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pdfPreliminary Claims System (PCS)
Screen Package
Febryary 01, 2019
PCS Screen Package
February 01, 2019
Page 1 of 74
Table of Contents
1.
Individual Information – Individual applying on their own .......................................................................................................4
2.
Individual Information – Individual applying on their own – Privacy Act Statement.................................................................5
3.
Individual Information – Individual answering questions not applying on their behalf ............................................................6
4.
Individual Information – Not the correct customer ..................................................................................................................7
5.
Individual Information – Third party applying on behalf of individual ......................................................................................8
6.
Individual Information – Individual third party applying on behalf of customer .......................................................................9
7.
Individual Information – Organizational third party applying on behalf of customer ............................................................. 10
8.
Individual Information – Other third party applying on behalf of customer ........................................................................... 11
9.
Individual Information – Custodian or legal guardian applying on behalf of legally incompetent individual .......................... 12
10.
Individual Information – Custodian or legal guardian applying on behalf of legally competent customer .............................. 13
11.
Protective Filing – with one or more leads ............................................................................................................................. 14
12.
Protective Filing no lead – Yes ................................................................................................................................................ 16
13.
Protective Filing no lead – There is no previous protective filing date before today ............................................................... 17
14.
Person Information – Select “No” to add or update notice due to vision impairment ............................................................ 18
15.
Person Information – Select “Yes” to add or update notice due to vision impairment ........................................................... 20
16.
Person Information – Edit identity information ...................................................................................................................... 22
17.
Person Information – Edit identity information: add other name ........................................................................................... 27
18.
Person Information – Edit identity information: add other name ........................................................................................... 28
19.
Person Information – Edit identity information: edit other name & error messages .............................................................. 29
20.
Person Information – Edit citizenship information ................................................................................................................. 30
20. Person Information – Edit citizenship information: Add citizenship ........................................................................................... 31
20.1 Person Information – Edit citizenship information: Add citizenship ......................................................................................... 33
20.2 Person Information – Edit citizenship information: Add citizenship ......................................................................................... 34
23. Person Information – Edit contact information: U.S. primary phone number ............................................................................ 36
24. Person Information – Edit contact information: International primary phone number .............................................................. 39
24.1 Person Information – Edit contact information: Manage address ............................................................................................ 41
24.2 Person Information – Edit contact information: Manage address ............................................................................................ 42
25. Residence Address – Current mailing address is the same as residence address ........................................................................ 45
26. Residence Address – Current mailing address is different from residence address .................................................................... 46
27. Disability – “Yes” to all .............................................................................................................................................................. 49
28. Earnings – “Yes” to all ................................................................................................................................................................ 50
29. Earnings – “No” is selected ........................................................................................................................................................ 56
30. Insured Status ............................................................................................................................................................................ 59
31. Children – No children ............................................................................................................................................................... 61
PCS Screen Package
February 01, 2019
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32. Children – Children is selected ................................................................................................................................................... 62
33. Supplemental Security Income – Yes to all ................................................................................................................................ 63
34. Supplemental Security Income - Do not wish to apply for SSI .................................................................................................... 67
35. Benefits Summary – Default view (table) ................................................................................................................................... 68
36. Next Steps – Variations: file for all four benefit types ................................................................................................................ 71
37. Next Steps – Variations: set up an appointment for all four benefit types ................................................................................. 72
38. Next Steps – Variations: closeout for all four benefit types ....................................................................................................... 73
39. Next Steps – Variations: combination ........................................................................................................................................ 74
PCS Screen Package
February 01, 2019
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1. Individual Information – Individual applying on their own
PCS Screen Package
February 01, 2019
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2. Individual Information – Individual applying on their own – Privacy Act Statement
PCS Screen Package
February 01, 2019
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3. Individual Information – Individual answering questions not applying on their behalf
PCS Screen Package
February 01, 2019
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4. Individual Information – Not the correct customer
PCS Screen Package
February 01, 2019
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5. Individual Information – Third party applying on behalf of individual
PCS Screen Package
February 01, 2019
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6. Individual Information – Individual third party applying on behalf of customer
Individual third party includes: spouse, parent, child, step parent, other family members, friend, and other relatives
PCS Screen Package
February 01, 2019
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7. Individual Information – Organizational third party applying on behalf of customer
Organizational third party includes: government agency, non-profit organizational/legal aid group, health service agency/hospital,
nursing care facility, non-related third party such as attorney, friend, advocacy group, legal entities, and attorney representatives.
PCS Screen Package
February 01, 2019
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8. Individual Information – Other third party applying on behalf of customer
PCS Screen Package
February 01, 2019
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9. Individual Information – Custodian or legal guardian applying on behalf of legally
incompetent individual
PCS Screen Package
February 01, 2019
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10.Individual Information – Custodian or legal guardian applying on behalf of legally
competent customer
PCS Screen Package
February 01, 2019
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11. Protective Filing – with one or more leads
PCS Screen Package
February 01, 2019
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PCS Screen Package
February 01, 2019
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12.Protective Filing no lead – Yes
PCS Screen Package
February 01, 2019
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13.Protective Filing no lead – There is no previous protective filing date before today
PCS Screen Package
February 01, 2019
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14.Person Information – Select “No” to add or update notice due to vision impairment
PCS Screen Package
February 01, 2019
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PCS Screen Package
February 01, 2019
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15.Person Information – Select “Yes” to add or update notice due to vision impairment
PCS Screen Package
February 01, 2019
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PCS Screen Package
February 01, 2019
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16.Person Information – Edit identity information
PCS Screen Package
February 01, 2019
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PCS Screen Package
February 01, 2019
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PCS Screen Package
February 01, 2019
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Note: The values in the drop-down list are from states GRT.
