SI 02301: Posteligibility Changes

Effective Dates: 08/07/2012 - Present

TN 15 (02-95)

A. Introduction

This section provides guidelines on how to act on first and third party reports of change. FOs receive reports during interviews with individuals and by mail, systems interfaces and alerts and computer matches with Federal and State agencies.

B. Definitions

1. First Party Report

A first party report is:

a report by a recipient or the recipient's eligible spouse, representative payee, legal guardian, authorized representative, or other person acting on behalf of the recipient at the recipient's request, or
a change or alert resulting from a Supplemental Income Record (SSR) computer interface with the Master Beneficiary Record (MBR), or
a report of admission to or discharge from a public institution or a title XIX institution by the institution or a government agency.

2. Third Party Report

A third party report is:

a report by a person or organization not listed in the definition of a first party report, or
a computer match with a Federal or State agency. See SI 02310.005 for an explanation of interfaces affected by the Computer Matching and Privacy Protection Act of 1988 (CMPPA).

C. Procedure

1. All SSI Reports

When you receive a report, act as quickly as possible:

obtain a current systems record(s) (SSR/MBR) and verify the type(s) of benefits involved;
identify the person/organization making it (see GN 03001.012);
obtain any additional facts needed about the change (see SI 02301.005B.5. on what reports should include);
remind recipients and payees of their reporting responsibilities during interviews (see SI 02301.005D above for procedure);
decide whether to process the report as a first or third party report;
decide if you should process a change and/or if you must refer it to another FO or employee level of responsibility; and
take the appropriate action.

2. First Party Reports

Use these guidelines to process first party reports:

Guidelines...	Refer to...
Contact the recipient if a report is unclear or contains insufficient information.	First or Third Party Reports
Use the SSI eligibility rules and the retrospective monthly accounting (RMA) rules to determine any effect on SSI (eligibility or payment amount).	SSI Eligibility, SI 00501.001 Summary of Suspension, Stop Payment and Termination Events by Payment Status Code (PSC), SI 02301.215 RMA, SI 02005.001
Determine if a COA affects SSI, follow COA procedures. Consider the need for a new payee if a COA separates payee/recipient by considerable distance.	COA, Change of Address or Residence, SI 02306.010 Determining the Need for a Successor Payee, GN 00504.100
Verify with a payee a report/request for change in payment delivery from an incapable recipient. Review capability and/or the need for a new payee if the request is for direct payment.	COA-General, GN 02605.001 Developing Capability, GN 00502.020 Determining the Need for a Successor Payee, GN 00504.100
Determine the need for an unscheduled redetermination when the change affects SSI and no redetermination is pending.	Unscheduled Redeterminations, SI 02305.022
Provide an initial written request for information/evidence needed to establish SSI.	Failure to Provide Information, SI 02301.235
Verify income and resource changes which allow SSI.	Earned Income, SI 00820.001 Unearned Income, SI 00830.001 Countable Resources, SI 01140.001
Follow GK due process procedures to reduce a future month's benefit.	Goldberg/Kelly Procedures, SI 02301.300
Consider a penalty when a capable adult recipient fails to report on time and causes an excess payment.	Assessing Penalties, SI 02301.100
Evaluate payee suitability and the need for a new payee when a payee/recipient fails to report on time and causes an excess payment.	Determining the Need for a Successor Payee, GN 00504.100
Develop any resulting overpayment.	Overpayments, SI 02201.005

3. Third Party Reports

Verify third party reports with the recipient/payee:

If the individual...	then...
AGREES with the report	process as a first party, see C.2, above.
DISAGREES with the report and CMPPA does not apply	provide an initial written request for information/evidence that supports his or her statements and process as a first party report, see C.2, above.
DISAGREES with the report and CMPPA applies	follow CMPPA instructions in SI 02310.005

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SI 023: Posteligibility Events

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