SI 00810: General - Income Rules for the Supplemental Security Income Program
TN 55 (01-18)
Citations: Social Security Act, as amended, section
A. Definition of unstated income
Unstated income is income not reported or otherwise known to the Social Security Administration (SSA) but determined to exist because an individual’s (or couple’s) living expenses exceed income from known sources. Claimants, recipients, and deemors may be found to receive unstated income.
B. Policy for developing unstated income
REMEMBER: Income is anything received in cash or in kind that can be used to meet an individual’s needs for food or shelter.
1. Amount of unstated income
The amount of unstated income to be charged is the difference between stated (or known) monthly income and monthly living expenses.
2. When to consider unstated income
Develop the existence of unstated income whenever the information in file, including statements of the claimant/recipient, deemor, or third parties, creates questions as to how living expenses are met. Adjudicators are responsible for deciding whether the information in file creates such questions and to what extent unstated income must be explored.
C. Procedure for developing unstated income
1. Unstated income indicators
Failure to disclose income may be due to a lack of understanding of reporting responsibilities and types of income that affect Supplemental Security Income (SSI) eligibility and payment amounts. Misunderstandings may arise when income is received in kind, including in-kind income derived from third-party payments on behalf of the individual. There also may be a reasonable explanation for a discrepancy between income and living expenses, for example:
savings are being used,
work ended recently,
debts have been incurred, and
outstanding bills have not been paid.
a. Situations pointing to unstated income
Common situations pointing to unstated income:
Stated income is insufficient to pay costs normally associated with resources owned (gas, maintenance, insurance, and licensing of an automobile);
Stated income is insufficient to provide for known living expenses; or
No income is alleged and the individual (or couple) does not live in a setting in which food and shelter are provided (such as a public institution or the household of another).
b. No indication of unstated income
If, based on the allegations and other information available at the time of the interview, there is no reason to believe that unstated income exists, no further development or documentation is required. In evaluating the case facts, do not make assumptions that are not supported by those facts.
c. Possible indication of unstated income
If insufficient or conflicting evidence exists, question the individual or deemor about possible unstated income and allow the individual or deemor the opportunity to explain how expenses are met.
REMEMBER: There may be a reasonable explanation for a discrepancy between income and living expenses. Careful interviewing is needed to ascertain if the person is receiving help from a local church, food bank, community service center, or other sources.
If a satisfactory explanation is provided, obtain the explanation on a Form SSA-5002 (Report of Contact or DROC screen) or other form (e.g., the “Remarks” section of the SSI application, redetermination form, Modernized Supplemental Security Income Claims System (MSSICS) screens).
If the explanation is inadequate, query the Office of Child Support Enforcement’s National Directory of New Hires (NDNH) database to determine if the individual has earned wages or has received unemployment compensation he or she did not report. For instructions on using the National Directory of New Hires (NDNH) query, see SI 00810.550. If the query does not show any undisclosed income, obtain the explanation of how expenses are met over the individual’s or deemor’s signature, and determine the amount of unstated income per SI 00810.035C.2. in this section. If fraud is suspected, see GN 04101.000 through GN 04101.010. If the query indicates the individual or deemor may have undisclosed income, see SI 00810.550C.
2. Determining chargeable unstated income
Once unstated income is found to exist, determine the amount by comparing usual monthly living expenses with total monthly income. Be aware of the tendency to overlook expenses, but do not assume expenses that may not exist.
Obtain a signed allegation of usual monthly living expenses for the following items:
rent or mortgage, including property tax;
food;
clothing;
utilities;
miscellaneous household expenses;
insurance;
medical and dental care;
automobile and other transportation expenses;
other expenses (such as newspapers, barber, toilet articles);
installment loans; or
illegal drugs, if the file shows that the individual uses them.
Whenever possible, obtain evidence of alleged expenses, using receipts, payment stubs, canceled checks, or contacts with knowledgeable sources.
Document the file with a Report of Contact showing the comparison of living expenses with income (including any income detected by querying the NDNH). Charge the difference as unstated income. For Modernized Supplemental Security Income Claims System (MSSICS) cases, use the Other Income (IOTH) screen to enter unstated income. For non-MSSICS cases, enter the amount as type “S” income in the UM field of the SSA-1719B (Supplemental Security Income Posteligibility Input) or SSA-450SI (SSI Data Input and Determination). Enter the word “UNSTATED” in the “Claim or ID No.” portion of the field. Suppress the automated notice and prepare a manual notice (see SI 00810.035C.3. in this section).
