Click to go to Chapter
Ch.1- Social Security Administration
Ch.2- Eligibility Requirements
Ch.3 Dual Entitlement
Ch.4- Applications
Ch.5- Disability
Ch. 6 Insured Status
Click to go to Chapter
Ch.1- Social Security Administration
Ch.2- Eligibility Requirements
Ch.3 Dual Entitlement
Ch.4- Applications
Ch.5- Disability
Ch. 6 Insured Status
Click to go to Chapter
Ch.1- Social Security Administration
Ch.2- Eligibility Requirements
Ch.3 Dual Entitlement
Ch.4- Applications
Ch.5- Disability
Ch. 6 Insured Status
§ 101 In General
§ 102 Internal Offices
§ 103 Telephone Services
§ 104 Internet Website
§ 105 Field Offices
§ 106 The Programs Operations Manual System
Section 101 - In General
The Social Security Administration (SSA) is the branch of the Federal government which has the duty of administering several provisions of the Social Security Act. The Social Security Administration (SSA) was under the jurisdiction of the Department of Health and Human Services until March 1995, when it became an independent agency. The Social Security Act provides for the payment of monthly benefits to retired and disabled workers and their dependents and to certain survivors of covered workers who are deceased. Social Security also provides for Medicare and other programs such as Supplemental Security Income and Black Lung benefits. The benefits referred to as Social Security benefits, however, are those monthly benefits payable to retired workers, disabled workers, and the survivors of covered workers. Because regular Social Security benefits are based on the earnings of covered workers, SSA also keeps track of the earnings of almost all American workers.
SSA pays 65 billion dollars each month to 56 million people throughout the United States, and there are 159 million covered workers whose wages are recorded by the Social Security Administration each year. For each beneficiary receiving a check there are 2.8 workers paying taxes. Taxes are collected by the Internal Revenue Service, and then reported by IRS to SSA. The Social Security Administration is one of the largest government agencies.
SSA is divided into many different bureaus and branches to accomplish all its duties. The main offices are located in Baltimore, Maryland. The entire United States is divided up by SSA into districts, each of which has its own District Office. Many of these District Offices also have branch offices. There are 1300 field offices throughout the nation. The District Office is designed to handle all contact with members of the public. Most dealings you may have with SSA normally will be done through your local District Office.
This chapter will discuss the different bureaus and their general functions and will discuss the different types of District Office employees with whom you will come in contact.
Section 102 - Internal Offices
The Social Security Administration (SSA) makes contact with members of the public through District Offices and Teleservice Centers (see Section 103 and 105 below). However, much of the work of SSA is done by people in offices which have no contact with the public. We will discuss some of these major offices that the public never sees. These are referred to as internal offices.
Central Office (CO). The main office of SSA is called the Central Office. It is the headquarters of SSA and is located in Baltimore, Maryland. The Central Office issues all regulations and instruction to the District Offices. It interprets the law, and issues policy statements.
Office of Central Records Operations (OCRO). This office deals with the huge volume of information necessary to perform the duties of the Social Security Administration. Its main functions include the assigning of Social Security numbers to workers, keeping track of changes of names on Social Security records, and maintaining the records of earnings reported by employers for each individual Social Security number. This office is also located in Baltimore, Maryland. When a person files a claim for Social Security benefits, the District Office where the claim is being handled must contact the Office of Central Records Operations to obtain the earnings record of the worker.
Program Service Centers (PSC). There are six Program Service Centers located throughout the United States. These offices process claims that cannot be processed by the District Office. They also process reinstatement of benefits after they have been suspended or terminated. After a claim has been processed in a district office it is sent to the Program Service Center for storage and further processing. The claims folders are generally assigned to the different program service centers based on the Social Security number of the wage earner on whose earnings the claim is based. Sometimes the Program Service Center will have direct contact with beneficiaries. They handle such things as student reports, annual report of earnings and overpayment notices. Any information requested from a Program Service Center can be returned directly or can be returned through a local District Office, whichever you prefer.
Office of Disability Operations (ODO). This office is similar to a Program Service Center, but it handles cases based on disability benefits. If a worker who is disabled is age fifty-nine or older, his file is maintained in the Program Service Center instead of the Office of Disability Operations. When the person turns sixty-five his disability benefit is automatically converted to a retirement benefit by the Program Service Center. This conversion to a retirement benefit is only a technicality; the amount of the benefit does not change. The files of disabled workers under age fifty-nine are kept in the Office of Disability Operations. This office is also located in Baltimore, Maryland.
Division of International Operations (DIO). This office is similar to a Program Service Center, but it covers cases where beneficiaries reside outside of the United States. It is also located in Baltimore, Maryland.
