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Social Security Administration

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Social Security Administration. Benefits Planning Query Handbook. (BPQY)The information in a BPQY is used to provide customized services and

    Social Security Administration

Benefits Planning Query Handbook

    (BPQY)

    Distributed by

Office of Program Development and Research

    Office of Retirement and Disability Policy

    February 2009

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    Table of Contents

    Introduction ................................................................................................. 2 Sources of Data: SSA Electronic Records ................................................. 2 Resolving Statement Discrepancies............................................................ 2 Who Can Get A BPQY? .............................................................................. 3 Requesting a BPQY .................................................................................... 3 How to Reach Social Security ..................................................................... 3 Red Book .................................................................................................... 4 Summary .................................................................................................... 4 Understanding the BPQY ............................................................................ 4

    Cash ............................................................................................................................. 5

    Medical Reviews .......................................................................................................... 7

    Representation ............................................................................................................. 8

    Health Insurance .......................................................................................................... 8

    SSI Work Exclusions.................................................................................................... 9

    SSDI Work Activity ..................................................................................................... 10

    Earnings Record ........................................................................................................ 11

BPQY Cover Letter…………….………………............................................12

    Consent for Release of Social Security Information…...............................13

    Consent for Release of Internal Revenue Earnings Information…………..14 Medicaid State Listing Chart.......................................................................15

    Possible Medicaid Entries...........................................................................16

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    BPQY Handbook

Introduction

The Benefits Planning Query (BPQY) has improved the Social Security Administration’s

    (SSA) efforts to inform Social Security Disability Insurance (SSDI) beneficiaries and

    Supplemental Security Income (SSI) recipients about their disability benefits and the

    use of the work incentives. A BPQY statement contains comprehensive information

    about an individual's disability benefits and work status. This includes the status of the beneficiary's disability cash benefits, health insurance, scheduled medical reviews,

    representative payee, and work history. In essence, the BPQY provides a snapshot of

    the beneficiary's benefits and work history as stored in SSA's electronic records.

A BPQY is a planning tool that can be used by Area Work Incentive Coordinators

    (AWIC), the Plan to Achieve Self-Support (PASS) Cadre members, advocates and other

    individuals such as Work Incentive Planning and Assistance (WIPA) counselors. The

    information in a BPQY is used to provide customized services and information on SSA’s

    employment support programs to beneficiaries with disabilities who want to start or keep working. Analysis of an individual’s disability and work status is the first step when

    planning a successful return to work initiative.

Sources of Data: SSA Electronic Records

Multiple sources of data in SSA’s electronic records are compiled in a BPQY. They

    include

    ? Master Beneficiary Record (MBR)

    ? Disability Control File (DCF)

    ? Supplemental Security Income Display (SSID)

    ? Summary Earnings Query (SEQY)

    ? Inquiry Response (QRSL)

Resolving Statement Discrepancies

Every year the Social Security Statement is sent to 140 million workers. It lists a

    person's work earnings and provides valuable information for long range financial

    planning. Workers are asked to review their earnings statement carefully and to

    contact SSA if they identify problems with their record.

The BPQY similarly communicates information on SSA records specifically for

    beneficiaries with disabilities and encourages financial planning for a return to work.

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    BPQY Handbook

    The information is generally accurate but if earnings were not reported by the

    beneficiary or if work reports were not processed by SSA, the data must be updated

    and corrected. A beneficiary, benefits counselor or advocate acting on behalf of a

    beneficiary should review the BPQY data and report any suspected discrepancies or

    errors to a representative of SSA immediately. Discrepancies or errors in any item on

    the BPQY must be resolved as soon as possible to avoid future misunderstandings

    and/or overpayments. A subsequent BPQY should confirm that correction(s) were

    made.

Who Can Get A BPQY?

The BPQY statement is given to beneficiaries and their representatives upon demand

    with proper authorization.

Requesting a BPQY

    A BPQY (SSA-2459) is given to beneficiaries upon request. The BPQY and its cover letter (SSAL-634) will be mailed directly to the beneficiary at the address shown on the current SSA record. If the individual has SSI eligibility only, the address is not

    propagated. SSI only addresses must be manually entered by overtyping the

    information on the BPQY Print Options screen.

Signed consents are required only if the BPQY will be sent to someone other than the

    beneficiary, his/her Representative Payee or Authorized Representative. An advocate,

    benefits counselor or other organization such as WIPA must submit two signed Consent

    for Release of Information (SSA-3288) forms that have been appropriately signed by the

    beneficiary. The first Consent for Release of Information is needed to make Social

    Security records available and the second Consent for Release of Information is needed

    to authorize the release of Internal Revenue Service earnings records. Both releases

    must contain the beneficiary’s Social Security Number or the Claim Number of the

    worker under whose work record the benefits are paid. (The Claim Number appears on

    the beneficiary’s Medicare card.)

