TN 13 (09-01)

A. POLICY--WHAT IS AN EAP

An EAP is an expedited payment made by the field office (FO) Third Party Payment System (TPPS) to:

• an initial claimant (SI 02004.005A.1.) who:

• has a financial emergency (SI 02004.005A.2.);

  • is eligible for SSI benefits (SI 02004.005A.3.); and

  • has not been paid on the claim yet--i.e., no EAP, IP, PD/PB, OTP, or regular payment has been paid.

  An EAP may be paid to a person in the month the application is filed. Effective August 22, 1996, the law prohibits payment for any day prior to the first day of the month following the month in which an application is filed or an individual first becomes eligible. If the applicant is determined to be eligible, the month of application will have a payment status code (PSY) of E02. An EAP can be made to an applicant in an E02 month. Compute the EAP based on the amount of SSI due for the following month.

1. Initially Applying

A person who received an EAP on a prior claim may receive an EAP when reapplying for SSI. A person who appeals prior denials and is successful on appeal may receive an EAP.

2. Financial Emergency

A financial emergency exists when a person has insufficient income or resources to meet an immediate threat to health or safety, such as the lack of food, clothing, shelter or medical care.

An emergency can exist when a person has liquid resources, but cannot access them quickly enough to meet an immediate threat to health or safety. Absent evidence to the contrary, accept a person's allegation that he/she does not have enough money to meet an immediate threat to his/her health or safety. When a couple lives together, the members share responsibility for meeting a financial need.

A person has the right to choose a specific health professional, shelter, clothing, food, etc., to meet a need. Do not make this choice for a person to avoid making an EAP. For example, do not refer a person to cheaper health service of another type, or another source, to avoid making an EAP.

3. Eligibility

A person must be due SSI benefits to receive an EAP. A person can receive an EAP if he/she will receive SSI benefits based on a finding of presumptive disability/blindness. If there is a financial emergency and the FO cannot make a presumption of disability or blindness according to DI 11055.240, advise the disability determination services (DDS) of the emergency. The DDS may be able to make a finding of presumptive disability/blindness (DI 23535.010).

B. POLICY — MAXIMUM EAP AMOUNT

1. Definition

The maximum EAP is the smallest of these three amounts:

• The Federal benefit rate (FBR) plus the federally administered SSP level. (The SSP includes Mandatory Minimum State Supplementary (MMSS) and Optional State Supplementary (OSS) payments

  (SI 01401.001).)

  If the EAP is paid before the first month for which payment is due, use the FBR and SSP for the first month for which payment is due. Otherwise, use the FBR and SSP for the month in which the EAP is paid.

• The total amount of benefits due from the first month for which payment is due through the month in which the EAP is paid.

• The amount requested for the financial emergency.

2. Example: EAP Greater Than Any One-Month's Payment AMount

a. Facts

In October 2001, the individual is found eligible for SSI. He requests $800 to meet a financial emergency. He applied in December 1999 (the E02 month), and is due benefits from January 2001 on. The FBR is $531. The State supplement level is $159. Because of his countable income, the total monthly SSI benefit he is due each month is $200.

b. Computation to determine maximum EAP payable:

• FBR plus SSP: 0ctober 2001 FBR is $531 plus SSP of $159 equals $690 ; or

• Total amount due: January 2001 through October 2001, the monthly amount due is $200, times 10 equals $2,000; or

• Amount requested to meet the financial emergency: $800;

c. The correct EAP amount is $690 (smallest of the three computed amounts).

3. Example: EAP Limited to Amount Requested For Emergency

a. Facts

In February 2001, the individual is found eligible for SSI. He requests $500 to meet a financial emergency. He applied in January 2001 (the E02 month), and is due benefits from February 2001 on. The FBR is $531. The State supplement level is $159. Because he has no income, the total monthly SSI benefit he is due is $690.

b. Computation to determine maximum EAP payable:

• FBR plus SSP: February 2001 FBR is $531 plus $159 equals $690 ; or

• Total amount due: for February 2001 is $690; or

• Amount requested to meet the financial emergency: $500;

• Therefore, the EAP amount is $500.

c. The correct EAP amount is $500 (tha smallest of the three computed amounts).

C. POLICY--RECOVERY OF EAP MONEY

1. Retroactive Benefits Payable

If the person who received the EAP is due retroactive SSI benefits, recover the EAP amount in full from the retroactive benefits.

2. No Retroactive Benefits Payable

If the person who received the EAP is not due retroactive SSI benefits, recover the EAP in 6 equal installments from the first 6 payments due. Recover the EAP in fewer months if: the person asks for them to be recovered in fewer months; or if fewer than 6 months' payment are due, e.g., because there is a closed period of disability of less than 6 months.

See the procedures in SI 02004.010.

3. Example

The individual filed for SSI on February 3, 2001. The first month for which she is due SSI benefits is March 2001, in which she will receive a title II benefit of $341. The FBR is $531, so she is due $210 SSI for March. The EAP, paid to her in February, is $210. Since she did not receive any retroactive SSI benefits, she must repay the EAP of $210 in 6 equal installments. Each installment is $35 ($210 divided by 6), so each payment for March through August will be reduced to $175.