NOTE: Never input unstated income as type “H” income (in-kind support and maintenance).
3. Notices for unstated income
NOTE: If the individual is blind or visually impaired, see instructions at NL 01001.010 for more information on the special blind or visually impaired notice options.
The SSI system is unable to issue an automated notice that explains unstated income. Therefore, the automated notice must be suppressed and a manual notice issued. Sample notice paragraphs for the most common situations involving unstated income are located in NL 00804.175. However, field offices may expand upon the paragraphs to fit the particular circumstances of the case. The paragraphs may be used in an initial award or denial notice, or in any posteligibility notice.
D. Examples of unstated income
1. Satisfactory explanation received — no unstated income charged
Mrs. Janet Anderson, who lives alone, applies for benefits, alleging monthly rent of $300 and an income of $400 per month plus food stamps. Ms. Anderson also reports owning a current model car, which is excluded from resources. Ms. Anderson happened to mention during the interview that her mother paid the lender for all her car payments so far, and the CR, therefore, finds no reason to believe that unstated income exists. No further development of unstated income is needed, and no proof of the mother’s payments on the car is required to resolve the unstated income issue. Document the file with the explanation.
If, on the other hand, Ms. Anderson did not mention during the regular interview that her mother paid the lender for her car payments, the CR might wonder how she could pay for the car and its expenses along with her $300 rent and other living expenses. If the CR judged that unstated income should be explored, he would ask Ms. Anderson to explain how she was meeting her expenses. Ms. Anderson’s satisfactory explanation, coming in response to questions about unstated income, would need to be recorded on a Form SSA-5002 (Report of Contact or DROC screen) or other form.
2. Inadequate explanation received — unstated income charged
Five months ago, Mrs. Cynthia Williams had to stop working due to a disabling condition. Today, she filed for SSI benefits. She reported as her only income a $300 monthly disability check from her former employer. Mrs. Williams lives with her unemployed husband and their three young children, none of whom has any income. The family receives food stamps worth $150 each month.
The couple has no bank accounts and they own their own home. Their monthly mortgage payments are $575.
The CR asks Mrs. Williams how she is meeting her expenses on an income of $300 per month plus food stamps. She replies that she pays “one bill now and another bill later” but has been able to keep the mortgage and utilities up to date. The CR asks Mrs. Williams for proof of past due bills to substantiate the unpaid bills or that the bills are paid from time to time. However, Mrs. Williams does not provide additional proof of their bills. Finding the explanation unsatisfactory and with no proof of bills, the CR queries the NDNH database. The query uncovered no additional sources of income. Failing to uncover another source of income or support, the CR treats the income or support received as unstated income.
The CR completes an SSA-795 (Statement of Claimant or Other Person) (or DPST in MSSICS) with Mrs. Williams, containing her explanation of how she meets expenses and listing her usual monthly expenses, which total $900. The CR determines that the couple has monthly unstated income of $600 ($900 expenses minus $300 stated income), making Mrs. Williams eligible. After determining, the portion of chargeable unstated income allocated to Mrs. Williams and her husband each month is $300 ($600 divided by two), the CR prepares a Report of Contact comparing expenses with income and explaining the determination of chargeable unstated income.
THE FOLLOWING EXAMPLE IS BASED ON THE 2016 FEDERAL BENEFIT RATE (FBR) DOLLAR AMOUNTS:
SSI Federal Benefit with Mrs. Williams monthly disability check from her employer:
Total monthly disability check from Mrs. Williams employer = $300. Mrs. Williams unstated income =$300
1. $600
-20 (Not counted due to the $20 general exclusion)
=$580 (Countable income)
2. $733 (SSI Federal Benefit Rate)
-580(Countable income)
=$153 (SSI Federal Benefit)
The CR then inputs the $300 disability check amount Mrs. Williams receives monthly from her former employer on the Sick Pay (Unearned) page. $300 unstated income is also entered both, Mrs. Williams’ and her husband’s IOTH pages in the SSI claims system (i.e., MSSICS/SSI Claim).
For non-SSI Claims System cases, the CR would input this as type “S” income, coding it as “UNSTATED,” suppress the automated notice and issue a manual denial notice.
E. References
MS INTRANETSSI 014.003 Income Selection
MS INTRANETSSI 014.037 Sick Pay (Unearned) List
MS INTRANETSSI 014.038 Sick Pay (Unearned)