How to Reach Social Security

Beneficiaries may request a BPQY by contacting their local SSA office or by calling

    SSA’s toll free number 1-800-772-1213 from 7 a.m. to 7 p.m., Monday through Friday. People who are deaf or hard of hearing may call our toll-free TTY/TDD number, 1-800-

    325-0778, between 7 a.m. and 7 p.m. on Monday through Friday.

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    BPQY Handbook

To locate your local SSA office, call our toll free number 1-800-772-1213. A telephone

    representative will either help you or put you in contact with your local office. Many

    local telephone directories list local offices under “Social Security.”

If you have internet access, use the Social Security Office Locator on our home page,

    Social Security Online, at www.socialsecurity.gov. Enter your postal ZIP code and we will give you the address, telephone number, and directions to your local office.

Red Book

The Red Book (Publication No. 64-030) is a summary guide to employment supports for

    individuals with disabilities under the SSDI and SSI programs. It is a general reference

    source about employment-related provisions developed for educators, advocates,

    rehabilitation professionals and counselors who serve individuals with disabilities. Its

    purpose is to provide a working knowledge of the technical provisions involved so that

    they can advise individuals with disabilities to appropriately and recognize when to seek

    case-specific guidance from SSA.

The Red Book is available online at: http://www.ssa.gov/redbook/eng/main.htm.

    En Español at: http://www.ssa.gov/redbook/esp/principal.htm. Alternative media is also available (Braille, audio cassette tape, disk, or enlarged print)

    at:

    http://mwww.ba.ssa.gov/work/ResourcesToolkit/pubsnformsorderform_cgicapable.html#content.

Summary

The BPQY was designed to communicate relevant information to facilitate a successful

    return to work effort based on information in SSA records. Any plan for returning to

    work begins with knowledge of an individual’s existing disability benefit status as well as

    an understanding of how work will impact an individual’s disability benefits. A BPQY is

    an excellent starting point.

Understanding the BPQY

The following sections define terms used in a BPQY statement.

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    BPQY Handbook

Cash: This block details type and status of benefits and payment amounts.

    Benefits Planning Query (BPQY)

    Confidential Social Security Data

    NAME: EMILY CLAIMANT SSN: 123-45-6789

    Supplemental Security Social Security Disability

    Income (SSI) Insurance (SSDI)

    RECORD See Below See Below

CASH

    Disabled Worker Disabled Individual Type of Benefit

    Current Pay Current Pay Current Status

    No No Statutory Blindness

    07/02 05/99 Date of Disability Onset

    12/02 05/99 Date of Entitlement

    $292.70 $331.00 Full Amount

    $292.70 $331.00 Net Amount

    No No Others Paid on this Record

    $292.70 $331.00 Total Family Cash Benefit

    $0.00 $0.00 Overpayment Balance

    $0.00 $0.00 Monthly Amount Withheld

Name: Name of the individual who is the subject of the BPQY.

SSN: BPQY gives the SSN of the individual who is the subject of the statement, even if

    benefits are being paid from a parent’s record under a different SSN.

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    BPQY Handbook

    Type of Benefit: Shows the type benefit received. NOTE: In SSDI cases, a

    beneficiary may receive benefits on more than one record (SSN), but only the most

    recent benefit is reported on the BPQY.

? Possible SSDI entries are as follows:

    Disabled Worker, Disabled Adult Child, Disabled Widow, Disabled Widower,

    Disallowed Claim, Denied Claim-Medical Denial

    ? Possible SSI entries are as follows:

    Disabled Individual, Disabled Spouse, Disabled Child, Blind Individual, Blind Spouse,

    Blind Child, Disabled Student, Blind Student

Current Status: An individual may be in a “current pay” status (getting a check) or in a

    “deferred” status (suspended or terminated entitlement).

Statutory Blindness: “Yes” means that SSA has determined that the individual’s visual

    impairment meets the definition of Statutory Blindness, under the Social Security Act for

    SSDI/SSI benefit purposes. The substantial gainful activity (SGA) level is higher for

    statutory blindness than for other types of disabilities.

Date of Disability Onset: The most recent medical disability onset date established by

    SSA.

Date of Entitlement: The most recent date of entitlement to SSDI benefits and/or the

    most recent date of eligibility for SSI. Earlier periods of entitlement and/or eligibility are

    not displayed.

Full Amount: The full amount of the monthly cash benefit before any deductions or

    reductions for Medicare premiums, overpayment collections, etc.

    Possible entries are: $$$$.00, Suspended, Deferred or Terminated.

The SSI full amount includes any federally administered state supplement, but does not

    include any state administered state supplement payment.

Net Amount: The amount of cash benefits paid by check or electronic funds transfer to

    the individual’s financial institution. This is the cash amount received after deducting

    any Medicare premium, overpayment recovery, garnishment, etc. from the “Full

    Amount”.

