TN 1 (04-07)

A. When to Use Form SSA-8001-BK

Use Form SSA-8001-BK (Application for Supplemental Security Income) (SSI) when you cannot use the Modernized Supplemental Security Income Claims System (MSSICS) and you have either of the following situations.

• You have a clear technical denial. (See SI 00602.001 for a description of the abbreviated application (ABAP) process.)

• You are deferring development on a disability/blindness claim. (See SI 00603.002 to decide if deferred development is appropriate.)

B. Procedure -- General Completion Rules

1. ABAPs

Complete the mandatory items/questions and questions pertinent to the issue of ineligibility. (See SI 00602.010A.2 for a description of the mandatory items/questions.)

2. Deferred Development

Complete all items/questions.

If answers to questions on the SSA-8001-BK indicate probable ineligibility but the applicant appears to be eligible based on additional information, document the application and explain why the claimant is likely to be eligible.

EXAMPLE: The claimant answers that her name is on a savings account with $5,300 in it. She explains that the account is a joint account with her mother and all the money is her mother's; her own name is on the account simply to make it easier for her to pay her mother's bills. The claims representative adds this information to “Remarks.”

3. Answer Unknown

Write “Unknown” if the applicant is uncertain about the information except for the social security number (SSN). (See SI 00604.016B.3. if the SSN is unknown.) See MSOM MSSICS 001.006 for use of question marks for mandatory fields for applications taken in MSSICS.

4. Time Period

Obtain answers to questions on the form for the period beginning with the first moment of the filing date month unless a question specifies a different time period.

C. References

• SI 00601.060, SSI Interviewing

• SI 00603.010, Non-disability Eligibility Questionable

• SI 00601.012, Proper Applicant