SI 00510: Requirement to File for Other Program Benefits
TN 8 (12-07)
A. Policy — Other Program Benefits
1. Other Program Benefits Subject to Filing Requirements
Types of other benefits for which an individual must file include:
Title II benefits (SI 00510.005B) and (DI 13050.020B.3.),
Veterans Pension and Compensation payments (see SI 00510.005A.2, SI 00510.010A, SI 00510.010D),
Retirement benefits,
Workers' Compensation payments (SI 00510.010D).
Pensions, and
Unemployment Insurance benefits.
2. Requirement to File for Apportionment of Augmented VA Benefit
Payments from the Department of Veterans Affairs (VA) issued to the veteran or the veteran's surviving spouse may be augmented for dependents. Effective 11/17/94, the dependent's portion of the VA benefit is not income to an absent dependent unless he/she receives it directly.
Therefore, to get SSI, an individual is required to file for apportionment (direct payment) of an augmented VA benefit if he/she:
Is the spouse or child of a living veteran or the child of a deceased veteran with a surviving spouse and the veteran or surviving spouse receives VA compensation, pension, or educational benefits; and
Does not reside with the designated beneficiary, (i.e., the veteran or the veteran's surviving spouse); and
Has not been denied apportionment since living apart from the designated beneficiary.
NOTE: Dependents who are receiving a VA benefit by apportionment do not receive automatic cost-of-living adjustments. You are not required to refer these individuals to the VA to request an increase.
3. Other Program Benefits Exempt from the Filing Requirements
Types of other benefits exempt from the requirement to file for other program benefits are:
Temporary Assistance for Needy Families (TANF),
General Public Assistance,
Bureau of Indian Affairs General Assistance,
Victims' compensation payments,
Other Federal, State, local or private programs which make payments based on need, and
Earned Income Tax Credits.
4. Conditions Exempting VAIP from Filing Requirement
Based on Public Law (P.L.) 96-272, enacted in June 1980, certain individuals cannot be required to file for Department of Veterans Affairs Improved Pension Plan (VAIP) nor can their SSI and/or State supplementation eligibility be suspended for failure to file. These are individuals who:
Currently reside in Alabama, Alaska, Arizona, Colorado, Delaware, Idaho, Mississippi, Nevada, New Mexico, South Carolina, South Dakota, Texas, or Wyoming; and
Were entitled to a VA pension as of December 31, 1978.
(See SI 00510.010A. for situations where individuals must file for VAIP.)
5. Payments which are not Program Benefits
Payments such as child support, alimony, accelerated life insurance, etc., are not program benefits for which an individual must file.
B. Policy — Social Security Benefits
1. Title II Benefits
Title II benefits are the greatest source of other program benefits. Title XVI adjudicators must explore potential entitlement to Title II benefits during the initial application and posteligibility reviews. Claimants/recipients must pursue potential entitlement to retirement and/or disability benefits based not only on the his/her own earnings record, but also on a different SSN for Title II dependents, including divorced spouses, and/or survivor's benefits. However, they are not required to file for Medicare only as a condition for SSI eligibility.
NOTE: Medicaid eligibility may continue for individuals in certain categories, i.e., certain widow(er)s, surviving divorced spouses and disabled adult children, even if entitlement to or an increase in Title II benefits results in SSI ineligibility (see SI 01715.015B. for persons categorically eligible for continued Medicaid coverage).
2. Pursuing Title II Entitlement and Adjudicating Title II
a. Potential Title II Entitlement
In both SSI initial claims and posteligibility situations, if a claimant/recipient is potentially eligible for Title II benefits and either chooses not to file or not to elect full retroactivity, SSA must notify him/her in writing of the requirement to file for all other benefits (see SI 00510.020B. for referral procedure).
b. Adjudicating Title II Aspects of Title XVI Application
Because an application for SSI payments is also an application for Title II benefits, adjudicators must take steps to determine whether the claimant is entitled to Title II benefits. If an individual does not file a separate Title II application concurrently with the SSI application, action must be taken to adjudicate the Title II aspects of the SSI claim (see SI 00601.035 for policy and procedure for adjudicating Title II).
REMINDER: A redetermination (RZ) form may also be a protective filing for Title II benefits (see GN 00204.015) which must be closed out by taking a Title II application or issuing a protective filing closeout notice.
C. Procedure — FO Identification of Potential Entitlement to Other Program Benefits
Since the claimant/recipient may be entitled to more than one type of program benefit, e.g., Title II retirement or Title II survivor benefits, be sure to identify all potential sources of benefits.
Obtain clues to an individual's possible entitlement to other program benefits from:
Information obtained during the initial claim interview; including responses to lead questions on the application
Recipient's responses during the redetermination process
Inquiries received from another agency
FO precedent files on pension plans and foreign pension qualifying conditions in Social Security Programs Throughout the World.
Form SSA-93-U4 (Quality Review Feedback Report)
Third party reports
Critical birthday diaries (see SI 02309.001)
SSA queries: AACT, SEQY, SSID, etc.