EEOICPA BULLETIN NO.09-10                      

 

Issue Date:  March 1, 2009

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Effective Date:   March 1, 2009

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Expiration Date:  March 1, 2010

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Subject: Processing Social Security Administration Form SSA-581.

Background:  When the Division of Energy Employees Occupational Illness Compensation (DEEOIC) first initiated procedures for verifying covered employment, action was taken to obtain employee wage and earning information from the Social Security Administration (SSA). This information proved important for validating periods of claimed employment and linking named employees to covered beryllium vendors, atomic weapon employers or Department of Energy facilities.

DEEOIC submits form SSA-581 (Authorization to Obtain Earnings Data from the Social Security Administration) to the SSA to obtain earnings information for an employee.  Once SSA has completed the request, SSA mails an SSA-L460 to the address specified, indicating the amount of income earned by the employee during the time period indicated on the SSA-581.  As part of the procedure for interacting with the SSA, the DEEOIC devised a centralized process for obtaining employment records.  Since the procedure has been in place, the number of SSA-581 referrals has steadily increased. 

To streamline and improve the timeliness of SSA-581 referrals to the SSA, this Bulletin confers authority to obtain SSA wage and earning data to the District Office (DO). Rather than forwarding the SSA-581 forms to a centralized location for processing, all relevant actions pertaining to the completion of the form and interaction with the SSA will occur at the DO.  

 

References: Energy Employees Occupational Illness Compensation Program Act of 2000, as amended, 42 U.S.C. § 7384 et seq., 20 CFR § 30.805, PM E-800.

 

Purpose:  To provide guidance to the District Offices for submitting Form SSA-581 to the Social Security Administration.

 

Applicability:  All Staff

 

Actions:

 

1. The Resource Center (RC) is responsible for obtaining a completed SSA-581(see Attachment 1 for an example) for certain walk-in claims filed through the RCs.  The SSA-581 form is collected from all employee claimants and from clearly eligible survivors. Each DO has an office-specific form indicating where SSA must send the results of the inquiry.  The SSA-581 forms for each office are located on the Share Drive in the Policies and Procedures folder, Forms subfolder.  The RC advises the claimant that the completed SSA-581 is needed for the collection of wage and earning data from the SSA.  If the Resource Center does not obtain the SSA-581, or if a claim (EE-1 or EE-2) is submitted directly to the DO, the Claims Examiner (CE) should send an SSA-581 to the claimant, if it is needed for employment verification and/or determination of wage loss.  To be processed by SSA, a signed SSA-581 must be dated no earlier than 60 days from the date of submission to the SSA.  If the timeframe between the signature date of the SSA-581 and submission to SSA exceeds sixty (60) days, the CE or RC will need to obtain a new, signed and dated SSA-581. 

 

2. Whenever subsequent development is undertaken with regard to employment verification, a request should be made to the claimant to complete a SSA-581 form, if pertinent wage and earning documentation is not present in the case record. A claimant should be advised that completion of the SSA-581 is a crucial part of the employment verification and/or wage loss process and that their signature on this SSA-581 is only valid for sixty (60) days.  The information required on the SSA-581 form depends on the type of request.  In a development letter, the CE advises the claimant of the information needed on the SSA-581:    

 

a. Employee Claims:  The employee or CE is to complete the following sections of the SSA-581: name; social security number; date of birth of employee; and other name(s) used.  The claimant must add information for address/daytime telephone number of employee; date signed; signature of social security number holder or authorized representative; and printed name of social security number holder or authorized representative. 

 

b. Survivor Claims: The survivor or CE is to complete the following sections of the SSA-581 form: name of social security number holder (employee); employee’s social security number; date of employee’s birth; date of employee’s death; and other name(s) used.  The survivor will fill-in the survivor’s address/daytime telephone number; indicate the appropriate box to show relationship; add the date signed; sign the form; and print their name in the requested space. 

 

The CE will explain that the survivor must provide proof of the employee’s death and his or her relationship to the employee.  Proof of death includes: a copy of the death certificate, mortuary or interment record, or court issued document.  Proof of relationship includes:  marriage certificate, birth certificate, adoption papers, or other court issued document(s).  SSA requires that these documents be submitted in order to process requests from survivors. 

 

  Once the correspondence is prepared and released to the claimant, the CE should update the claim status screen in ECMS by entering code DE (Developing Employment) with a reason code of LE (Letter to Employee) or DO (Developing Other) with a reason code WL (Wage Loss).  The WL code is only input when the reason for the collection of the SSA-581 pertains to a claim for wage loss. The status effective date for code input is the date on the correspondence to the claimant.

