TN 24 (12-94)

2051. Situation Where Used:

PE: On an SSA-L8151 when the individual is getting an increase payment for CCM, and computer matching income is posted to the record. This paragraph follows paragraphs giving the income used to compute payments under the caption Your Payment is Based on These Facts.

Please check the information above about (1) (2) (3) . We received this information from computer matching with (4) (5) . We cannot use this information to change (your) SSI until we give (you) time to check it. If (you) do not contact us within 30 days, we will assume the information is correct and use it to change (your) SSI checks.

2052. Situation Where Used:

May be used with 2064 or 2051 above. This paragraph is issued in automated notices whenever (1) due amounts increase for the current calendar month of the interface, or the supplemental month and, (2) computer matching is posted for the current calendar month or the supplemental month. Because the system is not capable of waiting 30 days before using the computer data to reduce payments, the FO must determine if an additional payment for either of the 2 months is due.

We cannot pay (1) the correct amount for (2) in (your) regular check, so (your) local Social Security office will send (you) another check for (3) . Contact the office listed in the last paragraph of this letter to find out if and when (you) will receive this check.

2053. Situation Where Used:

When a 1619(b) eligible loses 1619(b) status and enters a true suspense (ineligibility) status at the time that computer matching income is posted. Issue on an SSA-L8155 amended to reflect 30 days for payment continuation (see paragraph 2064).

Use with paragraph 2054 under the caption Information About Medicaid and before the caption Your SSI is Based on These Facts . Also used with paragraphs 2055 and 2575.

If (1) receiving Medicaid, (you) will no longer be eligible for Medicaid based on SSI beginning (2) . This is because of income (3) (4) in addition to (your) income from work. We explain more about (5) (6) income below.

2054. Situation Where Used:

Use after paragraph 2053. See situation for paragraph 2053. Use with paragraphs 2059 and 2575.

(1) will make a final decision about whether (you) might still be eligible for Medicaid on a different basis. Please contact that office if you have any questions about Medicaid.

2055. Situation Where Used:

Use under the caption Please Remember This which follows Your SSI is Based on These Facts . Used when paragraphs 2053, 2054, 2059 and 2575 are required.

If (1) less income, (you) may be able to receive SSI checks again, or may be eligible for Medicaid based on SSI. Please let us know right away if any of the following things change:

• (Your) income

• Where (you) live; or

• The people (you) live with.

(You) might be able to receive SSI if any of these things change.

If (you) contact us before (2) , and we find that (you) are eligible again, we may be able to start (your) SSI without making a new decision about (your) health problems. After that date, we would have to make a decision about (your) health problems before (you) could receive SSI.

2056. Situation Where Used:

An individual in 1619(b) status has a computer matching notice posted to the record but will remain in 1619(b) status. A notice is required because this computer match income, combined with an increase in other unearned income at a later date, could cause ineligibility.

Use on an SSA-L8166 with paragraph 2057. This paragraph follows the income listing under the caption Your SSI is Based on These Facts.

Please check the information above about (1) (2) (3) . We received this information from computer matching with (4) (5) .

Although we are changing this information on (your) record, we are not changing (your) current eligibility. However, if (your) income or other information about (you) changes in the future, this income from (6) (7) could affect (your) eligibility.

We cannot use this information until we give (you) time to check it. If (you) do not contact us within 30 days, we will assume this information is correct. If there are later changes to (your) record, we may use the information about (8) (9) (10) to affect (your) eligibility.

2057. Situation Where Used:

Use with paragraph 2056. This paragraph is the first paragraph under the first caption for this notice, Information About Medicaid.

When (1) SSI checks stopped because of (your) income from work, we told (you) that (you) may be eligible for Medicaid based on SSI. This letter does not change (your) eligibility.

2058. Situation Where Used:

PE: Current payment case where posting of computer matching data does not change due amounts (for example, income is posted to a deemor but deeming does not currently apply). Use on an SSA-L8166 after the income listing under the caption Your Payment is Based on These Facts.

Please check the information above about (1) (2) (3) . We received this information from computer matching with (4) (5) .

