Virginia Commonwealth University's Benefits Assistance Resource Center Briefing Paper Vol. 4 March, 2002 Getting the Right Answers to Work Incentives Questions: Navigating the Social Security Administration's Website (www.ssa.gov) Developed by: Lucy Miller Introduction When providing benefits planning, assistance and outreach services, Benefits Specialists constantly encounter difficult questions about SSI/SSDI benefit operations and work incentives. Because Social Security operations are complex and are subject to change no training program or benefits manual could ever offer 100% of the information that a Benefits Specialist will ultimately need. What distinguishes highly effective Benefits Specialists from those that are merely mediocre is the willingness and ability to conduct the necessary research to find answers to pressing questions. This document is designed to provide specific instruction on how to use SSA's website to gain the answers Benefits Specialists need. The Social Security Act How to Locate: Start on the SSA Home Page (www.ssa.gov) Scroll down the categories on the far left side of the screen until you reach the general heading of "SSA Program Rules" Click on "Laws, Regulations and Rulings" Click on "Compilation of Social Security Laws" What does the Social Security Act contain: The SSA website offers the full text of the Social Security Act, as amended, and selected provisions of the Internal Revenue Code. The Social Security Act is the actual legislation starting in 1935 that governs all Social Security programs this is the primary source document for all Social Security questions. The online Social Security Act is updated periodically and the date of the last update will be indicated. New legislation related to SSA, as well as proposed legislation can be found on this page. Pros and cons of using the Social Security Act for research: The best thing about the Social Security Act is that it is the ultimate distillation of the SSA programs. It carries the force of law and reading it really helps Benefits Specialists understand the original intent of provisions. The down side to using the Act is that legislation can sometimes be difficult to read. It also is not written to provide operational detail and therefore it will not offer information about how SSA implements provisions in practice. The Code of Federal Regulations (CFR) How to Locate: Start on the SSA Home Page (www.ssa.gov) Scroll down the categories on the far left side of the screen until you reach the general heading of "SSA Program Rules" Click on "Laws, Regulations and Rulings" Click on "Code of Federal Regulations" What does the CFR contain? The CFR puts some "meat" on the bones of the Social Security Act. The Code of Federal Regulations describes how the SSA puts legislation into practice and how provisions will be implemented. Regulations are written by SSA staffers and go through a public commentary process before they are made final. This web page lists all final regulations related to Title 20 of the CFR (basically all regulations related to Social Security). Regulations related to SSDI are contained in Part 404 and SSI regulations in Part 416. This web page also offers places to check on the newest regulatory changes and an "SSI Law and Regulation Finder" that provides specific references to SSI law and regulations. Pros and cons of using the CFR for research: The advantage of using the CFR is that it offers general summary information about how the SSA implements the law. It is written in relatively simple language for the general public and is fairly understandable. It is a great place for Benefits Specialist to begin researching very complex concepts like "deeming" or SGA determinations. It offers some operational information, but not an overwhelming amount of detail. The downside to using the CFR is that it is general in nature and does not describe the exact "how-to" that guide day-to-day operations in an SSA Field Office. The CFR is also not used by SSA staff in their daily work and so is not particularly helpful when trying to resolve differences in interpretation of provisions. Social Security Rulings and Acquiescence Rulings How to Locate: Start on the SSA Home Page (www.ssa.gov) Scroll down the categories on the far left side of the screen until you reach the general heading of "SSA Program Rules" Click on "Laws, Regulations and Rulings" Click on "Complete Social Security Rulings and Acquiescence Rulings" What do the Social Security Rulings and Acquiescence rulings contain? There are two types of Rulings: Social Security Rulings and Acquiescence Rulings. Social Security Rulings may be based on case decisions made at all administrative levels of adjudication, Federal court decisions, Commissioner's decisions, opinions of the Office of the General Counsel, and other policy interpretations of the law and regulations. Although Social Security Rulings do not have the force and effect of the law or regulations, they are binding on all components of the Social Security Administration (SSA) and apply nationally. Acquiescence Rulings explain how SSA will apply decisions of the United States Courts of Appeals that are at variance with SSA's national policies in adjudicating claims under Title II and Title XVI of the Social Security Act and Part B of the Black Lung Benefits Act. Acquiescence rulings only apply to the states that are in the Circuit Court jurisdiction in which the case was heard! Acquiescence rulings are important because they describe policies and practices that are unique to certain circuits. Pros and cons of using the Social Security Rulings and Acquiescence Rulings for research: The Social Security Rulings are important because they describe policy interpretations that apply in all states, but that may not be described anywhere else. Some may be detailed in the POMS, but they are not easy to locate. The Acquiescence Rulings (AR) are critical because they represent significant variance in how SSA interprets the law across circuits. All Benefits Specialists should acquaint themselves with the ARs in force in their home state. This information is not reliably found anywhere else. The Rulings are not easy to read and understand, but are necessary information. The SSA Program Operations Manual System (POMS) How to Locate: Find the