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
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
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
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.