PCS Screen Package
February 01, 2019
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Note: This is the drop list for “Birth Date Proof”.
Note: This is the drop list for “Birth Date Proof Type”.
PCS Screen Package
February 01, 2019
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17. Person Information – Edit identity information: add other name
Select name type: Full name
PCS Screen Package
February 01, 2019
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18. Person Information – Edit identity information: add other name
Select name type: Single name
PCS Screen Package
February 01, 2019
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19. Person Information – Edit identity information: edit other name & error messages
PCS Screen Package
February 01, 2019
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20.Person Information – Edit citizenship information
Default view
PCS Screen Package
February 01, 2019
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20. Person Information – Edit citizenship information: Add citizenship
“Yes” to U.S. citizenship, “Yes” to citizenship ended.
PCS Screen Package
February 01, 2019
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PCS Screen Package
February 01, 2019
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20.1 Person Information – Edit citizenship information: Add citizenship
“Yes” to U.S. citizenship, “No” to citizenship ended.
PCS Screen Package
February 01, 2019
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20.2 Person Information – Edit citizenship information: Add citizenship
Not a U.S. citizen
PCS Screen Package
February 01, 2019
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Note: The values in the drop-down list are from the historical country GRT.
PCS Screen Package
February 01, 2019
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23. Person Information – Edit contact information: U.S. primary phone number
PCS Screen Package
February 01, 2019
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PCS Screen Package
February 01, 2019
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Note: The values in the drop-down list are from the language GRT.
Note: The values in the drop-down list are from the language GRT.
PCS Screen Package
February 01, 2019
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24. Person Information – Edit contact information: International primary phone number
PCS Screen Package
February 01, 2019
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PCS Screen Package
February 01, 2019
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24.1 Person Information – Edit contact information: Manage address
Select existing addresses
PCS Screen Package
February 01, 2019
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24.2 Person Information – Edit contact information: Manage address
Add new addresses and verify address
PCS Screen Package
February 01, 2019
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Note: The values in this drop-down list are from the country GRT.
PCS Screen Package
February 01, 2019
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Note: The values in the drop-down list are from the states GRT.
PCS Screen Package
February 01, 2019
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25. Residence Address – Current mailing address is the same as residence address
PCS Screen Package
February 01, 2019
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26. Residence Address – Current mailing address is different from residence address
PCS Screen Package
February 01, 2019
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Note: The values in the drop-down list are from the country GRT.
PCS Screen Package
February 01, 2019
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Note: The values in the drop-down list are from the states GRT.
PCS Screen Package
February 01, 2019
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27. Disability – “Yes” to all
PCS Screen Package
February 01, 2019
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28. Earnings – “Yes” to all
PCS Screen Package
February 01, 2019
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PCS Screen Package
February 01, 2019
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PCS Screen Package
February 01, 2019
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PCS Screen Package
February 01, 2019
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Note: the year drop down from the table will be dynamic based on the person's date of birth.
PCS Screen Package
February 01, 2019
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Note: The values in the drop-down list is from the historical country GRT.
PCS Screen Package
February 01, 2019
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29. Earnings – “No” is selected
PCS Screen Package
February 01, 2019
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PCS Screen Package
February 01, 2019
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PCS Screen Package
February 01, 2019
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30. Insured Status
PCS Screen Package
February 01, 2019
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PCS Screen Package
February 01, 2019
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31. Children – No children
PCS Screen Package
February 01, 2019
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32. Children – Children is selected
PCS Screen Package
February 01, 2019
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33. Supplemental Security Income – Yes to all
PCS Screen Package
February 01, 2019
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Note: This is the resources dropdown list.
PCS Screen Package
February 01, 2019
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Note: This is the income dropdown list.
PCS Screen Package
February 01, 2019
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PCS Screen Package
February 01, 2019
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34. Supplemental Security Income - Do not wish to apply for SSI
PCS Screen Package
February 01, 2019
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35. Benefits Summary – Default view (table)
PCS Screen Package
February 01, 2019
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PCS Screen Package
February 01, 2019
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PCS Screen Package
February 01, 2019
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36. Next Steps – Variations: file for all four benefit types
PCS Screen Package
February 01, 2019
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37. Next Steps – Variations: set up an appointment for all four benefit types
PCS Screen Package
February 01, 2019
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38. Next Steps – Variations: closeout for all four benefit types
PCS Screen Package
February 01, 2019
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39. Next Steps – Variations: combination
PCS Screen Package
February 01, 2019
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| File Type | application/pdf |
| Author | Fujitsu |
| File Modified | 2019-02-11 |
| File Created | 2019-02-11 |