    Others Paid On This Record: Indicates if other people are entitled to benefits on this record. Other individuals' cash or medical benefits are affected when the disabled

    individual’s work activity results in termination of cash benefits. If a Disabled Adult

    Child/Widow(er) benefit is listed as a "Type of Benefit", other beneficiaries on this record

    will not have their benefits reduced due to the work activity of the Disabled Adult

    Child/Widow(er) but others’ benefits may increase.

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    BPQY Handbook Total Family Cash Benefit: The full amount of cash benefits paid to the individual with

    a disability and other entitled family members on this record.

Overpayment Balance: The current balance of any outstanding monies owed to SSA

    for incorrect cash payments.

Monthly Amount Withheld: The amount of cash benefits that SSA is withholding to

    apply towards a past overpayment of benefits.

    Medical Reviews: Shows data from any SSDI or SSI medical review diary.

     MEDICAL REVIEWS

    Next Medical Review 09/0807/01/06

    Medical Re-exam Cycle 3+ years3+ years

Next Medical Review: The date SSA has scheduled to review the individual’s medical

    condition. If “Unknown” is displayed, no medical review is scheduled.

Medical Re-Exam Cycle: There are 3 types of medical review diaries. The letter codes

    represent the reason for establishing a medical re-examination diary, while the numeric

    codes represent the type of periodic review diary. Possible entries are:

    Code Description

     A thru U+ Reason for a 1 year medical re-examination diary

    3+ 3-year periodic review diary (non-permanent disability)

    5+ 5-year periodic review diary (permanent disability)

    7+ 7-year periodic review diary (permanent disability)

NOTE: There may be different medical re-exam cycles for SSDI and SSI. The entries

    will show that the medical diary is deferred due to Ticket to Work.

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    BPQY Handbook Representation:

    REPRESENTATION

    Representative Payee Yes Yes

    Authorized Representative No No

    Representative Payee: A “No” indicates that the disabled individual receives cash benefits directly; a “Yes” means that he/she has a Representative Payee. There are

    separate lines for SSDI and SSI because it is possible that a person has a

    Representative Payee for SSDI and not for SSI or the converse can be true.

Authorized Representative: A “No” indicates that the disabled individual does not have

    an authorized representative; a “Yes” means that he/she has appointed an Authorized

    Representative.

Health Insurance:

    HEALTH INSURANCE MEDICARE MEDICAID

    PART A PART B PART C/D* Type Eligible for Medicaid

    (SSI)(1634 States only)

    12/2004 12/2002 01/2006 Start Stop

    No Yes 100% Buy-In or Subsidy

CAUTION: With the Medicaid program, there are sources of eligibility that are

    unknown to SSA. If an SSI recipient resides in a state that allows Medicaid eligibility

    with SSI eligibility (i.e., a 1634 state) the BPQY will show the Medicaid eligibility

    information. For all other situations (i.e., 209b states or SSI criteria states), verify Medicaid eligibility through the local or state Medicaid Agency and not SSA. See

    attached for a list of possible Medicaid entries.

Type: Shows the type of Medicare and/or Medicaid health insurance entitlement and/or

    eligibility on SSA’s records. It includes Medicare Part A (hospital) and Part B (medical)

    and Medicaid eligibility status under SSI.

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    BPQY Handbook

    *Note that Part C (HMO with drug benefit) and Part D (prescription drug) information

    has been temporarily removed due to unreliable data on SSA records. When this

    problem is fixed, this information will again appear on the BPQY.

Start: Date current coverage began.

Stop: Date coverage ended.

Buy-In or Subsidy: Shows “Yes” or “No” for Parts A & B. A “Yes” means the state of

    residency is paying the premium for this beneficiary and “No” means the premium is

    either deducted from their monthly check or paid by premium billing.

Part A is premium free except for extended Medicare eligibility.

Under Part C/D the possible entries are: 0%, 25%, 50%, 75% or 100%. This shows the

    amount of low income subsidy the beneficiary is receiving for their premium payment

    based on SSA records. The state of residency pays the beneficiary's Medicare

    premiums under one of the Medicare Buy-In programs (e.g., QMB, State SSI, etc.) and

    the drug benefit premium can be paid from the limited-income subsidy or one of the

    state’s Medicare Buy-in programs.

    *Note that Part C and Part D information has been temporarily removed due to

    unreliable data on SSA records. When this problem is fixed, this information will again

    appear on the BPQY.

SSI Work Exclusions: Details SSI Work Incentives that exclude earned income

    from the calculation of the SSI payment amount.

    SSI WORK EXCLUSIONS

    Blind Work Expenses

     Impairment-Related Work Expenses

     Student Earned Income Exclusions

    PASS Exclusion

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