TN 13 (11-10)

A. Policy for IAR notices sent to State

SSA sends a notice about the status of the individual's pending claim to the State agency providing interim assistance when:

• An GR code is posted to a claimant's record on the SSR; and

• The individual is found to be eligible or ineligible for an SSI initial payment; or

• We reinstate the individual after a period of suspense or termination.

NOTE: We send a notice in posteligibility situations only when we reinstate the individual's benefits after a period of suspense or termination.

B. Process for providing IAR notice to the State

1. Case involves a systems limitation or GR code cannot be posted to SSR

When the case involves a systems limitation or the GR code cannot be posted on the SSR, prepare an SSA-L8165 (SSI Important Information) upon receipt of the IAR authorization. Fax the manually prepared SSA-L8125-F6 (Notice of Interim Assistance Reimbursement) to the appropriate electronic folder, then send the SSA-L8125-F6 to the component handling IAR in the RO if an OTP or force payment is involved.

NOTE: When multiple checks are involved, make sure the SSA-L8125 includes multiple check information.

2. Manual IAR Accounting Forms

a. SSA-8125

The SSA-8125 is the manual form the FO must prepare, and send to the State agency when:

• An A-OTP is issued for the full retroactive payment to the State agency;

• The GR code cannot be posted on the SSR;

• There is a systems limitation and the IAR Payment Pending provisions do not apply;

• A force due payment is involved; or

• The State alleges not receiving an automated SSA-L8125 for a direct payment IAR case.

NOTE: The SSA-8125 is obsolete due to the implementation of eIAR. This reference is retained in POMS because the form may be encountered in pipeline cases.

b. SSA-L8125-F6

The SSA-L8125-F6 is the manual form the FO must prepare for cases involving:

• A manual dedicated account, installment, an attorney or eligible non-attorney fee;

• A systems limitation;

• eIAR exception cases; and

• proration cases.

NOTES:

• The State agency staff completes the “State’s Account of Reimbursement Claimed” section and sends the form to the SSA FO that will issue an A-OTP to the agency, for the exact amount of IAR. Once the FO issues the A-OTP, the CR must complete the bottom of the form, fax it to the appropriate electronic folder, and send the form to the component handling IAR in the RO.

• The manual SSA-8125 and SSA-L8125-F6 are available on e-forms. For information on completing the accounting forms, see SI 02003.040.