Today's SSI story concerns a claimant who was approved for both SSI disability benefits and Disability Insurance Benefits on June 17. Her monthly checks have started but he's yet to receive any back benefits. The holdup is called the windfall offset, which was designed to pay the claimant SSI benefits as if the Disability Insurance Benefits had been paid when they were due. The windfall offset in practice is bizarrely convoluted. But, still, it's been more than six months. Why haven't they done the windfall offset? We can't get an answer but we know that the underlying problem is understaffing at the field office.
19 comments:
Not only are offsets convoluted, but they can also be grossly unfair for a claimant who in reality has never received any personal benefit from what SSA is offsetting. Take for example a representative payee who applies for SSI benefits on behalf of a claimant and had SSA deposit their monthly benefits into the payee’s personal checking account for more than ten years – with claimant maybe receiving $30 token funds monthly if any at all. With such improper mingling of beneficial funds with payee’s personal funds there can be no real way to determine whether such offsets are being properly calculated because it is supposed to be only benefits the claimant has personally benefited from receiving, not their payee – and of course we know payees are not supposed to mingle a claimant benefits with their own personal funds but it happens more than you think out there. Only recourse is to go to federal court and prove where SSA has been sending a claimant's monthly benefits to get the improper offset suspended so the claimant can receive fully what he is entitled to.
Most CS’s have no idea how to do windfall offsets in my area. We had a cadre of TE’s that did them in the past.
They decided the cadre was unnecessary so now they just don’t get done regularly and if they do get done, they’re usually wrong.
I was involved in the cadre but they have our TE do the offsets. He’s quitting and has been MIA so they just sit.
I’m sure at some point they will ask me to do them but I haven’t done one in years and it’s a workload that takes constant exposure and practice to be competent. They are so easy to mess up and so difficult to fix once done wrong.
The percentage of SSI CRs that can do an offset correctly has to be in the single digits. They are time consuming and unfortunately go to the bottom of the piles in favor of workloads that can be completed in a few minutes. This should be a centralized workload in the PCs
I was there when windfall offset started. No one could easily do the math :) Prime issue if I recall right wasn't doing the first "what if" run through, it was later finding out a PE event changed the SSI comps and having to recomp things again. The system was unable to calculate it because it wasn't designed to use negative numbers in a payment calculation. You ended up instead using absolute values of numbers and at that point most folks got lost. Trying to come up with a worksheet or (11980s remember, no PCs yet) a HP calculator script was hard. When MSSICS came up it was constrained by the underlying system but one has to believe that in year 2022 the agency could setup a viable online calculator for staff to use? But yeah, figuring out teh inputs to have the system output the desired payments was much more difficult than it seems.
They could greatly reduce the windfall cases by just eliminating the 5 month waiting period and then not taking concurrent claims if the claimant’s PIA is over the FBR.
People file to get Medicaid, because the Dept of Public Social Services make them, etc. Even when it's explained there will be no financial benefit, many still file. It would help if the agency stopped routinely taking SSI claims that will be technical denials right off the bat.
There is no psi or goal for windfalls this fiscal year ergo we don’t work them because mgmt doesn’t care because it’s not on a list. Only items with a goal get worked. This fiscal year, workcdrs, windfalls, anything rib, survivor, etc non dib don’t have psi’s so the only things getting worked are dibs, appeals, overpayments, rzs. This is huge. We don’t have staff to work anything without a workload goal. It is unbearably frustrating. I’m sure more will leave in March when I’m sure they take telework away and it will only get worse. KK only cares about SSI, beves, and SS5s.
Yeah, I’m familiar. And that’s when SSA gets the clack for another agency’s requirements. All too familiar.
If someone would make it so interest can incur on back pay, I bet they'd get that out ASAP. It's the claimants money, and it's being held. In the real world, interest would incur on any moneies that belongs to others.
Would that mean interest on overpayments too? Some are 30 or 40 years old.
Even recent ones with interest would probably make the agency more money than what they'd pay on retro checks they processed too slowly.
I too have worked windfalls since inception in 4/1982 !(via hammer and chisel). Yes they are complex (see Steigerwald). Yes one needs to work them regularly to be proficient, They are part of the PSI goals on weekly monitoring reports. The whole concept is thanks to Ronald Reagan. Not indicating windfall just due to a high PIA does not always work since a month or two of benefits may be lost due to the T2 waiting period. There is also the issue of interim assistance reimbursement when all T16 does to a local social services agency. My understanding based on prior contact w/ RO that a claimant can always withdraw T16 . I do not know the implications re: the IAR but am willing to learning. The quickest way is to decline to pursue / get something from atty rep involved and create a manual E 4345 (manual offset) and update the the SSR to ( no windfall offset = wind = d ).
As someone from a DDS, I have never heard this term and have no idea how someone would go about performing it. Working in the FOs seems hard.
I’m all for giving them interest on holding back pay as long as the agency can also charge interest on overpayments.
Be careful what you wish for.
Working in the FO is hard, important and can be rewarding at times. Windfall Offsets have been a problem since first created. No one will seriously reform SSI. As a former commissioner said on a nationwide managers conference call many years ago reform ideas always create winners and losers. So, the status quo carries on...
If the claimant withdraws, they could lose retroactive Medicaid, that can mean thousands of dollars owed. I was a TE, offsets are complex, but once you learn it, it's not hard. Seems there aren't enough experienced staff. Probably because staff isn't treated well, that's why I retired anyway.
10:26 AM, December 28, 2022
Technical denials shouldn't be triggering offsets.
If I’m not mistaken, the new hire training now includes windfall offset training. I think it’s part of the OTT online stuff.
It was always part of trading. It was in the “advanced” training when I came through. It’s just that it was never a regular workload for CS’s in our area.
Windfall Offsets, along with several other workloads, should be specialized and handled centrally or at a minimum, within regional cadres. Expecting every CS to know every aspect of every program is entirely unreasonable without significant program simplification.
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