SI 00501: Eligibility Under the Supplemental Security Income (SSI) Provisions
TN 39 (08-04)
A. Introduction - Systems Requirements
With minor changes (see SI 00501.418B. and SI 00501.418C.), most current systems instructions apply to these cases. These changes will allow the system to process payment in these cases and route all output correctly. Follow these instructions to ensure that the correct address and servicing FO codes are posted to the record. The purpose of the sequence of the address inputs is to reflect the actual residence and mailing addresses of the child while allowing the Cumberland FO to retain jurisdiction of the case.
B. Procedure - Initial Claim System Input
When processing a MSSICS or Non-MSSICS initial claim establish an SSI record using the following criteria:
Unit (UN) No. Field: Use “ZZZ” for the unit in the UN field. “ZZZ” in the UN field will exclude processing time;
State Agency (SA) Field: Use office code “V22” in the SA field. “V22” is the office number for OIO;
Mailing Address (AD) field – Input the APO/FPO/DPO (Army Post Office or Foreign Post Office, or Diplomatic Post Office) address as provided by the applicant (e.g., AD395th QM BN.);
Mailing Address City (AY) Field – Input “APO” or “FPO” or “DPO” for the city (e.g., AYAPO.);
Mailing State (AT) Field – Input the two letter code that corresponds to the geographic location of the U.S. military base. (e.g., ATAE.; ATAA.; ATAP.);
Mailing Zip Code (ZP) Field – Input the zip code for the APO as provided (e.g., ZP09169);
Residence Address (RA) Field – Input the child's foreign address;
Residence Address City (RY) Field – Input “Cumberland” for the city (e.g., RYCumberland.);
Residence State (RT) Field – Input “MD” for the state (e.g., RTMD.);
Residence Zip Code (ZC) Field – Input Cumberland's zip code “21502” (e.g., ZC21502.);
Federal Living Arrangement (LA) Field – Input the state and county code for Cumberland, MD “21000A” (e.g., LA050421000ACZ);
Override (SO) Field – Systems override needed “ST”, input SOST;
Third Party Insurance (PT) Field – Input “F”, to suspend Medicaid eligibility and the four position date (MMYY) of the application effective date (e.g., PTF0504) (See SI 00601.009 – Application Effective Date);
Complete all other fields on the SSA-450 SI based on the full application, taking into consideration all factors of SSI eligibility. (See SM 01005.000 – SSA-450 Input Instructions).
C. Procedure - Posteligibility System Input
For MSSICS cases first complete the COA on the Representative Payee System (RPS). See C.1. below for RPS special processing under this provision. When processing MSSICS or Non-MSSICS cases use the following criteria (See MSOM MSSICS 010.002 – Residence Address (LRES) screen).
1. Address Inputs
a. Mailing Address (AD) Field
Input the APO/FPO address as provided (e.g., AD395th QM BN.).
b. Mailing City (AY) Field
Input “APO” or “FPO” for the city (e.g., AY1APO.).
c. Mailing State (AT) Field
Input the two letter code that corresponds to the geographic location of the U.S. military base. (e.g., AT1AE.; AT1AA.; AT1AP.).
d. Mailing Address ZIP Code (ZP) Field
Input the ZIP Code as provided (e.g., ZP109169.).
e. Residence Address (RA) Field
Input the child's foreign address (RA17C Jackson Circle, Giessen Germany.).
f. Residence Address City (RY) Field
Input “Cumberland” for the city (i.e., RY1Cumberland.).
g. Residence State (RT) Field
Input “MD” for the state (i.e., RT1MD.).
h. Residence Address ZIP Code (ZC) Field
Input the ZIP Code for Cumberland, MD (i.e., ZC121502.).
i. Living Arrangement (LA) Field
Input each segment of the LA field as follows:
ID — Input “1.”
Date — Input the month and year (MMYY) of the month after the month the child leaves the United States.
State and County Code — Input the State and county code for Cumberland, MD (i.e., “21000A.”). (NOTE: If changing an address through the Representative Payee System (RPS) input the appropriate state and county code and district office code in the RPAD screen. Due to a current system limitation leave out the last letter “A” (e.g., input the state and county code as “96001”). Also, input the Cumberland FO's district office code “275”.
Federal Living Arrangement — Input appropriate living arrangement code, (i.e., “21000AC”).
Optional State Supplementation Code — Make no entry.
j. Systems override needed (SO) Field
Input “SOST”.
2. Medicaid Related Inputs
a. Child Leaves the United States
Make input to suspend Medicaid eligibility.
MSSICS Case
Complete the BHLT screen. Enter “A” in question 2-M (Agree to Assign Rights to Payments for Medical Support and Medical Care to the State Medicaid Agency) of the BHLT screen (See MSOM INTRANETSSI 019.020).
Non-MSSICS Case
Suspend Medicaid eligibility by using an SSA-450-SI, input the following:
Prior Error (PR) Field — Input PR9 (See SM 01015.002D. - Description of PR Field).
Third Party Insurance (PT) Field — Input “F” and the four position date (MMYY) of the month after the month the child left the United States (e.g., PTF0990) (See SM 01005.350C. - Description of PT Field).
b. Child Returns to the United States
Make input to reinstate Medicaid eligibility.
MSSICS case
Complete the BHLT screen (See MSOM INTRANETSSI 019.020). Enter the appropriate responses for the new residence State.
Non-MSSICS Cases
Using an SSA-450-SI, input the following:
Prior Error (PR) Field - Input PR9; and
Third Party Insurance (PT) Field - The appropriate PT code if required in the new residence State and the four position date (MMYY) of the month after the month the child returns to the United States; or
Delete (DL) Field - The delete identifier and code “PT” if a third party insurance indicator is not appropriate for the new residence State (i.e., DLPT) (See SM 01005.500C. - Description of the DL field);
NOTE: Be sure to make the SSA-450-SI input to affect Medicaid eligibility either before or in the same run as the input which changes the address.
3. Diaries and Alerts - General
Process all diaries and alerts as current instructions provide. However, pay particular attention to diaries/alerts which affect any aspect of the criteria for continuation of benefits in these cases.
4. KB Diaries
a. Importance of KB Diaries to This Provision
KB diaries are particularly sensitive in these cases because eligibility under this provision only applies to children.
b. Processing KB Diaries
When you receive a KB diary alert indicating attainment of age 18:
develop for continuation of benefits; and
continue benefits if the child is in a school or training program designed to prepare him or her for employment (see SI 00501.010); or
suspend benefits after proper notification if the child is not in school or a training program designed to prepare him or her for employment.