Regional Offices (RO). The entire United States is divided into ten regions by the Social Security Administration. Each region has a Regional Office which deals directly with the Central Office and then deals with the local District Offices within the region. An individual District Office in the region does not have direct contact with Central Office. Instead it deals through the Regional Office. The Regional Office is staffed with experts in all areas of Social Security. Regional offices also review the District Offices to make sure that they are applying the rules and regulations of Social Security consistently.
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Section 103 - Telephone Services
Teleservice Center (TSC) and Telephone Service. The Social Security Administration (SSA) has set up special centers designed to handle telephone inquiries from members of the public. These are called Teleservice Centers (TSC). They are designed to take the burden of voluminous phone calls away from the District Office. The nationwide toll free number is 1-800-772-1213. Service representatives handle calls from 7 a.m. to 7 p.m. on business days. Pre-recorded information and automated services are available after hours. Hearing impaired callers with TDD equipment can call 1-800-325-0778 between 7 a.m. and 7 p.m. Medicare information is available from 8 a.m. to 8 p.m. Eastern time at 1-800-638-6833. The telephone service is busiest in the early part of the week and the early part of the month. You will get through quicker if you call at other times.
The Teleservice Centers are staffed by Service Representatives (Section 105). They have computer terminals available to obtain the computer records of all beneficiaries who have been established on the computer. They are able to handle changes of address, and reports of missing checks. If a claim has been recently filed and has not yet been set up on the computer system, you will be referred to the local District Office where the claim is being handled. That phone number was given to you at the time you filed your initial application on the receipt form that Social Security gives everyone who files a claim. The Teleservice Centers can also provide general information about Social Security, although it is recommended that you speak with a Claims Representative if the question is more than basic.
District Office Telephone Service. Many District Offices have telephone service available to file claims, report changes of address or missing checks and obtain information regarding Social Security. Almost all business you may have with the Social Security office can be handled over the telephone. You can even file a claim on the phone. Many District Offices have what is referred to as a teleclaims unit. These units are staffed by Claims Representatives who will obtain the necessary information from you over the phone, complete the application form and mail it to you for your review and signature. It is against the policy of many Social Security offices to send out blank application forms. If you call them up to file a claim, you will have to give the information over the phone, so that the Claims Representative can properly fill out the application. This is done to ensure that there is no misunderstanding of information and that all the information and required evidence is obtained.
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Section 104 - Internet Website
The official Social Security website is found at http://www.ssa.gov/. It is comprehensive with many links. You can get a benefit estimate, request a statement of your social security record and even apply for most type of benefits online. You can quickly get access to research data and reports, forms, program rules, regulations, statutes and rulings. You can put in your zip code and find
the nearest field office. Of course, you must be fairly comfortable working with computers online to take advantage of these services. Because the official website is so comprehensive, many users will be overwhelmed. A search for "amount of benefits" for example, returns over 15 pages of results, each with 20 links to administrative rulings, actuarial data, projections of replacements rates and much more information that is very useful to sophisticated users. Because so much information is available, it may take some time and effort to hone in on just what you are looking for. There is a separate website for Medicare information found at http://www.medicare.gov/.
There are over 1,300 district and branch offices throughout the United States. Click here to find the nearest one to your zip code. Each district or branch office is responsible for dealing with all members of the public who reside in that district. Any business you may have to conduct with SSA will be done through your local District Office. You may determine where your District Office is located by looking in the telephone book under United States Government, Social Security Administration, by calling the nationwide toll-free number, or going online. You may deal with any District Office you prefer. District Offices are open during regular business hours. The exact times of opening and closing change from one office to another. Some offices open at 8:00 a.m. and close at 4:30 p.m. Other offices open at 8:30 a.m. and close at 5:00 p.m. Most of your business with Social Security can be conducted over the telephone or online.
If you wish to visit your district office in person, usually you cannot make an appointment. Visitors at the district office are taken on a first-come, first-served basis.
Field Office Locator
Best times to visit the District Office
If you go at the wrong time, you may have to wait an hour or more. It all depends on how crowded the office is when you get there. The volume of visitors to District Offices usually follows a pattern. Generally speaking, you are better off going to your District Office towards the end of a month. The first week to ten days is usually the busiest. It is at these times that you may encounter a wait of an hour or more. Generally the latter part of the week is less busy than the early part of the week. Mondays are usually very busy, whereas Fridays are slow.
The District Offices are busy during lunchtime. This is because many people who work go there at their own lunchtime and also because the Social Security employees have to eat, too. Interviewers at the Social Security office have staggered lunch hours so that at least half of them will be on duty during this time. However, because the other half is out to lunch the lines can grow and you may encounter delays at this time. Likewise, the employees at the District Office take coffee breaks. They receive a coffee break in the morning and in the afternoon. Again, these breaks are staggered, but at around 10:00 a.m. and around 3:00 p.m., half of the interviewers are on their coffee breaks.
