TN 10 (09-01)

Citations:

Section 1631(e) of the Social Security Act, 20 CFR 416.200 and 416.203

A. Introduction

After a supplemental security income (SSI) application is filed, the Social Security Administration (SSA) may need additional information/evidence to adjudicate the claim. Claimant's/recipient's failure to provide information/evidence may result in denial or suspension of benefits.

B. Policy

1. SSA responsibilities

1. SSA must obtain the necessary information/evidence to determine an individual's eligibility and payment amount. The SSA-L8009-U3, (Supplemental Security Income, Important Information IC), is used for initial claims situations. SI 02306.020 has instructions for requesting posteligibility information/evidence and the proper notices to use. (See SI 02006.005 for developmental tolerances in title II offset cases.)

2. SSA must offer assistance to claimants/recipients and interested third parties in obtaining information/evidence needed to determine the claimant's eligibility and/or payment amount. The offer should be made during the initial contact with the individual and all subsequent contacts that involve requests for additional information/evidence.

   NOTE: Aged aliens are a special population requiring supportive assistance, because of possible language barriers, factors related to advanced age, and limited education. (See GN 00203.011 for interpreter services, SI 00601.060F. for special interviewing procedures and SI 00502.142 if a disability determination is needed to meet alien eligibility criteria.)

   NOTE: Victims of domestic abuse may require additional assistance in obtaining information or evidence due to the specific circumstances of their situations. Assistance obtaining evidence may be particularly necessary when a victim of domestic abuse has fled the abusive situation, but maintains income or resource associations with the abuser. See RM 10220.210D.1. for additional information in cases where a new SSN has been assigned to a fleeing spouse.

2. Claimant/Recipient/Representative payee responsibilities

The claimant/recipient/representative payee is responsible for:

1. Answering all claims-related questions to the best of his/her knowledge.

2. Providing the necessary information, documents, or evidence to prove that the requirements for SSI eligibility are met.

3. Authorizing SSA to obtain any necessary verification from third parties.

4. Pursuing activities that are needed to process the initial claim or redetermination such as:

   • signing release forms and letters,

   • requesting information, and

   • appearing for required examination when disability/blindness is an issue.

5. Obtaining the cooperation of a sponsor, sponsor's living-with spouse (if the claimant or recipient is an alien lawfully admitted for permanent residence and deeming applies), an ineligible spouse, parent(s) and household members. (See SI 02301.005A.2. on recipient responsibilities in posteligibility situations.)

6. Reporting any changes as described during the initial interview.

3. Unconfirmed eligibility (initial claims)

1. Occasionally, there may be instances when you cannot confirm eligibility for a past period(s) for which no payment has been made (e.g., past periods must be developed following an administrative law judge (ALJ) reversal). A determination of “unconfirmed eligibility” (payment status code N05) should be made for the past period(s) in question if all of the following are true:

   • the claimant/representative payee has acted in good faith (see SI 00601.100B.2.) but is unable to provide the needed information/evidence or an allegation (e.g., amount of income received) and the field office (FO) is unable to provide any further assistance, and

   • you cannot determine eligibility and payment or ineligibility based on the information in file, and

   • you have exhausted all leads in attempting to obtain the information/evidence from other sources.

     NOTE: See SI 00830.005A. regarding adjudication before completion of full development of unearned income.

2. The claims file must contain documentation of the adjudicative decision per SI 00601.080B.3.

3. You must issue a manual award notice to properly explain the period of “unconfirmed eligibility.” The notice language is in NL 00804.135.

C. Procedure -- obtaining information/evidence

Take these steps when obtaining information/evidence.

• Request information/evidence directly from the claimant or, if necessary, from third parties. (See GN 03910.050 for represented claimants.)

• Explain to the claimant, recipient, or representative payee what information/evidence is needed and why. Offer assistance in obtaining what is needed.

• Provide the claimant, recipient or representative payee with a completed SSA-5000 (Collection and Use of Information by SSA) when required per GN 03360.015.

• Use a completed SSA-8510 (Authorization for the Social Security Administration to Obtain Personal Information) when requesting information from third parties (see SI 00601.100D. for the procedure on the use of this form). The SSA-8510 is also available on MSSICS as part of the initial claim and redetermination process using the APIA screen. See MSSICS 008.027 for more information about the APIA screen.

• Issue a SSA-L8009-U3 in initial claims situations according to SI 00601.120 to request information/evidence from a claimant or representative payee. (See SI 02306.020 for posteligibility policy and notices.)

