SI 02305: Redeterminations of Eligibility and/or Payment Amount
Citations:
Social Security Act – Section 1611(c)(1) Social Security Act Amendments (1987) –Section 1619 (b)(2)(A) Public Law 99–643
Regulations – 20 CFR 416.204
TN 56 (10-07)
A. Definition
Redeterminations
A redetermination (RZ) is a review of a recipient's/couple's non-medical eligibility factors (i.e., income, resources, and living arrangements) to determine whether the recipient/couple is still eligible for and receiving the correct SSI payment.
B. Policy
In order to avoid payment errors and to identify existing payment errors as soon as possible, it is extremely important to:
Complete RZs accurately;
Maintain the required documentation; and
Update the Supplemental Security Record (SSR).
1. Scheduled RZs
Scheduled RZs are selected and conducted at periodic intervals. Intervals vary depending on the likelihood of payment error.
2. Unscheduled RZs
Unscheduled RZs are conducted based on a report of change in a recipient's/couple's circumstances that may affect eligibility and payment amount. Instructions for unscheduled RZs are in SI 02305.022.
C. Procedure
1. What to Review
Review all factors of eligibility
2. Exceptions
In general, the following eligibility factors are not reviewed.
Age, unless the FO questions the previous determination.
Citizenship, unless the recipient is identified on the SSR as a non-citizen (AR code is other than A, C, or D with a date of eligibility of 01/01/82 or later, or M, N, or Q) or if the previous determination is questionable.
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Disability/blindness, unless:
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A disability redetermination is due per DI 11070.001.
NOTE: A disability redetermination is always required upon attainment of age 18
Continuing disability/blindness is an issue per DI 13005.001, or
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An aged individual potentially qualifies under 1619(b) per SI 02305.030C.5.1.
NOTE: Section 1619 cases may require a continuing disability review (CDR). See DI 13005.018B to determine when a CDR is necessary.
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3. Conducting RZ Interviews
Conduct RZ interviews using appropriate forms or by completing the appropriate RZ path in the Modernized SSI Claims System (MSSICS).
D. References
The Modernized System Operations Manual (MSOM) Modernized SSI Claims System (MSSICS), MSOM MSSICS 001.001 through MSOM MSSICSCOMPS 002.001
RZ Forms or MSSICS, SI 02305.032
Systems Processing for SSI Redeterminations, SM 01501.000 ff.
http://emis.ba.ssa.gov/emis/emisusers/mgmnt/dprv/dips_userguide/webhelp_published/index.htm
RZ for Non-qualified Grandfathered Aliens, SI 00502.153E.
Accessing PE ODS, PE ODS RZ/LI User's Guide