TN 4 (06-10)

Citations:

Social Security Act Section 1631(e)(1)(B)

Regulations 20 CFR 416.207
20 CFR 416.1321

A. Background

Eligibility for Supplemental Security Income (SSI) benefits requires that deemor(s) give permission for SSA to request any financial records that financial institutions may have for the deemor (i.e., financial permission). If a deemor does not give us financial permission and we cannot establish good cause, the claimant cannot receive SSI benefits.

Specific processing is required in initial claims when a parent deemor will not give SSA financial permission and the claimant will attain age 18, causing the deeming relationship to terminate.

B. Overview of applicable policies

1. SSI protective filing policy

An open protective filing date (e.g., one where no closeout notice has been issued, or, the closeout notice was issued but the protective filing closeout period has not yet expired) is always material to eligibility. Therefore, the protective filing date must be used as the application filing date for blind or disabled adult and blind or disabled child applications.

See details:

• SI 00601.015, Protective Filing – General

• SI 00601.037, Closing Out Leads and Protective Filings

2. Policy for deemor’s financial permission

Eligibility for SSI benefits requires a child claimant’s deemor to give permission for SSA to request any financial records that financial institutions may have about him or her (i.e., financial permission). If the child attains age 18, causing the deeming relationship to terminate, the deemor’s financial records are no longer required to determine the claimant’s eligibility for SSI benefits.

Good cause may apply in certain situations.

See details:

• SI 00515.002, Good Cause – Harassment or Abuse

• SI 00515.003, Good Cause – Failure to Cooperate

• SI 00515.004, Good Cause – Minor Children

C. Criteria for processing certain initial claims involving financial records permission

Before processing a case by using the procedures in SI 00515.010D in this section or SI 00515.010E in this section, verify that the case meets all of the criteria in either C.1 or C.2:

1. Application completed during the 60-day protective filing period

Follow the procedures in SI 00515.010D in this section if an application is completed during the 60-day protective filing period and:

• an ineligible parent does not give us financial permission;

• good cause does not apply;

• an SSA-L991 is issued;

• the child claimant attains age 18 during the 60-day protective filing period;

• the claimant meets all non-disability eligibility factors as of his or her 18^th birthday; and,

• a deferred or full application is completed during the 60-day protective filing period.

2. Application completed during the month claimant attains age 18

Follow the procedures in SI 00515.010D in this section if an application is completed during the month the claimant attains age 18 and:

• an ineligible parent does not give us financial permission;

• good cause does not apply;

• the claimant meets all non-disability eligibility factors as of his or her 18^th birthday; and,

• a deferred or full application is completed during the month the claimant attains age 18.

NOTE: Asking for financial permission is required when completing deferred or full application.

D. Processing initial claims when a full application is filed

When processing cases that meet the criteria in SI 00515.010C in this section, follow these procedures to maintain the original protective filing date and to provide benefits accordingly.

IMPORTANT: Do not use the Modernized Supplemental Security Income Claims System (MSSICS) to build the Supplemental Security Record (SSR) for these cases as an N18 denial (i.e., failure to cooperate or failure to give permission to contact financial institutions) will result and erroneously deny the claim for the life of the application.

1. Actions to take before sending the claim for a disability determination

Before sending the claim for a disability determination, you must take the following actions:

a. Document deemor’s refusal to provide financial permission

Explain to the deemor that financial permission is an eligibility requirement for SSI benefits.

Document the deemor’s refusal to provide financial permission as follows:

• Print a copy of the “Financial Permission Request - Deemor (T16)” letter from the General section of the Document Processing System (DPS). Have the deemor read and sign the document, indicating his or her refusal to provide financial permission. For more information related to obtaining financial permission, see SI 00515.001.

• Document the deemor’s refusal to provide financial permission on the Shared Processes (EVID) screen.

b. Build the Supplemental Security Record (SSR)

Take the following actions to build the SSR:

• Lock the MSSICS pending file (if the claim was initiated in MSSICS).

• Input the claims information using form SSA-450-SI (Supplemental Security Income Data Input and Determination) with procedures found in SM 01005.000.

  IMPORTANT: Input the original protective filing date in the Application Date (AP) field.

• Input payment status code H80 (i.e., Hold – early input) in the Payment Status (PS) field of the SSA-450-SI.

• Once the SSR is established, use an SSA-1719-B (Supplemental Security Income Posteligibility Input) to input “FAILURE TO GIVE FINANCIAL PERMISSION—DEEMOR – NAME – NO GOOD CAUSE- MMDDYY” in the remarks section of the SSR.

After completing the actions in SI 00515.010D.1.a. in this section, send the claim for a disability determination.

NOTE: These cases are excluded from Electronic Disability Collect System (EDCS) processing.