  NOTE: Instruct alien claimants to bring evidence of immigration status with them to the FO. Remind them not to send immigration documents through the mail since aliens are required to have their immigration document(s) in their possession at all times. (See SI 00502.130 for documentary evidence of alien status and SI 00502.115 for online SAVE verification of alien status.)

• Advise the claimant, recipient or representative payee that information/evidence must be provided within 30 days after the date of the SSA-L8009-U3 notice.

• Negotiate a new due date if 30 days is insufficient time to obtain the information/evidence or more time is needed.

  Grant up to a 30-day extension based on a reasonable period for obtaining the type of evidence/information needed and any special circumstances involved. (See SI 00601.100B. regarding offering assistance.)

  EXAMPLE: The claimant was hospitalized for 3 weeks within the 30-day closeout period. He notified us as soon as he returned home. Since several documents were requested, an additional 30-day extension appears reasonable. However, if the claimant went into the hospital for 2 days at the end of the 30-day period and we requested only 1 or 2 documents which the claimant stated he had in his possession, a 7-day extension would be reasonable.

  Further extensions should be granted on a case-by-case basis based on the special circumstances involved and should not exceed 30-day increments.

• Explain that timely cooperation in providing the information/evidence is important. Note that any delay may affect processing the claim and receipt of benefits.

• Assist the claimant or recipient in obtaining necessary information/evidence from third parties, if the individual is having difficulty (e.g., homeless individuals). Consider developing for a representative payee if you believe this difficulty indicates the claimant/recipient cannot manage funds or direct the management of funds.

• Assess the need for a new representative payee if there is evidence that the potential payee, who is other than the legal guardian or parent with custody of a minor child, fails to meet his/her responsibilities per SI 00601.100B.2.

• Determine eligibility and payment based on the information in file if you cannot obtain the information/evidence from a third party and the claimant has acted in good faith. (See SI 00830.005 if evidence of unearned income is not readily available.)

• Document the claims folder, in appropriate form, or complete the evidence screens per GN 00301.286, with all the required information/evidence used to adjudicate the claim or decide on an action.

D. Procedure -- form SSA-8510 (Authorization for the Social Security Administration to Obtain Personal Information)

1. How to Use

a. Claimant

If the claimant authorizes release of information about himself/herself, complete the first line with the claimant's name and Social Security Number (SSN). Leave the second line blank.

b. Parent, legal guardian, or representative payee

If the parent, legal guardian, or representative payee authorizes release of information about a minor claimant or incapable adult claimant, complete the first line with the parent/legal guardian's or representative payee's name and the claimant's name (e.g., John Doe for Jane Doe or John Doe, guardian of Jane Doe) and the claimant's SSN. Leave the second line blank.

c. Third party

Where it is necessary to obtain information about a third party who has income subject to deeming, shared expenses, subsidized rent, or who has sponsored an alien:

• complete the first line with the name and SSN of the third party, and

• complete the second line with the claimant's name and SSN.

d. Alien claimant from Cuba or Haiti and filed application for asylum

If the alien claimant is originally from Cuba or Haiti and alleges filing an application for asylum, obtain a signed SSA-8510 so SSA may contact the U.S. Citizenship and Immigration Services (USCIS) regarding an asylum application. (See SI 00502.115B.4.e. and SI 00502.130B.7.c., Category 2(B) and Category 2(C) Cuban/Haitian entrants.)

e. Multiple forms

Avoid unnecessary additional contacts with the claimant, parent, legal guardian, or representative payee. Obtain the signature on one or more SSA-8510s to authorize disclosure at the time the application is completed. Do this even if it is not clear at that time whether or not the forms will be needed.

NOTE: If the claimant, parent, legal guardian or representative payee objects to signing more than one SSA-8510, continue processing the application. Do not require signature on the extra copies as a condition of proceeding with the application.

f. Attachment

Attach the SSA-8510 to the appropriate form to be completed or to the form requesting information.

2. Time limitation

Use the signed SSA-8510 only in developing the application, redetermination, or other posteligibility event. The SSA-8510 is valid until the claimant withdraws their claim or revokes the authorization.

3. Photocopies

Do not use photocopies of the signed SSA-8510 to obtain information.

4. Unused forms

Destroy any unused SSA-8510s prior to shipping folders to the Wilkes-Barre Direct Operations Center (WBDOC).

E. Exhibit - form SSA-8510

To view the form, go to SSA-8510.

F. References

• Closeout--initial claims, SI 00601.110

• Closeout--posteligibility, SI 02301.235

• Purchasing certified documentary evidence, GN 00301.215

• Representative payee, GN 00502.001 - GN 00502.055