Although we are changing (your) record, we are not changing (your) current SSI payment. However, if (your) income or other facts about (you) changes in the future, this income from (6) (7) could affect (your) payments.

We cannot use this information until we give (you) time to check it. If you do not contact us within 30 days, we will assume the information is correct. If there are later changes to (your) record, we may use the new amount of (8) (9) (10) in figuring (your) SSI payments.

2059. Situation Where Used:

Use with paragraphs 2053, 2054, 2055 and 2575 for cases going from 1619(b) eligibility to eligibility suspension/termination. This paragraph follows the listing of income under the captionYour SSI is Based on These Facts.

Please check the informaion above about (1) (2) (3) . We received this information from computer matching with (4) (5) . We cannot use this information to change (your) SSI until we give (you) time to check it. If (you) do not contact us within 30 days, we will assume the information is correct, and use it to decide the effect on (your) eligibility for Medicaid based on SSI.

2060. Situation Where Used:

Recipient is in 1619(b) status (as shown on the Supplemental Security Income Record) when we receive computer-matching information. However, he/she is returning to current pay status because income (from any source) has decreased.

Please check the information above about (1) (2) (3) . We received this information from computer matching with the (4) (5) and have used it so (you) could begin receiving SSI payments right away. However, you have 60 days to ask for an appeal if you disagree with this information.

2061. Situation Where Used:

Recipient with a ineligible spouse or parent has deemed income that does not affect the SSI payment. However, part of the deemed income was reported through computer matching, so we are giving the recipient 30 days to disagree with the information. This paragraph can be used with paragraphs 1601 and 2058.

This amount includes the (1) (2) received by (3) for (4) .

2062. Situation Where Used:

Used when:

• In the same computer run, we receive computer-matching information that changes an individual's countable income; and

• In the same computer run, the system identifies an underpayment due the recipient (whether or not it is caused by the computer-matching information); and

• A RMA transitional computation cycle applies, so we use current income to compute the current payment.

Please check the information above about (1) (2) (3) . We received this information from computer matching with the (4) (5) and have used it to decide (your) SSI amount for (6) . We will also use it to (7) (your) SSI beginning (8) .

However, you have 30 days to check this information. If you think it is wrong, you should contact us. If you do not contact us, we will assume the information is correct.

(9)

2063. Situation Where Used:

IC: Used when the following events occur:

• We receive computer-matching information that increases a person's countable income. As a result, the system sent a notice giving the person 30 days to contact us before we use the information to reduce future SSI payments.

• Before the end of the 30 days, the system computes an underpayment (because of changes in other income) and uses the computer-matching information to reduce the amount of the underpayment.

• The person is in a transitional computation cycle.

Please check the information about (1) (2) (3) . As we told you in an earlier letter, we received this information from computer matching with the (4) (5) . We said we would wait 30 days before using the information to decide the amount of (your) SSI payment. However, (you) are now due more money for (6) and we used the computer-matching information to decide how much money (you) are due.

You still have 30 days from the date of the earlier letter to contact us if you do not agree with the information. You also have 60 days, as explained below, to ask for a formal appeal.

2064. Situation Where Used:

Income from computer matching reduces an ongoing payment. This paragraph replaced paragraph 2050 in December 1990. It comes under caption 1907, Your Payment is Based on These Facts, and is in addition to paragraph 2575.

Please check the information above about (1) (2) (3) . We received this information from computer matching with (4) (5) . We cannot use this information to change (your) SSI until we give you time to check it. If you disagree with this information, you should contact us.

• If we do not hear from you within 30 days, we will assume the information about (6) (7) (8) is correct, and use the information to reduce (your) SSI checks.

• If you appeal in the next 30 days, we will not reduce (your) checks until we decide the appeal.

• However, you have 60 days, as explained below, to ask for a formal appeal.

2575. Situation Where Used:

Use on SSA-L8155, Notice of Planned Action, when computer matching income is involved. Replaced paragraph 2565 in January 1993.

NOTE: When using the preprinted SSA-L8155, amend the appeal language to change the 10 days to 30 days.

