SI 02301: Posteligibility Changes
TN 30 (11-06)
A. Introduction
This section explains the use of payment status code N05 to suspend eligibility for a past nonpay period. Other uses for N05 to suspend eligibility and instructions are in:
SI 00501.415 – Failure to provide information for living with blind/disabled children of military personnel stationed overseas, and
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SI 00515.001 – Failure to give permission to contact financial institutions.
NOTE: Giving permission to contact financial institutions is an eligibility requirement for SSI. If the recipient is otherwise eligible, reinstatement is effective the month after the month permission is given.
B. Procedure – Suspending N05 for a Past Nonpay Period
Use N05 to suspend SSI when a recipient cannot or does not provide information to determine eligibility/payment amount for a past nonpay period (no payment issued). This situation usually occurs when reinstating SSI after a favorable appeal decision. Before considering N05 for a past period, follow the instructions on requesting and obtaining information in SI 02301.235. When placing a record in N05, be sure to input to the remarks section on the SSR, “N05 FOR A PAST PERIOD.”
NOTE: Do not use N05 to withhold payment for a past nonpay period before completing development to establish eligibility/payment amount. See SM 01311.355 on how to withhold an underpayment temporarily.
C. Procedure - Manual Notice Required
Suppress the systems notice and issue a manual notice to reinstate benefits when inputting N05 for a past nonpay period. Select appropriate paragraphs from NL 00803.025 including paragraphs that describe all changes during the review period. For N05, use PMTM01 (NL 00804.135) under the caption “Your Payment is Based on These Facts.” (For a sample notice, see NL 00804.700, notice number 3.)
Use this chart to determine the proper notice form:
If the reinstatement action is... |
then issue Form... |
---|---|
adverse after a period of S06, S07 or S08* |
SSA-L8155-U2 (Notice of Planned Action), see |
an increase or no change in payment amount after an eligibility suspension |
SSA-L8151-U2 (Notice of Change in Payment), see |
effectuation of an appellate reversal |
SSA-L8166-U2 (Important Information Notice), see |
*To determine whether the reinstatement action is adverse after a period of ineligibility or nonpay due to S06, S07 or S08, compare the next month's benefit due with the last monthly benefit paid before the ineligibility or nonpay period on the record. See SI 02301.300 about adverse actions.
D. Procedure – Removing N05 for a Past Period
Remove an N05 determination on a record and reinstate benefits for a past period subject to the rules of administrative finality (SI 04070.000) when:
the recipient appeals the N05 determination and provides new information establishing eligibility/payment amount, or
the FO receives new information establishing eligibility/payment amount.
E. References
SI 02301.205 – Suspension and Reestablishing Eligibility
SI 02301.210 – Reinstatement
SM 01305.001O.4 – Payment Status Code