Processing Units. The business handled by the District Office is divided into different units. Each unit is staffed by one or more employees. Among interviewers, the basic division is between claims units and service units. Claims units handle initial applications and the more complex areas of Social Security rules. They are staffed by Claims Representatives. The service units handle what are referred to as "post-entitlement" issues. These are the events that occur after you have become entitled to checks, such as changes of address, reports of missing checks, annual reports of earnings, and so forth. Service units are staffed by Service Representatives. A Service Representative is not able to handle an initial claim.
Generally, there is a special unit set up in each District Office to handle disability related cases and a special unit for Supplemental Security Income cases (Section 1401). In larger offices the work will be further divided among the Claims Representatives and Service Representatives based on an alphabetical breakdown.
Each Claims Representative and Service Representative will be assigned a certain part of the alphabet and the cases of all persons with names that fall within that part of the alphabet will be assigned to that particular Representative. That worker will handle the paperwork for the claim, but may interview people regardless of the alphabetical breakdown.
The different Claims Representatives and Service Representatives are periodically re-assigned to different alphabetical breakdowns, so do not be surprised to find that a different Claims Representative is handling your case a few months later.
The different types of employees that you come in contact with at the local District Office will be discussed later in this chapter.
In addition to District Offices, the Social Security Administration also sets up Branch Offices and contact stations. The Branch Office is a smaller version of the District Office and comes under its jurisdiction. It is staffed with the same types of employees found in the District Office. The manager of a Branch Office reports to the manager of the District Office with which it is associated.
The contact station is not a regular office. It is simply a place where a Field Representative or a Claims Representative will go on a periodic basis to service people in outlying areas. They are usually set up in areas where the jurisdiction of the District Office is large. The Field Representative will go to the contact station at set times, such as the third Tuesday of the month, for example. All paper work is taken back to the District Office and processed there by the regular personnel according to the alphabetic breakdown.
If you live far from your local District Office, you should find out if a contact station is set up closer to you and when the Social Security representative will be there. Contact Stations are commonly established in municipal buildings or senior citizen centers.
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District Office Personnel In General
Each District Office is staffed with many different types of employees, each one handling specific functions. Every District Office has a district manager who is the highest authority in the office. He or she is not usually involved with the technical aspects, such as deciding claims. His or her duties are basically administrative, such as maintaining personnel records and making sure the office work moves along quickly. He or she also deals with Congressmen and Senators who make inquiries on behalf of their constituents (Section 1014). The District Manager is the person to contact in the District Office if you wish to praise a particular employee for a job well done or to complain about an employee for poor service.
Generally, the district manager does not deal with the public on a regular basis. The employees who deal with the public regularly are Claims Representatives, Service Representatives, Field Representatives, and the receptionist. In addition to these personnel, there are supervisors, clericals and technical employees who deal with the paperwork and the computers. If you visit your local Social Security office and have to wait because all the interviewers are tied up interviewing people, you may see employees sitting at desks not interviewing anyone. Do not be upset, these are probably the non-interviewing personnel.
The Receptionist
When you go to your District Office, you will be greeted at the front desk by the receptionist who will ask your name and ask a few questions to determine the nature of your visit. It is his or her job to determine which employee should service you. At the District Office, different types of business are handled by different employees.
In addition to the reception duties, the receptionist usually handles matters dealing with Social Security numbers, such as applications for new numbers or changing names for the Social Security records. The receptionist has little training other than that and it is not a good idea to take advice on anything else from the receptionist. Some overzealous receptionists have been known to give erroneous information about Social Security matters. It is wise to take your advice only from a Claims Representative or Service Representative.
After taking your name and determining the nature of your visit, the receptionist will generally ask you to be seated and will assign you to the next available representative who handles your type of case. It is possible that other persons who have arrived after you will be taken care of first because a representative who handles their type of business is available before a representative who handles your type of business.
The Claims Representative (CR)
The Claims Representative position is perhaps the single most important position in the Social Security organization. It is the responsibility of the Claims Representative to be knowledgeable about all aspects of the Social Security regulations. The duty of the Claims Representative has two sides. One aspect is to represent the Social Security Administration (SSA) and the other aspect is to assist claimants who are making claims for benefits under the Social Security program. The major responsibility of the Claims Representative, of course, has to do with initial claims for benefits. The Claims Representative interviews a prospective claimant, determines the type of claim he or she should be making and completes the appropriate claims forms.