2. Actions to take when the claim is returned from the Disability Determination Service (DDS)

If the claim is medically denied, no further action is needed. DDS will generate the medical denial notice.

Take the following actions for medical allowances.

NOTE: For cases in which a pre-effectuation review (PERC) is necessary, only take these actions after the PERC has been completed. See SI 00603.031 for instructions as to when a PERC is required.

a. Input payment status N05

Input payment status code N05 (i.e., Nonpay - failure to give permission to contact financial institutions and other nonpay events) in the PS field of the SSA-450-SI for each month of the protective filing period occurring prior to, and including, the month of age 18 attainment.

The system will properly post payment status E02 (i.e., Nonpay – eligible for benefits but not due a payment (applies to first month of eligibility only) in the earliest of:

• The month after the month of age 18 attainment, or,

• The first month after attainment of age 18 that the recipient meets all eligibility criteria.

b. Issue a manual notice of award

Suppress the automated notice using the Notices (NP) field on the SSA-450-SI and issue a manual notice of award using the procedures in NL 00801.010. For additional information about using the NP field to suppress automated notices, see SM 01005.535.

E. Processing initial claims when a deferred application is filed

When processing cases that meet the criteria in SI 00515.010C in this section, follow these procedures to maintain the original protective filing date and to provide benefits accordingly.

IMPORTANT: Do not use MSSICS to build the SSR for these cases as an N18 denial (i.e., failure to cooperate or failure to give permission to contact financial institutions) will result and erroneously deny the claim for the life of the application.

Use the following procedures when a deferred application is filed using either MSSICS or an SSA-8001-BK (Application for Supplemental Security Income) and SSA-8010-BK (Statement of Income and Resources).

1. Actions to take before sending the claim for a disability determination

Explain to the deemor that financial permission is an eligibility requirement for SSI benefits.

Document the deemor’s refusal to provide financial permission as follows:

• Print a copy of the “Financial Permission Request - Deemor (T16)” letter from the General section of DPS. Have the deemor read and sign the document, indicating his or her refusal to provide financial permission. For more information related to obtaining the financial permission, see SI 00515.001.

• Document the deemor’s refusal to provide financial permission on the EVID screen.

Do not lock the MSSICS pending file for a deferred application unless the claim is medically allowed. For more information on how to adjudicate medical allowances for deferred applications, see SI 00515.010E.2. in this section.

NOTE: Systems changes released on November 21, 2009, made the Financial Institutions Permission screen (AFIP screen) a mandatory screen when completing a deferred application.

2. Actions to take when the claim is returned from the DDS

If the claim is medically denied, use MSSICS to build the SSR and post the medical denial. No further action is needed. DDS will generate the medical denial notice.

Take the following actions if the claim is a medical allowance.

a. Complete a PERC

• Lock the MSSICS pending file.

• Complete a PERC using an SSA-8000-BK, (Application for Supplemental Security Income) and SSA-8010-BK. For more information about completing a PERC, see SI 00603.035.

  IMPORTANT: Input the original protective filing date in the Application Date (AP) field.

b. Build the SSR with payment status code N05

Take the following actions to build the SSR with a payment status code of N05:

• Input the updated claims information and medical allowance information using the SSA-450-SI procedures found in SM 01005.000.

• Input “FAILURE TO GIVE FINANCIAL PERMISSION—DEEMOR – NAME – NO GOOD CAUSE - MMDDYY” in the remarks section of the SSR.

• Input payment status code N05 in the PS field of the SSA-450-SI for each month of the protective filing period occurring prior to, and including, the month of age 18 attainment.

• The system will properly post payment status E02 in the earliest of: the month after the month of age 18 attainment, or, the first month after attainment of age 18 that the recipient meets all eligibility criteria.

• Record the completed PERC in the Pre-effectuation Review Contact (PERC)/Update (PC) field of the SSA-450-SI. For more information about using the PC field, see SM 01005.660.

IMPORTANT: Only input the PC field if you are transmitting payment status code N05 in the same input. Failure to input payment status N05 during the same transmission may result in the claim being erroneously paid for months when the deemor refused to provide financial permission.

c. Issue a manual notice of award

Suppress the automated notice using the NP field on the SSA-450-SI and issue a manual notice of award using the procedures in NL 00801.010. For additional information about using the NP field to suppress automated notices, see SM 01005.535.

F. Related references

SI 00515.001, Requirement for Permission to Contact Financial Institutions for SSI Eligibility

SI 00515.002, Good Cause – Harassment or Abuse

SI 00515.003, Good Cause – Failure to Cooperate

SI 02301.220, Ineligible for a Past Nonpay Period (N05)

MSOM MSSICS 008.025, Financial Institutions Permission (AFIP)