Work Incentives Planning and AssistanceNational Training and Data Center

Verification of BenefitsNovember 2015

2

Learning ObjectivesUpon completion of this training participants will be

able to:

• Describe why it is essential to verify benefits prior to providing WIPA services

• Identify which benefits need to be verified and when that verification should be obtained

• Describe specific strategies for verifying each of the most common federal benefits

3

Why Verify Benefits?Verification of benefits is necessary whenever CWICs provide individualized advisement in order to ensure that:

1. Information provided is 100% accurate;2. Information provided is comprehensive and

complete; and3. Any potential benefits problems are identified.

4

Who Needs Benefits Verification?• Generally, people getting only I&R services do NOT need

to have benefits verified since they are only receiving generic information about how work affects benefits. However, if there is doubt about which Social Security benefits are received, verify before providing information.

• Beneficiaries receiving individualized WIPA services should have benefits verified, before meeting with a CWIC. Some very simple cases may not need a BPQY.

• Verification is REQUIRED if a BS&A is being developed.

5

How Do I Know What to Verify?• Thorough information gathering is the key to knowing what

information needs to be verified.• Make sure your information gathering protocol includes

gathering information about:– All Social Security benefits;– Health insurance including Medicaid and Medicare with all

associated assistance with premiums (Medicare Savings Plans (MSP) and Low Income Subsidy ;

– Other federal, state, and local benefits;– Marital status and benefits received by spouse and

dependent children; and– Private disability or pension benefits.

6

Which Benefits Need to be Verified?

• Verify any benefits that could be affected by paid employment.

• Social Security benefits are just the tip of the iceberg. Verify ALL federal, state, or local benefits that were identified during the information gathering process – including those received by spouse and dependent children.

7

What Information Should be Verified?

• What must be verified varies by benefit - each benefit is different

• Verify pertinent details needed to provide comprehensive individualized advisement, such as:– Amount, type, entitlement date, work incentives

used and available, recertification dates, etc.• Recommendation for what to verify is available on

“Benefit Verification Quick Reference Guide”

8

How Do You Verify Benefits?• Obtain information from administering agency

1. Beneficiary provides written documentation of current benefit(s) provided by benefit agency:

– VA award letter, housing redetermination notice, SNAP award/redetermination notice

2. Obtain verification from benefit agency, or partner agency with access to shared data system:

– Statement/Report/Letter or verbal verification

• Verification should NOT come from a third party

9

Preparing for Efficient Benefits Verification

• Do you know which agencies administer the various benefits or programs in your area?

• Have you researched each agency to find out what methods of verification are available? Is there an online self-service option?

• If contact with a local agency office is necessary, have you contacted the office to find out the process they require for accessing information?

• Have you developed relationships with staff at the various agencies?

10

Verification Using Self-Service Online Accounts

• When possible, ask beneficiary or representative payee to set up their own online account and provide verification information to you.

• When necessary, provide assistance with setting up online accounts. – This can be done in person or over the phone but express verbal

permission to help with this function must be obtained and documented.

– Once the account is set up, advise the beneficiary on how to request verification and/or guide them through the process.

– Make sure the beneficiary knows how to use the account moving forward.

11

Verification Involving Contact with Administering Agency

• Step 1: Obtain signed releases of information

– Some agencies (i.e. SSA) require the beneficiary sign their specific release(s)

– Contact the administering agency and clarify what releases are required

– Write down the protocol for future reference

12

Verification Involving Contact with Administering Agency

• Step 2: Contact agency and request verification

– Establish: Who you contact, how you request, what you need, and where to send it• Will differ by agency

– Establish a process (who and how) • Write down protocol for future reference

– “Benefit Verification Quick Reference Guide” provides ways to verify federal benefits

13

Verifying Social Security Benefits

• Primary source of information needed by CWICs is the Benefits Planning Query or BPQY

• This report verifies type/amount of Social Security disability benefits and provides important information about current and past work and work incentive usage

• The BPQY is NOT available through the “my Social Security” online feature. This report must be generated by Social Security personnel

• A Third Party Query (TPQY) is not equivalent to the BPQY and cannot be used instead of the BPQY

14

Requesting a BPQY

• Whenever possible, WIPA staff should support beneficiaries in requesting a BPQY by calling the Social Security toll free line at 1-800-772-1213 or going to the local Social Security office. Social Security will not charge a beneficiary for the BPQY.

• If the beneficiary seems unable to do this, or if there is undue delay, CWIC may request the BPQY (on behalf of the beneficiary) directly from the FO serving the beneficiary in question or through the 800 # per current instructions. WIPA projects should not batch the requests.

