TN 3 (11-96)

A. Policy

The following policy applies to eligibility for State supplemental payments.

1. Applications and Redeterminations

An application for Supplemental Security Income (SSI) is an application for all federally-administered payments, including SSI, State supplementary payments (SSP), title II benefits and Medicaid (Medi-Cal in California, AHCCCS in Arizona, Tenn-Care in Tennessee) where applicable.

An SSI redetermination is also a redetermination of federally-administered SSP eligibility and payment amount and Medicaid eligibility when the State has elected Federal Medicaid determinations.

2. State Supplementary Payments

Most States pay at least some recipients SSP. SSP includes mandatory minimum State supplementary payments (MMSS) and optional State supplementary payments (OSS). A State may elect Federal administration of its MMSS program, or its MMSS and OSS programs. SSA will not agree to federally administer a State's OSS program if the State administers its MMSS. Federal administration means:

• the State pays SSA to administer its supplement,

• SSA determines the amount payable in each case,

• SSA collects the SSP portion from the State, and

• Treasury issues a combined SSI and SSP check to (or directly deposits for) the eligible individual.

State-administered SSP requires a separate application with the State. If an individual is eligible for State-administered SSP, the State issues separate payments.

These instructions give direction for decisions involving federally-administered SSP. A list of these States is published in SI 01415.001 ff.

3. Converted Recipients

Aged, blind and disabled individuals converted from the State welfare rolls are deemed to have filed for SSI on January 1, 1974. Converted recipients are paid the larger of the OSSor MMSS payment for which they are eligible.

MMSS eligibility does not terminate after a suspension. MMSS eligibility only terminates when an individual loses categorical eligibility (i.e., is not aged, blind or disabled) or dies.

In addition to the SSI suspension events listed in SI 02301.215, which can interrupt MMSS payments and minimum income level (MIL) protection, MMSS payments and MIL protection will be suspended when an individual:

• is not a resident of the State of conversion for a calendar month; or

• was not converted in Federal living arrangement (FLA) D and later becomes a FLA D recipient. (See SI 02005.084D.3. for an example of this situation.)

4. OSS Eligibility

OSS payments, like all SSP, are excluded from income, whether State- or federally-administered.

States may supplement some, or all, SSI recipients (or some individuals who would be eligible for SSI but for income) according to the rules laid out in regulations. To have Federal administration, a State must provide OSS based on eligibility category and the State may vary the amount of payments based on geographical location and living arrangement.

SSA completes written agreements with States for Federal administration of SSP. These agreements set out the exact variations applicable and limit the number of variations a State may have. SSA does not administer “special needs” benefits.

Instructions for determining State and county of residence are in SI 01410.040.

5. Multicategory Eligibility

An individual may be eligible under more than one category (e.g., both disabled and blind). An individual's category of eligibility can be very important. For example, an individual can be both aged and disabled in a State that does not pay OSS on the basis of disability but does provide OSS to the aged. An individual's categorical or multicategorical eligibility can permit participation in the SSI work incentives.

It is SSA's responsibility to identify the most advantageous category(ies) for an individual and help establish eligibility, including situations when the Federal and State categories differ. SI 00501.300 provides a more complete discussion of multicategory eligibility.

NOTE: Effective May 1, 1991, the section 1619(b) work incentive is available to aged individuals who are also blind or disabled and whose earned income causes SSI ineligibility. (See
SI 02302.030C.5. for a more detailed discussion).

6. OSS and FLA

The FLA may dictate the OSS living arrangement and payments. However, an OSS living arrangement decision does not dictate the FLA decision.

B. Procedure - Field Office Responsibilities

FO: Use the following criteria to determine eligibility for SSP.

• identify individuals converted from the State-administered predecessor programs as indicated on the supplemental security record ( SSR) in the (CONV) field (as described in SM 01601.625);

• determine and post to the SSR the State and county of residence for all claimants and recipients following the rules in this subchapter; and

• determine and maintain the correct OSS information on the SSR in federally-administered States.

C. Procedure - Partial Payments

When an individual is eligible for SSI payments, but the appropriate SSP level cannot as yet be determined:

• pay the lower amount of SSP, if the amount of (not the receipt of) SSP is at issue; or

• pay the SSI without the SSP if the receipt of SSP is at issue.

In either of the above situations, control the case for resolution of the SSP issue. If resolution results in a higher payment, reopen the earlier decision and pay the correct amount. Input notice suppression when you input the “interim” SSP decision and issue a manual notice about the payment amount. In the notice, explain that SSA has not yet completed its decision as to the appropriate payment amount. Use an SSA-L8025 for an award, an SSA-L8151 if payment is being increased, an SSA-L8155 if payment is being decreased, or an SSA-L8166 if payment stays the same. Note that you will also need to issue a manual notice when changing the “interim” SSP decision to explain that SSA has completed its decision as to the appropriate payment amount.

When State/county of residence changes, see SI 02306.010 for instructions on mailing address changes. In initial claims, if you are in the former servicing (“losing”) office, input the new mailing address and the former residence address and OSS code pending input by the new servicing (“receiving”) office. Do not substitute an OSS “Z” for another federally-administered OSS code because of a residence change.

D. References

• Categories for Federally-Administered OSS, SI 01401.001B.8.

• Change of Address, SI 02306.010

• CONV Field on the SSR, Systems Identification of Conversion Cases, SM 01601.625

• Geographical Variations for Federally-Administered OSS, SI 01401.001B.6.

• Living Arrangement Variations for Federally-Administered OSS, SI 01401.001B.7.

• Mandatory Minimum State Supplementary Payments, MMSS, SI 01401.001B.4., SI 02005.082

• Medicaid Institution (FLA D), SI 00520.011

• Minimum Income Level, MIL, SI 02005.082

• Multicategory Eligibility, SI 00501.300

• Section 1619 Work Incentives, SI 02302.010 ff.

• SSI Notice Language, NL 00804.100 ff.

• State Supplementation Criteria, SI 01401.001B.

• Suspension, Termination and Stop Payment Events, SI 02301.215

• Systems Identification of Conversion Cases, CONV Field, SM 01601.625