Policy and Procedure Name:	Social Security Number
Policy #:	CP-19-08
Code/Rule Reference:	93 P.L. 579 – Privacy Act of 1974
Effective Date:	01/08/21
Approved:	Ann Shannon, Chief of Claims Policy and Support
Origin:	Claims Policy
Supersedes:	Policy #CP-19-08, effective 11/14/16
History:	Previous versions of this policy are available upon request

 

I. POLICY PURPOSE

 

The purpose of this policy is to ensure that conflicts or errors related to social security numbers entered into the claims management system are promptly corrected.

 

II. APPLICABILITY

 

This policy applies to claims services staff.

 

III. DEFINITIONS

 

Customer: A business or person whose information is entered into the claims and/or policy management system and associated with a unique customer number, enabling the business or person to participate in a claim, quote, policy or case. Examples include:

Business Customer

·        Employer

·        Provider

·        Third-party administrator

·        Representative

Person Customer

·        Claimant

·        Dependent

·        Guardian

·        Officer or owner of a business

 

Social Security cross match: The electronic receipt of information from the Social Security Administration (SSA) that provides the name, date of birth, date of death, if applicable, and any social security benefits paid to the individual associated with that SSN, used by BWC to validate information in the claim file and/or to calculate temporary total compensation (TT), permanent total disability (PTD) and/or Disabled Workers’ Relief Fund (DWRF) payment rates.

 

IV. POLICY

 

A.     It is the policy of BWC, in compliance with federal law, that a social security number (SSN) is not required for an individual to obtain workers’ compensation benefits.

 

B.     It is the policy of BWC to enter a correct SSN, when available, into the claims management system for a customer and to correct any conflicts or errors promptly after a thorough investigation.

 

V. PROCEDURES

 

A.     General Claim Note and Documentation Requirements

1.     BWC staff shall refer to the Standard Claim File Documentation and Altered Documents policy and procedure for claim note and documentation requirements; and

2.     Shall follow any other specific instructions for claim notes and documentation included in this procedure.

 

B.     Claims services staff shall request a SSN verification on any new claim assigned to them if a SSN verification has not already been completed.

 

C.    Claims services staff shall promptly investigate an issue regarding an SSN when:

1.     Claims staff is notified of a conflict or error with a customer SSN; or

2.     Verification of the SSN through the Social Security Administration (SSA) fails.

 

D.    Investigation of a conflict or other error with an SSN may include, but is not limited to:

1.     If there are duplicate SSNs, claims services staff shall determine which, if either, SSN was verified through the SSA;

2.     Claims services staff shall determine if the SSN is correct based on the information received;

3.     Claims services staff shall contact the customer related to the SSN by phone for clarifying information;

4.     If a different SSN is provided by the IW, claims services staff shall:

a.     Determine if there are other claims for the SSN provided by the IW; and

b.     Resolve claims as necessary prior to updating the SSN; and.

5.     If phone contact with the IW is not successful, claims services staff shall send the “SSN Investigation” letter CORR 563; and set a work item in Coresuite for follow up.

6.     Claims services staff shall consult with Employer Services if the conflict is related to a customer entered by that division.

7.     Claims services staff shall document all attempts to obtain a correct SSN in claim notes.

 

E.     If Employer Services is unable to complete a business function due to an unverified duplicate customer SSN for which claims services staff is responsible,  claims staff shall immediately consult with the supervisor, and if approved:

1.     Remove the incorrect SSN from the claims management system;

2.     Indicate the tax status in the claims management system as “Tax ID unavailable”; and

3.     If compensation is being paid to the customer, also indicate “Tax exempt.”

 

F.     When claims services staff receive the correct SSN, claims staff shall enter the number into the claims management system for automatic SSA verification. Once the SSA has verified the SSN, claims services staff need take no further action.