POMS Online at: http://policy.ssa.gov/poms.nsf/aboutpoms What does the POMS contain? The POMS will be the main reference source for Benefits Specialists. It is the manual used by SSA staff to direct how they do their jobs. It describes in great detail how to apply all SSA regulations in day-to-day practice, and gives specific instruction on how to process or develop all provisions. The POMS covers all programs of the SSA, not just SSI/SSDI, and is organized into 8 broad categories to include: RM--Records Maintenance HI--Health Insurance RS--Retirement & Survivors Insurance DI--Disability SI--Supplemental Security Income GN--General NL--Notices, Letters, and Paragraphs VB Special Veteran's Benefits It also contains all SSA forms with instructions for SSA staff on how these forms are to be completed. It is an enormous operational policy manual system that is constantly being revised and expanded. Only the POMS can help a Benefits Specialist understand the internal workings of the SSA with regard to SSI/SSDI provisions. Benefits Specialists must become proficient in using the POMS to conduct research in order to provide accurate, current, and complete information to beneficiaries and recipients. Pros and cons of using the POMS for research: The best thing about the POMS Online is that it is a searchable database. No other sources of information included in this document will offer this feature. While the POMS is enormous, it can be searched with relative ease to gather the specific information. It also is the only source of detailed information on how SSA operationalizes the regulations. Finally, the POMS is written in the language of SSA and is very useful when communicating with Claims Representatives. The disadvantage of the POMS is that it is written for SSA employees and contains a myriad of technical terms and instructions that are alien to Benefits Specialists. It takes time and experience to use the POMS effectively and efficiently. Another problem is that the POMS constantly changes and not all sections are revised to include the new information at the same time. This means that sections may contradict one another. Finally, although the POMS is very inclusive, it does not always address every question in a manner that is understandable to Benefits Specialists. There will be times when assistance is needed to interpret the POMS correctly or to fill in the gaps when specific answers are not provided. The Social Security Handbook & Other SSA Publications How to Locate: Start on the SSA Home Page (www.ssa.gov) Scroll down the categories on the far left side of the screen until you reach the general heading of "Benefits Specialists" Click on "Publications" Click on "Social Security Handbook" What does the Social Security Handbook contain? The SS Handbook contains brief descriptions of all SSA administered programs, as well as related programs administered by other agencies. It is a readable, easy to understand resource for the complex Social Security programs and services. The Social Security programs are so complex it is impossible to include information about every topic, but the Handbook does includes all the most common and helpful information. The current version of the Handbook includes the provisions of the Social Security Act (the Act), as amended through December 31, 2000, regulations issued under the Act, and precedential case decisions (rulings). In case of a conflict between the contents of the Handbook and the Act, Regulations, and Rulings, the latter take precedence. Pros and cons of using the Social Security Handbook for research: The best feature of the Handbook is that it is written for the novice beneficiary or recipient. It contains very plain language that is easy to understand. Benefits Specialists are encouraged to print sections out of this publication to give to beneficiaries/recipients when explaining provisions, or to teach beneficiaries how to research questions on their own. Although it is not "searchable", the Handbook is laid out in a very logical, organized manner, which makes it easy to locate specific information. On the downside, the Handbook is not inclusive of everything that a Benefits Specialist would want to know. Information is fairly brief and sticks very closely to the wording in the CFR. The Handbook is also not current, caution must be exercised when using the Handbook to insure that the most updated information is accessed. Other Information Useful to Benefits Specialists The SSA website contains much more information than is listed in this document. Under the general publications category, SSA provides access to all publications available in English and Spanish. These publications cover a wide range of topics and are extremely useful when counseling beneficiaries and recipients. These publications are free, written in plain language, updated on a regular basis, and approved by the SSA as containing correct information. In addition, the Policy, Research and Statistics page provides access to a wealth of research information useful for benefits specialists. Data on the number of beneficiaries/recipients by state and region, research monographs on a variety of topics as well as position papers are all available online. Finally, the SSA Office of Employment Support Programs provides information on its web page at www.ssa.gov/work which is useful for beneficiaries, advocates, employers, service providers and Benefits Specialists. Descriptions of the Benefits Planning Assistance and Outreach (BPAO) and Ticket- To-Work Initiatives are provided as well as contact information on BPAO providers. Content on these web pages is really geared toward employment issues for persons with disabilities who receive SSI/SSDI and other interested parties. Frequently Asked Questions As a BPAO Benefits Specialist, do I really need to use the POMS? Why can't I just use my BPAO manual and call my Regional Training Center Liaison to get the answer to my questions? Yes, BPAO Benefits Specialists really do need to be proficient at using the POMS to research questions for several reasons. The BPAO manual, while an excellent document, cannot take the place of the POMS for getting the necessary detail you may need to understand complex issues. Also, using the POMS increases your independence and the speed at which