Application Process
The initial application is submitted to SSA with the assistance of the SOS
What are the 4 Process Phases we have discussed throughout training?
Application Verification, Pending Decision, Post Decision Approval, Post Decision Denial
We can tell what phase a case is in based on the tasks available in this section of Compass.
The Task Box
For HIPAA Compliance purposes, in addition to the claimant's first and last name (as well as the first and last name of the caller if NOT the claimant), we must also verify these THREE forms of PHI before we can discuss a claimant's case.
Claimant's Date of Birth, Full Mailing Address, and 10 digit phone number.
These are the two main roles within the Best Benefits Service Line who work directly with the claimants to assist them through their Social Security Application Process.
Senior Outreach Specialists (SOS) and Disability Specialists (DS)
What must happen before the Field Office will forward an application to the DDS?
Claimant must pass the Phone Interview
These are the two main tasks associated with the Application Verification Phase.
Phone Interview- Application Verification
Consents- Application Verification
We can view various documents related to the claimants case under this tab in Compass.
Documents
When calling the claimant's local Field Office, they will ask for these forms of PHI before discussing the claimant's case.
Claimant's full SSN, Place of Birth, Mother's Maiden Name, and EDPNA on file
What is a Champion Case?
What happens once the DDS receives the application?
The application is assigned to an Adjudicator who will gather medical evidence to make the medical decision
45 year old Karen Smith has a Consultative Exam scheduled for next week. What Phase in the overall Application Process can we expect her case to be in?
Pending Decision
We can find the claimant's place of birth and mother's maiden name under this section in Compass.
Documentation Completion
You are assisting an adult claimant with completing the E1696. What will you instruct them to complete once they receive their email with the E1696?
Scroll to the last page and click to sign their name.
What is the difference between a 1696 and an E1696?
The E1696 is done through e-mail and is immediately sent to the FO. The paper 1696 we separate and fax to the FO.
If the claimant passes the phone interview AND has active work credits, what will we set the claim type to?
Concurrent
What actions must we take in Compass in order to complete the Application Verification Phase?
Update the PI outcome in Compass and confirm we are on file with the Field Office and update the dates in Compass
We will update this section in Compass to reflect the dates we received the consents.
Application Tab under Consents and Submission
We must follow this rule when placing a claimant on hold.
If the Fee Agreement applies to a claimant's case, how much do we charge for our fee?
25% of their Back Award, if approved, not to exceed $9,200
Fill in the blank! For adult cases, the Field Office must receive back the claimant's Application Summary with a ____ ______ before they will forward the claim to DDS.
Wet Signature
If an adult claimant does not pass their Phone Interview, what is our next step?
Verify to see if SSDI is pending before closing the case
You speak to a claimant's mother and she says she never had a PI. What is your next step?
Let her know we will get one scheduled and call the FO to schedule the PI.
If the claimant speaks a foreign language, we must get an interpreter on the line. What is the name of the interpreter service we use?
Voiance
Who are the Centauri EDPNAs?
Victoria O Connell
Matthew Wood
Amelia Baxter
Matthew Garcia
Ashley Bennie