary to try to gather annual wage
information.
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Secondary Sources of Verification
Some sources available to Social Security include:
• The Detailed Earnings Query (DEQY) - lists yearly earnings by
employer;
• Disability Control File (DCF) unverified monthly wage postings;
• Online Child Support Enforcement postings;
• Earnings report from reliable governmental sources (worker’s
compensation, Unemployment Insurance, etc.)
Sources CWICs may need to help with include:
• W-2 Forms, 1099 Forms or completed tax returns;
• Last pay stub for a year from employer that lists year-to-date
earnings; and
• Earnings reports from another reliable source (VR agency, EN,
supported employment provider, One-Stop Center, etc.)
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Verifying Self-Employment Income
• Social Security uses annual tax returns to verify selfemployment income (SEI).
• Social Security counts NET earnings from self-employment
(NESE).
• To determine SGA, Social Security will average the
COUNTABLE NESE (less work incentives) over the number
of months the beneficiary operated the business in the
year.
• Month-by month verification of SEI is only necessary
during the TWP. Remember that TWP months are used if
the beneficiary works in the business for 80 or more
hours, regardless of earnings.
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Missing Wage Data
• When no monthly breakdowns are available or there are
gaps in wage data, CWICs need to help beneficiaries
reconstruct monthly earnings. The goal is to make the
most accurate estimate using the information available.
• See POMS DI 10505.005, for detailed instructions on ways
to reconstruct monthly wages using partial information.
• If there is not enough information to reconstruct monthly
earnings, Social Security will divide the gross countable
annual wages by the number of months the beneficiary
alleges he/she worked in that year.
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How Social Security Reconstructs Wage Data
If all the beneficiary knows is the wage rate and the months
worked, Social Security reconstructs monthly wages in this
manner:
1.
2.
Multiply the wage rate by 173 (average monthly hours for full time
work); or if work was part time, establish an estimated number of
hours worked per month. For example, if the beneficiary indicates
half time work, use 173/2 = 86.5 hours per month.
Multiply the monthly estimate by the number of months worked in
the year and compare this figure to the verified annual wages.
Reconcile or adjust monthly estimates as necessary.
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More Wage Reconstruction Strategies
• If the beneficiary can only provide an hourly wage rate,
Social Security determines the approximate hours worked
by dividing the verified annual wages by the rate. They
divide this figure by the number of months the beneficiary
alleges he/she worked to establish a monthly estimate.
• If a weekly wage rate can be determined, Social Security
multiplies this by 4.333 to determine estimated monthly
wages. Social Security will reconcile this with verified
annual earnings and adjust as necessary.
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Verifying Wages That Are More Than
4 Years Old
• If no verified wage information is in the DCF or the SSR and
the beneficiary has not retained pay records, Social Security
assumes that old wages will not be easily verified through
employer contact.
• CWICs should still instruct the beneficiary to contact the
employer (if possible) to retrieve month-by month wage
data or use any preferred source of wage data.
• If this is not possible, CWICs should advise on other ways to
collect wage information from secondary sources.
• It is important to collect the most accurate data possible to
avoid incorrect TWP/SGA determinations.
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Tips for Developing Accurate Wage Data
• Remember to develop wages when they are EARNED, not
when they are PAID. Data from pay stubs may have to be
divided by the number of days worked. Social Security
uses a Pay Distribution Calculator Tool to do this.
• In-kind items received in lieu of pay are counted as earned
income.
• Countable earnings do NOT include sick pay, vacation
pay, reimbursement for business expenses or any other
income that is NOT remuneration for work performed.
• Be careful with self-employment cases. Social Security
counts NESE, not gross income from the business. Ask
about number of hours worked to determine TWP
months.
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CWIC Role in Determining Usage of TWP and
EPE Months
• Estimate usage of TWP months and if TWP has ended. If
TWP appears to have ended, CWICs should indicate start
and end of EPE.
• Examine work activity month-by-month—don’t assume!
• Understand that TWP information on the BPQY is only
what Social Security knows from beneficiary reports. If
the work has not been developed, no TWP months will
show as having been used.
• Use TWP/EPE tracking chart to demonstrate TWP and EPE
use as part of BS&A development.
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What to do if Wages Appear to be SGA
• If the evidence is clear that gross wages are below the SGA
guideline, no further development is necessary. Wage
information may be sent to Social Security for TWP analysis.
• If earnings are over the SGA guideline, check for work
incentives potential (Unsuccessful Work Attempts, IRWEs,
Subsidy or Special Conditions).
• Interview the beneficiary using the 820/821 forms to detect
potential for work incentives usage. Give examples to help
the beneficiary understand what information is being
sought. Further development may be necessary in some
cases.
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Identifying Potential
Unsuccessful Work Attempt (UWA) Cases
• Watch for short periods of SGA level wages (1-6 months)
with breaks in between.
• More than 6 months of SGA level work cannot be UWA.
• Ask beneficiaries about breaks in SGA level work – what
happened to cause the wages to stop or be reduced?
• Remember that the UWA criteria for work lasting 0-3
months is less stringent than the criteria which applies to
work lasting 4-6 months. More development will be
required for the 4-6 month cases.
• Document the reason for the break in employment on the
SSA 820/821 and use additional comments space to
explain as needed.
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Limits of UWA Provisions
• UWA is not applied during the Trial Work Period (TWP)
since benefits cannot be ceased due to work during this
time.
• UWA is also not applicable after Social Security has
determined the beneficiary has engaged in SGA and
established the cessation month.
• UWA is only used to make the original SGA determination.
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Developing IRWEs
• Ask beneficiaries about expenses they incurred because of
working that are related to the disability – give examples
and ask probing questions!
• Remember that the list of IRWEs in the POMS is not allinclusive. If an expense seems to meet all 5 criteria for an
IRWE, help the beneficiary submit the IRWE evidence to
Social Security for a determination.
• There is no required IRWE request form. Use the template
on the VCU NTC website to describe the IRWE, or simply
help the beneficiary write a description and attach it to
the 820/821 .
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Developing Subsidy & Special Conditions
• Start by going through the questions on the SSA 820/821.
• If an employer-based subsidy appears to be in evidence,
use the SSA 3033 to gather more information from the
employer.
• Help the beneficiary get the SSA 3033 form completed by
the employer. CWICs may need to talk directly to the
employer, but ONLY with a signed release from the
beneficiary (signed 820/821 meets this requirement).
• If special conditions are in evidence, the beneficiary may
need to gather information from the agency providing
services. CWICs should assist as needed.
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Reminders about Work CDRs and SGA
Determinations
• CWICs assist with providing the information needed for
TWP/SGA determinations, but only Social Security can
make these determinations.
• Help the beneficiary understand what to expect in terms
of TWP/EPE usage and whether work is likely to be
considered SGA.
• The beneficiary must be actively engaged in verifying
wages and developing work incentives – the CWIC cannot
do this in isolation.
• CWICs must be mindful of their ethical obligations when
helping beneficiaries develop and document past work
activity.
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Final Words
• Developing past work is a critical part of a CWIC’s job.
Active intervention on the part of the CWIC is required!
• Developing past work must be done in close collaboration
with Social Security and the beneficiary.
• If past work is undeveloped, there is no way to know
which work incentives remain available to a beneficiary.
• Full BS&A development cannot occur until all past work
has been thoroughly examined and work incentives usage
verified.
• CWICs must complete this work with all due diligence – no
shortcuts!
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