SI 02305: Redeterminations of Eligibility and/or Payment Amount
TN 54 (11-06)
A. Introduction
This section provides general instructions for developing all types of income.
B. Procedure – verifying Income
1. Verifying income for the period of review
Verify income through the end of the month prior to the month the RZ is initiated, unless development tolerances in SI 00820.140B. apply.
REMINDER: When requesting income verification from a third party in a month after the initiation month, ask for verified data for each month prior to the month you send the request. This will enable you to get the most current data available from that source.
2. Verifying periods outside administrative finality
Do not verify income received outside the rules of administrative finality unless fraud or similar fault is an issue as explained in SI 04070.020.
To avoid having cases reselected because of unverified earned income on the record, input verification codes for earned income in months outside the rules of administrative finality.
EXAMPLE: Current RZ Initiated on the First Day of the Month
The last RZ was initiated in 10/99. Earned income was verified through 09/99 and an earned income estimate of $100 per month was input to the SSR with a frequency code of “C.” The current RZ was selected on 10/01/02. The RZ and earned income development were initiated on 1/01/03. Input verification code “9” for the months barred by administrative finality (i.e., 10/99 through 10/00).
EXAMPLE: Current RZ Initiated Other Than the First Day of the Month
The last RZ was initiated in 10/94. Earned income has been verified through 09/99 and an earned income estimate of $100 per month was input to the SSR with a frequency code of “C.” The current RZ was selected in 10/01/02. The RZ and earned income development were initiated 01/15/03. Input verification code “9” for months barred by administrative finality (i.e., 10 /99 through 11/00).
C. Procedure – exclusions
Consider exclusions listed in SI 00810.410, SI 00830.050 through SI 00830.099, SI 00820.500 and SI 00830.060 which may reduce the amount of countable income. For income excluded under a PASS, develop for compliance with the plan per SI 00870.055, so it can be determined whether the exclusion should be continued, be adjusted, or stopped.
D. Procedure – work Incentives
Use every opportunity to inform disabled/blind recipients about the Work Incentives Provisions and encourage them to take advantage of the provisions. Where there is reasonable possibility of work, discuss:
Impairment related work expenses per SI 02305.097, SI 00820.540 and DI 10520.001;
Blind work expenses, when applicable, per SI 00820.535;
Plans for achieving self-support (PASS) per SI 00870.001;
Special payments for disabled people who work despite severe impairments (1619(a)) per SI 02302.001;
Extended Medicaid coverage (1619(b)) per SI 02302.001; and
Student child earned income exclusion, when applicable, per SI 00820.510.
E. Procedure – income of ineligible spouse
For the income of an ineligible spouse, develop the support payment exclusion, when appropriate, per SI 01320.145.
Document the income of an ineligible spouse on a signed statement or in the REMARKS section of a SSA–8203–BK, SSA–8202–F6, or the appropriate MSSICS screens. The earned income of the ineligible spouse is documented in Question 9 and Question 10 of the SSA-3988-OCR-SM.
NOTE: The unearned income of the ineligible spouse is documented in Question 11 on the SSA-3988-OCR-SM.
F. Procedure – income of others
Document the income of the following people on a signed statement, SSA–8010–BK, the REMARKS section of the SSA–8203–BK or SSA–8202–BK, or the appropriate MSSICS screen. In parent-to-child deeming cases, always document the income of others on a SSA–8010–BK when using a paper RZ form. Interviewers should not use the SSA–8010–BK for the eligible or ineligible spouse when conducting paper RZs because the RZ forms capture all the spouse's income and resources. (See SI 01310.600.)
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An eligible child's parent(s) and the parent's spouse living in the same household per SI 01310.110, SI 01320.500. Determine if an ineligible child allocation applies per SI 01310.110, SI 01320.500. Develop the support payment exclusion, when appropriate, per SI 01320.145. The earned income of an eligible child's parent(s) is documented in Question 9 and Question 10 of the SSA-3989-OCR-SM.
NOTE: The unearned income of the child's parents is documented in Question 11 of the SSA-3989-OCR-SM.
Sponsors of aliens and the sponsor's spouse per SI 01310.110, SI 01320.900. Determine if the eligible alien allocation applies per SI 01310.110, SI 01320.500. Develop the support payment exclusion, when appropriate, per SI 01320.145.
Essential persons per SI 01320.800; and
Ineligible children if their income is material as explained in SI 01310.110D.3. Develop the support payment exclusion, when appropriate, per SI 01320.145.
Record effective dates of changes and the reasons for any changes.
Verify income as required.
G. Procedure – unstated income
Explore the possibility of unstated income described in SI 00810.035 if allegations or information in prior in-office files raises questions about how living expenses are being met.
Resolve pending diaries and alerts since they may represent unstated income.
H. Procedure – prior estimates and verified earnings do not agree
Reopen the prior determination within the limits of administrative finality.
Input the verified earnings for the prior period as change items. Include effective dates and verification codes.
Develop any overpayments per SI 02201.005 through SI 02201.025. (The system computes overpayments and underpayments.)
I. Procedure – inputting estimates of income
As soon as possible after you obtain estimates of income, input them to the system via 1719B input when conducting the RZ on paper forms or Build Transaction SSR when using MSSICS.
Determine the effective date for inputting the estimates via 1719B, or through MSSICS, as follows:
If the estimated income does not change the ongoing payment amount or eligibility, the effective date for inputting the estimate is the current calendar month.
If the estimated income increases the payment amount for the current and/or future months, determine the effective date per see SI 00810.610.
If the estimated income makes the recipient ineligible for the current month or for the current and future months, the effective date for inputting the estimate is the first month of ineligibility.
If the estimated income reduces payment amount for current and future months, the effective date for inputting the estimate is the budget month for the first month that payment can be reduced. Do not input new estimates for earlier months. These months will be corrected when they are verified at a later date. This procedure prevents the system from computing an overpayment based on unverified data.