DI 11055: Supplemental Security Income (SSI) Disability Cases
TN 64 (09-09)
A. Policy
The EAP is a special one-time payment conducted in the Field Office in which the claimant receives an advance of the first month's benefit payment if an established financial emergency exists. The payment may be based on a finding that the non-medical eligibility factors are only presumptively met. However, there must be a sufficient basis for finding presumptive disability/presumptive blindness (PD/PB) eligibility on income and resources.
In claims based on disability or blindness, EAP requires either a PD/PB finding by the field office (FO) or a formal disability allowance by the Disability Determination Services (DDS). If the impairment is one of those listed in DI 11055.231, the FO may make an EAP based on PD/PB.
B. Procedure when the FO makes a PD/PB finding
If the claimant meets the EAP criteria listed in DI 11055.245A and SI 02004.005, and the FO makes a PD/PB finding, the FO must:
-
Follow procedure for making a PD/PB finding as outlined in DI 11055.230 and DI 11055.240;
NOTE: Include information regarding the EAP on the PD/PB remarks flag.
Process the EAP per FO Procedures for EAPs SI 02004.010;
Expedite the necessary non-medical development; and
Initiate PD/PB payments when non-medical development is completed.
NOTE: If the FO makes a PD/PB determination after transmitting the claim to the DDS, the FO must complete an SSA-831 and SSA-3367 (with supporting evidence, if required) with the PD/PB data transmitted to the DDS, using the Update-After-Transfer (UAT) utility in EDCS.
C. Procedure when the FO is unable to make a PD/PB finding
If the claimant meets the EAP criteria but the FO is unable to make a PD/PB finding, the FO must defer to the DDS for a possible PD/PB finding. Do not initiate an EAP until receipt of DDS notification of PD/PB.
NOTE: If the FO formally establishes non-medical eligibility by the time the DDS makes the PD/PB finding, the FO can also make PD/PB payments. Alert the DDS on EAP cases as follows:
1. If the case is a Certified Electronic Folder (CEF)
Attach the PD/PB flag per DI 11055.240C.4. and include information regarding the EAP (e.g., “FO could not make PD/PB finding, assistance requested”) in remarks.
2. If the case is excluded from electronic processing and the official folder is a paper Modular Disability Folder (MDF)
Attach Form SSA-408 (Route Slip) with a note to “Expedite – PD (or PB) Needed for EAP;”
Annotate the FO records and SSA-3367;
Check the appropriate category of PD/PB finding in Item 8 of the SSA-3367; and
Annotate the disability transmittal form to show the EAP decision along with the PD/PB finding.
REMINDER: Affix a terminal illness (TERI) flag on the front cover of the MDF for terminal illness claims.
For an exhibit, see OS 15020.301.