15

Requesting a BPQY• Requests for BPQY’s from CWICs must include two

signed Consent for Release of Information forms (SSA-3288).

• The SSA-3288 should be pre-filled with recommended language for release of Social Security and Internal Revenue Service records (see pp.12-13 of BPQY Handbook)

• www.socialsecurity.gov/disabilityresearch/documents/BPQY_Handbook_Version%205.2_7.19.2012.pdf

16

Important Tips for Obtaining BPQYs• If the beneficiary requests the BPQY directly from Social Security, help

him/her understand what they are requesting and what information they want to verify. Referencing the Red Book is highly recommended. No releases are necessary in these cases.

• CWICs should ask local Social Security offices how they prefer to process BPQY requests in advance. Discuss this with local WILs and/or AWICs and follow instructions.

• In general, Social Security offices will want faxed 3288s and will respond by fax or mail.

• Social Security should not charge a fee for producing BPQYs when requested by WIPAs or beneficiaries.

• Work with the AWIC to get problems resolved.

Slide 16

17

Understanding the Limits of the BPQY

• The BPQY does not contain all of the information a CWIC might need to provide comprehensive counseling.

• Some BPQYs contain errors. CWICs cannot trust that all information on the BPQY is correct in all cases.

• BPQYs can be confusing. There will be times when CWICs need to talk to a Social Security employee to resolve questions.

18

Verification Needed Beyond the BPQY• Reasons for reduction in SSI and differences in full & net amount of

benefits (mostly Title II), except overpayment recovery• Medicare Part D enrollment or any information related to low-income

subsidy eligibility• Specific information about Medicaid eligibility categories beyond SSI

conduit• Information about beneficiary’s spouse and dependents (other than

total amount of family benefit)• Verification of EXR status• Past work is not always fully developed (mostly Title II)

Slide 17

19

How to Verify Other Federally Administered Benefits

• Medicare Part D and Low Income Subsidy: – Beneficiary may call Medicare at 1-800-633-

4227 or use “my Medicare” self-service feature at https://mymedicare.gov/

• Ticket to Work: – Beneficiary calls the Ticket to Work Help Line at

1-866-968-7842

Slide 18

20

How to Verify Other Federal Benefits

• Veteran’s Benefits:– eBenefits:

https://www.ebenefits.va.gov/ebenefits-portal/ebenefits.portal

– 1-800-827-1000

• Housing and Urban Development:– Local Housing Authority

Slide 19

21

How to Verify State-Administered Benefits

• Verifying state benefits differs dramatically from one state to another and across benefit programs

• Build and maintain relationships with state and local benefit agencies to establish process– If no effective process, contact your TA Liaison for help

in creating a game plan to get an effective process• Single point of contact, online verification, contacting local

case worker

Slide 20

22

Dealing with Discrepancies

• All verified information should be examined, discrepancies identified, and clarification obtained from benefit agency:– Is it consistent with what the beneficiary told you?– Is it consistent with program/eligibility rules?– Is there missing or outdated information?

• Know who to call to clarify verification issues

Slide 21

23

BPQY Discrepancies

• BPQY Data Sources:- Master Beneficiary Record, Disability Control File, SSI

Display, Summary Earnings Query, Inquiry Response• Sometimes the information needs to be updated - check

for issues such as:- Outdated Work Activity Reviews- Unreported earnings- Change in living arrangement (ISM)

• Refer to BPQY Handbook for details

Slide 22

24

Document Your Verifications• Maintain documentation of verification and releases, such

as:– Copy of BPQY or benefit award letter from beneficiary.– Record verbal verifications in case notes or on verbal

verification record (note who, when, and what).• Maintain documentation of clarification on verification:– Put details in case notes or on hard copy of verification

(be sure to note who, when and what).– Ask yourself, will my co-worker be able to pick up this

documentation and understand it?

Slide 23

25

How Often to Verify

• If you are providing ongoing services, benefits may need to be re-verified multiple times

• If it has been more than six months or a new calendar year, identify if benefits need to be re-verified before providing further advisement

• Seek additional verification when you need to check that work has been developed, work incentives information updated, or requested changes acted upon

• Re-verify if the beneficiary informs you that benefits have changed or additional benefits are received

Slide 24

26

Additional Verification Details

• Include the beneficiary in the verification process

• If issues are identified during verification, communicate with beneficiary to identify resolution they prefer

Slide 25

27

Final Thoughts• Verification is the cornerstone of comprehensive

services. It is necessary to provide accurate information.

• Building and maintaining relationships with local benefit agencies is key to establishing an effective and efficient process for verifying benefits.

• Work with your colleagues to create your own Benefit Verification Quick Reference Guide.

Slide 26