The Claims Representative also determines what documents, evidence, or other information is required to successfully prosecute the claim and advises the claimant accordingly. The Claims Representative also will take steps to obtain the necessary information or documents. Additionally, on many of these initial claims, the Claims Representative makes the decision to pay or to deny the claim. In addition to these claims duties, the Claims Representative is also responsible for making determinations relating to representative payees (Section1414) for incompetent beneficiaries, for making determinations of the proper amount of wages which are subject to Social Security, and for making recommendations about whether or not overpayments may be waived in particular cases. It is also the duty of the Claims Representative to provide the public with information about the Social Security rules, regulations and procedures.
In theory, the Claims Representative knows everything about all of the various aspects of Social Security. This knowledge is not gained in a short period of time however, and in a given District Office there will be Claims Representatives with varying degrees of experience. The person who becomes a Claims Representative is considered to be a trainee for three years in that position because it takes at least that long to get a good working knowledge of all the rules and regulations involved with the job. It takes at least another year of experience to become fully versed in all the aspects of Social Security for which the Claims Representative is responsible.
The majority of seasoned Claims Representatives are thoroughly knowledgeable professionals who are well versed in all aspects of Social Security law and regulations. There are some exceptions to that general statement. Because of the very complex and technical nature of the area, a number of Claims Representatives, even though they are on the job for many years, are still not thoroughly competent. Just as there are incompetent doctors and lawyers, there are incompetent Claims Representatives. If you believe that the Claims Representative with whom you are dealing is giving you erroneous or inaccurate information, ask him to show you in the program operations manual the authority for his statement (see Section106). If you are still not satisfied, you should then ask to speak to an operations supervisor to double check.
The Service Representative (SR)
As noted above, there are two basic types of employees who interview the public - Claims Representatives and Service Representatives. The Claims Representative is discussed above. The Service Representative deals with "post-entitlement" aspects, i.e., things that affect people who are already receiving benefits.
Changes of address, reports of missing checks, annual report of earnings, refunds of overpayments, and Medicare claims are the most common things with which the Service Representative deals. These employees are also well versed in the "retirement test," also known as the earnings limitations rules. The "retirement test" is used to determine how earnings affect benefits. This is fully discussed in Chapter 8.
Service Representatives do not handle claims, payee determinations, changes to the earnings record or other complex areas of Social Security.
The workload in a District Office is divided among the Service Representatives according to an alphabetical breakdown. Beneficiaries are assigned to Service Representatives based on their last names. The Service Representatives are periodically re-assigned to different alphabetical breakdowns. You may not always have the same Service Representative assigned to your case each time you go to the District Office. The alphabetical breakdowns are used only for paper work processing. Interviewers may be assigned without regard to alphabetical breakdowns if this is required to avoid delays.
The job of the Service Representative requires a thorough knowledge of complicated rules and procedures. Most Service Representatives are very competent. Unfortunately, some are not. If you question the accuracy of information or advice from a Service Representative, you should ask him or her to show you in the claims manual or programs operations manual (Section106) the authority for the information. If you are still not satisfied, you may ask to speak to an operations supervisor.
The Field Representative (FR)
Each District and Branch Office has at least one Field Representative. A Field Representative is a Claims Representative who goes out of the office when the need arises. This usually occurs when a claimant or beneficiary is homebound or in a hospital. The Field Representative makes speeches before groups and visits contact stations. The Field Representative does not usually process the paper work personally. He or she brings it back to the District Office where it is assigned to the appropriate Claims Representative or Service Representative according to the alphabetical breakdown, as discussed above.
If you belong to a group or an organization that would like to hear a speaker on Social Security matters, you can call your local District Office and ask the Field Representative to make a speech. Field Representatives frequently work at night and on weekends for these purposes. The Field Representatives broad-based knowledge is usually sufficient to answer all general questions.
Section 106 - The Programs Operations Manual System (POMS)
The Programs Operations Manual System (POMS) is the rulebook used by all District Office personnel. These manuals are issued by the Central Office and provide the working rules and interpretations of the law and regulations. The official regulations of the Social Security Administration (SSA) published in the Federal Register and available in law libraries and online (click here), but are almost never used by the personnel in the District Offices. Instead, they rely almost exclusively upon the POMS. The POMS is available in every District Office for review by members of the public. You may see it online through the SSA website by clicking here, but be forewarned: these rules are laced with acronyms and bureaucratic shorthand.
Generally, the policy of the Social Security office is to require an interviewer to be present while a member of the public reviews the POMS. This is required because much of the language is written in bureaucratic shorthand which can be meaningless to you. A Claims Representative or Service Representative will be required to interpret this bureaucratic language. The POMS is the "Bible" of Social Security and all decisions must be founded upon the provisions contained in these manuals. If you doubt the accuracy of information given to you by any Social Security interviewer, you should ask to see where it is stated in the POMS. The interviewer should be able to locate the pertinent section to show you in black and white.