TN 19 (11-12)

Regulations 20 CFR 416.1161(a)(2) and (3), (b), (c), (d), 416.1163(b), 416.1165(c), (d)

A. Policy on what is excluded from deeming

We exclude from deemed income any public income maintenance (PIM) payment and any income used to compute such payment, as discussed in SI 01320.141B. in this section.

This exclusion applies to the income of an ineligible spouse or parent when used to compute a PIM payment regardless of who receives that payment.

This exclusion does not apply to persons who receive Medicaid while working under the Section 1619(b) provisions, as they are considered disabled individuals receiving SSI benefits for purposes of eligibility for Medicaid only.

This table provides the situations in which we pay PIM.

B. Policy on whose income to exclude from deeming

The exclusion in SI 01320.141A, in this section applies to the income of ineligible spouses and ineligible parents.

There is no deeming allocation for ineligible spouses, parents, or children who receive PIM payments.

C. Procedure for applying the PIM payment exclusion

In many cases we make assumptions about receipt of PIM payments when applying the PIM payment exclusions. However, in some cases we cannot rely on assumptions and must verify receipt of the PIM payment.

1. Assume the paying agency made the correct payment determination

Assume that the agency paying the PIM benefits considered all of the income of the person who received the PIM payment (either counting or excluding the income). Absent evidence to the contrary, no further verification of the income used in determining the PIM payment is necessary. For more information on how to count income based on need, see SI 00830.170.

2. Consider eligibility established even in the absence of payment

In cases where a person alleges eligibility for a PIM payment, but did not receive a payment:

• contact the appropriate agency; verify and document the reason the PIM paying agency made no payment; and,

• exclude the deemor's income if eligibility for the PIM program exists.

If the agency states that there is no eligibility for the PIM program, deem the ineligible spouse's or parent's (or parents’) income to the eligible individual or child as appropriate.

NOTE: We consider a deemor who files for Supplemental Security Income (SSI) on or after August 22, 1996 eligible for a PIM payment in the month before his or her application’s effective date (i.e., in the E02 month).

3. Assume the agency making the PIM payment considered the income of a spouse for cases with TANF involvement

In cases involving TANF, assume that the agency making the PIM payment considered all of the income of a legally married spouse who is living in the same household when determining a TANF payment to the family.

If a relationship does not meet the legal requirements for marriage under State law, but meets the “holding out” requirements for SSI purposes, verify that the TANF agency used the spouse's income in making the TANF benefit calculation before excluding it for deeming purposes.

4. Verify receipt of PIM payments in initial claims

In initial claims always:

• Verify the receipt of PIM payments if PIM eligibility is alleged by a deemor (or an ineligible child in the deeming household).
  It is not necessary to verify the amount paid to the deemor only that the PIM payment includes the deemor.

• Ask the claimant or recipient to submit any evidence in his or her possession or any evidence that he or she can reasonably be expected to obtain.

• If the individual is unable to submit sufficient evidence of eligibility for a PIM payment, request the evidence from the appropriate agency.

For cases involving TANF follow the procedures in SI 00830.403C.1 to verify the amount of the TANF grant and the amount of the payments to the eligible individual.

5. Develop PIM payments during redeterminations

a. General rule for developing PIM payments

If an ineligible spouse or parent alleges receiving PIM payments at a redetermination, it is not necessary to verify the PIM as long as it is consistent with information on the Supplemental Security Record for the period of review. Accept the allegation without further development unless the exception in SI 01320.141C.5.b, in this section, exists.

b. Exception for cases involving receipt of TANF and wages

If an ineligible spouse or parent alleges receiving TANF benefits but has also received wages at any time during the period of review, follow the instructions at SI 00830.403C.1. and verify continued receipt of TANF benefits.

NOTE: Verify continued TANF eligibility of the deemor with wages not the amount of the grant.

Do not assume the deemor remains eligible for TANF without verification if there is an indication that the deemor received wages while also receiving TANF. The claims representative must verify that the deemor continues to be entitled to TANF benefits because wages can only be excluded when the deemor continues to be included in the TANF grant.

D. References

• SI 00601.009 Application Effective Date

• SI 00830.170 Income Based on Need (IBON)

• SI 00830.175 Assistance Based on Need (ABON)

• SI 00830.300 Department of Veterans Affairs Payments

• SI 00830.403 Temporary Assistance For Needy Families (TANF)

• SI 00830.620 Disaster Assistance – Presidentially-Declared Disaster

• SI 00830.645 Refugee Cash Assistance, Cuban and Haitian Entrant Cash Assistance and Federally Reimbursed General Assistance Payment to Refugees

• SI 00830.800 Bureau of Indian Affairs General Assistance

• SI 01310.115 Deeming Concept - Child