Do You Disagree With The Decision?

If you disagree with the decision, you have the right to appeal. We will review your case and consider any new facts you have.

• You have 60 days to ask for an appeal.

• The 60 days start the day after you get this letter. We assume you got this letter 5 days after the date on it unless you show us that you did not get it within the 5-day period.

• You must have a good reason for waiting more than 60 days to ask for an appeal.

• To appeal, you must fill out a form call “Request for Reconsideration.” The form number is SSA-561. To get this form, contact one of our offices. We can help you fill out the form.

Appeal In 30 Days To Keep Getting Your Same Check

• We won't change your check if you appeal within 30 days.

• The 30 days start the day after you get this letter.

• If you lose your appeal, you might have to pay back some or all of this money.

How To Appeal

There are three ways to appeal. You can pick the one you want. If you meet with us in person, it may help us decide your case.

Case review. You have a right to review the facts in your file. You can give us more facts to add to your file. Then we'll decide your case again. You won't meet with the person who decides your case.

Informal Conference. You'll meet with the person who decides your case. You can tell that person why you think you're right. You can give us more facts to help prove you're right. You can bring other people to help explain your case.

Formal Conference. This is a meeting like an informal conference. The difference is we can make people come to help prove you're right. We can make them bring important papers about your case, even if they don't want to help you. You can question these people at your meeting.

If You Want Help With Your Appeal

You can have a friend, lawyer or someone else help you. There are groups that can help you find a lawyer or give you free legal services if you qualify. There are also lawyers who do not charge unless you win your appeal. Your local Social Security office has a list of groups that can help you with your appeal.

If you get someone to help you, you should let us know. If you hire someone, we must approve the fee before he or she can collect it.

CMAM01 Situation Where Used:

We receive information from computer matching that a recipient's or deemor's income has stopped, e.g., he is no longer receiving a pension from the Department of Veterans Affairs. This paragraph will be used with paragraph 2050, 2051, or 2058.

(1) no longer getting (2) beginning (3) .

CMAM02 Situation Where Used:

We will use this paragraph when:

• We receive computer-matching information from the Department of Veterans Affairs (VA); and

• This information shows in the beginning of a quarter, that a recipient will receive a quarterly VA payment at the end of the quarter; and

• The computer-matching information will not affect eligibility (but may affect payment amount).

We recently matched computer records with the Department of Veterans Affairs (VA) and learned that (1) will receive (2) of (3) in (4) .

Please check this information, because this VA payment may change the amount of SSI we can pay for (5) . We cannot use this information until we give you time to check it. If you do not contact us within 30 days, we will assume the information is correct and use it to change your SSI payments. However, before we change your payments, we will send you another letter about the change in how you can appeal that decision.

CMAM03 Situation Where Used:

Use on a SSA-L3074, Notice of Appointment, when a computer match alert is received, and personal contact is required.

We received information from computer matching with (1) . We learned that (2) (3) . Since this information may reduce or stop (your) SSI, we would like to discuss it with you. Under the computer-matching law, we cannot use this information to change (your) SSI until we give you 30 days to disagree with it. Please have with you when you (4) any records you have about (5) .

CMAM04 Situation Where Used:

Use on a manual SSA-L8155 when individual fails to respond to the SSA-L3074.

YOUR PAYMENT IS BASED ON THESE FACTS

In an earlier letter, we told you that we received information from computer matching with (1) . We learned that you have (2) . We told you that to keep getting SSI payments you must contact us about this information. Under the computer-matching law, we couldn't use this information to change your SSI until we gave you 30 days to disagree with it.

Since you have not provided the information we asked for, we will stop your payments beginning (3) . We will not change your check if you appeal within 30 days.

CMAM05 Situation Where Used:

Use on manual overpayment notice when this is the first determination the individual receives about the computer matching data.

WHY YOU WERE OVERPAID

We sent you a letter earlier telling you that we received computer-matching information from (1) about (2) . After we discussed this information with you, we checked it (3) before we made our decision about your overpayment.