 

3. Once the claimant returns the signed SSA-581 document and any accompanying documents, the CE or RC staff will complete the following sections:

 

a. The CE or RC staff will fill in the years deemed necessary to verify employment and/or establish wage loss on the “Periods Requested” line.  The CE or RC staff is to identify the time period for employment history by searching the Energy Case Management System (ECMS), the records in the case file, wage loss claims, or other documents or forms in the file. 

 

In the box titled, “Requesting Organization’s Information,” the CE or RC staff will sign in the section, “Signature of Organization Official” as well as provide the district office toll free telephone number and fax number.

        

b. The CE or RC staff will make sure that the upper right hand corner of the form allocated for “Requesting Organization:” indicates the correct district office where SSA’s response should be sent.

 

4. The original (signed) SSA-581, and supporting documents (if the request is submitted by a survivor) must be submitted via Federal Express to the SSA, Wilkes Barre Data Operations Center (WBDOC), at the following address:

 

The Social Security Administration

Wilkes Barre Data Operations Center

PO Box 1040

Wilkes Barre, PA 18767-1040

 

a.  The CE will update the case status screen in ECMS by entering SS (Sent to Social Security) status code. The status effective date is the date the SSA-581 form is sent to SSA.  The CE date stamps the form at the time that the form is sent to SSA, and this date serves as the status effective date.  A copy of the form is retained in the case file.

 

5. Following submission of a Form SSA-581, the CE or employee so designated by the District Director, is responsible for determining if SSA has received the earnings request (Form SSA-581) and for obtaining a status update on the employment verification request.

a.  If there has been no response from SSA within thirty (30) calendar days of the date of the submission to SSA the CE will call to obtain a status update.  The telephone call should be documented in the TMS section of ECMS and a printed copy placed in the case.  If SSA indicates that no SSA-581 form has been received, the CE must resubmit the form.  Otherwise, the CE will obtain the status and monitor for further follow-up. 

b.  Inquiries to SSA are made by calling one of ten phone numbers (Modules) depending on the last four digits of the relevant SSN.  (See Attachment 2).

c.  If the CE does not receive a completed SSA-L460 within thirty (30) days of the first inquiry call to SSA (the 60th day), the CE will make another follow-up call to determine the status of the request and proceed as necessary. At this point, it will be necessary to obtain a newly signed SSA-581 from the claimant and resubmit the SSA-581 to SSA as outlined above.

 

6. After the completed SSA-581 form is sent, and a copy is placed in the case file, a SSA Point of Contact (POC) designated by the District Director will ensure that the form is logged into a tracking spreadsheet.  Each DO is responsible for determining a method for developing a system of logging and tracking each claim, but the spreadsheet should contain, at minimum, the case number, date sent to SSA, and cost of the request. On a quarterly basis National Office will sample each log maintained by the DOs to monitor costs.

 

7. The designated employee must determine the cost of the request according to the period of years for which information is sought.  Form SSA-7050-F4 (Request for Social Security Earnings Information) (Attachment 3) identifies the cost by the number of years requested. For example, if one (1) year of earnings information is requested, the cost is $15.00. The cost increases incrementally by year, up until forty (40) years of requested employment.  For each year after forty (40) years, add $1.00 for each year. 

 

8. At the end of each quarter, the DOL National Office SSA POC will obtain the SSA-581 submission logs maintained in each DO and sample the contents to properly evaluate contract outlays. 

 

9. Upon receipt of a completed SSA-L460, the CE will update the case status screen in ECMS by entering the SR (Response from SSA) status code. The status effective date is the date the SSA-L460 form is date stamped into the district office. The designated employee will confirm the years received by SSA equals the years used to determine the cost.  If there is a discrepancy, the DO SSA POC must contact SSA immediately to rectify the issue.

 

Disposition: Retain until incorporated in the Federal

(EEOICPA) Procedure Manual.

 

 

 

 

Rachel P. Leiton

Director, Division of Energy Employees

Occupational Illness Compensation

 

Attachment 1

Attachment 2

Attachment 3

 

Distribution List No. 1: Claims Examiners, Supervisory Claims Examiners, Technical Assistants, Customer Service

Representatives, Fiscal Officers, FAB District Managers,

Operation Chiefs, Hearing Representatives, District Office Mail & File Section.