answers to critical questions may be found. At some point, access to technical assistance on SSA benefits may not be as available as it is now it is better to learn the skills necessary to become independent. Finally, using the POMS helps you understand the internal workings of SSA Field Offices. You need to speak the same language as the local Claims Representatives in order to communicate effectively with them. I have tried to do a search on the POMS, but was unable to find the phrase I was looking for what am I doing wrong? This is a common problem, because Benefits Specialists do not use the same terms as SSA staff. For example, a recent search for 401(k) plans resulted in no matches. Even searching under the phrases "retirement plan" and "pension plan" did not result in the correct POMS citations. It was only when the phrase "deferred compensation plan" was used that the information was found. Time and experience with using the POMS will result in a better understanding of the phrases used by SSA personnel. It is always a good idea to try as many different phrases as possible for a key work in a search. This process is time consuming, but you will get faster over time. Do I need to look up every question in all the sources you cited here in order to get all the information I need about an issue? No that method would be far too time consuming and usually unnecessary. Use the source that will best suit the intended audience and provide the level of detail that you need. For the most part, Benefits Specialists will need to start with the POMS. If the POMS citations are too numerous and complex, then a good strategy is to take a step back and begin with a simpler source of information such as the CFR or the Social Security Handbook. Once you have a basic understanding of the issue, you may find the POMS easier to understand. It is not a good idea to send POMS citations to lay people such as beneficiaries/recipients and family member, however, there may be times when this is appropriate. Using the POMS, the CFR and the Social Security Act to look things up takes too long I really need fast answers to the questions. How do I get the information I need as fast as I need it? If you have to choose between FAST and CORRECT it is always better to choose correct. Providing speedy answers that are wrong or incomplete is extremely dangerous business. Keep in mind that the mistakes caused by poor advisement can be quite serious. Those mistakes can take days, weeks or months to straighten back out again. In the meantime, the beneficiary/recipient may suffer severe consequences! In this case, the old adage, "a stitch in time saves nine" is absolutely applicable. Besides, the very fastest way to get complete, accurate, and current information is to use the web to access the materials described in this document! The more you practice, the faster you will get! Sometimes when I do a key word search in the POMS I get selected citations from other sections besides SI (SSI) and DI (SSDI). Could these citations be applicable? Yes, that can happen; for example, if you want to know what counts as wages for the purposes of SSDI, the citations explaining this issue are actually listed in the RS (Retirement and Survivor's) section. Don't assume that only citations beginning with DI are applicable. Since SSDI is only one type of Title II benefit, there are many times that RS citations may apply to DI. Also, keep in mind that some sections apply to all SSA programs; there is a "general" category and also one including information about SSA forms and letters. Experience will help ease the confusion over this, but there may continue to be times when you are not sure if a citation applies. Seek assistance from your RTC Liaison when in doubt. Resources Work Disability (DI, Part 4) DI 10501 -- Substantial Gainful Activity DI 10505 -- Evaluation and Development of Employment (includes subsidy* under "Determining Countable Earnings" and averaging** under "Determining Average Earnings") DI 10510 -- Evaluation and Development of Self-Employment DI 10520 -- Impairment Related Work Expenses (IRWE)* DI 11010.210-.200 -- Unsuccessful Work Attempt (UWA)** Title II -- Work Incentives DI 13010.035-.070 and E13010 Trial Work Period (TWP) DI 13010.20-.225 Extended Period of Eligibility (EPE) *IRWE and subsidy apply when determining SGA cessation and payment in the EPE **Averaging and UWA attempt apply when determining SGA cessation BUT NOT payment in the EPE SSI Income, Resources and Computations SSI (SI, Part5) SI 00800. SSI Income Chapters SI 01100. SSI Resource Chapters SSI 02005. SSI Computations SSI Work Incentives Earned Income Exclusions--General SI 00820.500 Student Child Earned Income Exclusion SI 00820.510 $65 Plus One-Half Remainder Per Month Earned Income Exclusion SI 00820.520 Work Expense Exclusions -- General SI 00820.530 Blind Work Expenses (BWE) SI 00820.535 Impairment-Related Work Expenses (IRWE) SI 00820.540 Work Expenses - Interaction with Other Policies SI 00820.545 Work Expenses Development and Documentation SI 00820.550 List of Type and Amount of Deductible Work Expenses SI 00820.555 Allocating Work Expenses SI 00820.560 BWE Worksheet SI 00820.565 Plans for Achieving Self-Support (PASS) SI 00870.001 ff. Property Essential to Self-Support (PESS) SI 01130.500 ff. Continuing Benefits and Recipient Statuses Under 1619 (A) & (B) SI 02302.006 ff. Virginia Commonwealth University's Benefits Assistance Resource Center Give us a call or e-mail us....We are the answer to your Social Security Work Incentives questions!!! Virginia Commonwealth University Benefits Assistance Resource Center P.O. Box 842011 1314 W. Main St. Richmond, VA 23284-2011 (804) 828-1851 VOICE -- (804) 828-2494 TTY -- (804) 828-2193 FAX http://www.vcu-barc.org 2002 , VCU-RRTC on Workplace Supports -- Permission to Reprint pard Virginia Commonwealth University, School of Education and Department of Physical Medicine and Rehabilitation is an equal opportunity/affirmative action institution and does not discriminate on the basis of race, gender, age, religion, ethnic origin, or disability. If special accommodations are needed, please contact Vicki Brooke at (804) 828-1851 VOICE or (804) 828-2494 TTY. This activity is funded through a contract (#0600-00-51200) with Social Security Administration.