SI 02301: Posteligibility Changes
TN 37 (12-09)
Citations:
Section 1631(e)(1) of the Social Security Act;
20 CFR 416.701 through 416.714
and
20 CFR 416.1321 through 416.1322
A. Policy on when to suspend SSI - N20
You may suspend Supplemental Security Income (SSI) using payment status N20 when a person fails to provide information needed to determine continuing SSI eligibility and benefit amount. After following the instructions in this section, you may suspend SSI using status N20 when the person who fails to provide the needed information is:
a capable recipient,
a representative payee who is the parent with custody of a minor recipient, or
a recipient’s legal guardian.
NOTE: A capable recipient or the payee must provide needed information for deemors listed in SI 01310.030 (Reporting Events in Deeming Cases). An N20 suspension may apply if a deemor fails to provide the needed information.
EXCEPTION: For a recipient who is a blind or disabled child living overseas with a member of the U.S. military (SI 00501.415), the proper payment status is N05 (not N20) when suspending SSI for failure to provide information.
B. Policy on when not to suspend SSI - N20
We do not suspend SSI using N20 when:
the U.S. Postal Service (USPS) returns an initial written request as undeliverable and you cannot locate the person (SI 02301.240 (S06)),
the recipient may need a representative payee (GN 00502.020) or change in payee (GN 00504.100),
a third party not listed in SI 02301.235A such as a neighbor, household member, employer or financial institution fails to comply, or
there is sufficient information to establish current SSI eligibility and benefit amount.
NOTE: When you are unable to confirm eligibility for a past nonpay period (that is, no payment issued), suspend SSI for the closed period using payment status N05 (SI 02301.220).
C. Policy on effective dates of suspension and reinstatement – N20
Suspension is effective the first month after management approves an N20 suspension that you can stop benefits under Goldberg/Kelly (GK) procedures (SI 02301.300).
NOTE: During the GK temporary period, the system in MSSICS can automatically reduce the following month's benefit and issue the GK notice timely if you input the required selection in the Goldberg/Kelly Screen (DBGK) (MSOM MSSICSCOMPS 002.002). Outside MSSICS, the system can produce an online GK notice in most cases. For exceptions and manual GK notice instructions, see SI 02301.307.
Reinstatement is effective the first month of an N20 suspension or a later month (or earliest day in a month) that information establishes eligibility and benefit amount. See SI 02301.205 on when to take a new application to reestablish SSI eligibility for N20 and N05 recipients.
D. Procedure for providing an initial written request
1. When to provide an initial written request
Provide an initial written request each time you request new information, evidence or an action that has not been requested before. Give 30 calendar days after the date of the request to comply.
EXAMPLE 1: You send an initial written request dated April 1 asking the recipient to call in for a redetermination. You complete the redetermination by telephone on April 24 and need evidence of wages. You send an initial written request to the recipient dated April 24 giving her through May 24 to provide the evidence.
EXAMPLE 2: You send an initial written request dated April 1 asking the payee to come in for a redetermination and bring evidence of wages. On April 24, the payee comes in and provides the evidence. He reports that the recipient also has income from self-employment. You hand the payee an initial written request dated April 24 which gives the payee through May 24 to provide evidence of the self-employment income.
2. How to provide an initial written request
Provide an initial written request following these steps:
|
STEP |
ACTION |
|---|---|
|
1 |
Complete only one of these forms (in English or Spanish). No other forms are approved for this use.
|
|
2 |
Address the request to the recipient or, if there is a payee, address it to the payee only. |
|
3 |
Date the request the same day you mail it (or hand it to the person). |
|
4 |
Fill in the due date (month/day/year) which gives the person 30 calendar days after the date of the request to comply. NOTE: The SSA-L8202-F4-INST contains preprinted language about the 30-day period. |
|
5 |
Retain a copy of the written request in the paper file or the NDRed (Non disability Repository For Evidentiary Documents). NOTE: It is not necessary to fax a copy of the request to the NDRed if the StaRZ & StriPEs – The Next Generation (SSTNG) or the Document Processing System (DPS) produces the request. The Online Retrieval System (ORS) stores the request. |
E. Procedure for handling undeliverable mail
If the United States Postal Service (USPS) returns a written request as undeliverable, follow the instructions as needed:
to locate the recipient in SI 02301.240
to reissue the request in GN 02605.060
on when to consider the need for a change in payee in GN 00504.100
on when to pay benefits directly to an incapable recipient in GN 00504.105.
F. Procedure to follow up with nonresponders
1. When to follow up
Follow up on an initial written request when the person:
does not respond within the 15 calendar days after the date on the written request, or
fails to comply with a scheduled appointment date on the written request.
Try to follow up by telephone and, if unsuccessful, follow up by mail.
2. How to follow up by telephone
Contact the person by telephone, if possible. Check the SSR/MBR and FO records for a current number. Follow up if you leave a message for the person to return your call. If unsuccessful, follow up by mail. Document attempts to follow up on the Report of Contact (DROC) screen in MSSICS (MSOM MSSICS 022.010) or a paper report of contact (SSA-5002) faxed into NDRED in non-MSSICS cases.
NOTE: The Development Worksheet (DW01) (MSOM MSSICS 022.004) lists and records followups on evidence.
CAUTION: Be careful not to disclose any Personally Identifiable Information (PII) about the recipient when leaving a message. Say for example, “It’s important that he call me right away.” Do not say something like, “I’m calling about his SSI check.” The fact that he is receiving a benefit from SSA is PII.
NOTE: A followup by visiting the home is optional. When considering a home visit, be alert to situations that could endanger an employee or may likely be futile. It is not necessary to document a reason for not making a home visit.
3. How to follow up by mail
Follow up by mailing a written followup request using these steps:
|
STEP |
ACTION |
|---|---|
|
1 |
Complete steps 1, 2 and 3 in SI 02301.235D.2. in this section |
|
2 |
Enter “SECOND REQUEST” next to the date of the request. |
|
3 |
Fill in the due date on the last written request if it gives the person at least 10 calendar days left to comply. If required, extend the due date and fill in the new date which gives the person 10 calendar days after the date of the followup request to comply (SI 02301.235H.2). Change references to the 30-day period in the text to 10 days. |
|
4 |
Mark the envelope with this legend “RETURN SERVICE REQUESTED ” and mail the request. |
|
5 |
If the USPS returns the mail:
|
|
6 |
Retain a copy of the followup request in the paper file or the NDRed. |
G. Procedure during personal followup contacts
During each telephone or face-to-face contact involving a request for needed information:
Remind the person of the information we need by the due date,
Explain to the recipient/payee that the recipient may lose benefits based on getting SSI such as Medicaid, food stamps , State Medicare buy-in (SMIB) and public housing if he or she does not comply with the request,
Consider the need for a payee (GN 00502.020) if the recipient does not understand the request or the possibility of losing SSI,
Arrange for an interpreter if the person has limited English proficiency (LEP) or is hearing-impaired (GN 00203.012),
Offer to help obtain the information (SI 02301.200)
Grant more time to comply if needed,
Discuss voluntary termination if the person does not want to pursue SSI (SI 02301.230),
Stop efforts and mail a followup notice if the person is hostile or abusive (GN 00203.013).
H. Procedure for extending the time to comply
1. The person needs more time
When the person needs more time to comply, grant the time if the person has a good reason for needing it. Discuss the time needed and grant:
The number of days agreed on, or
Another 30 days if the person is trying or willing to comply and is uncertain how much longer he or she needs.
Grant additional extensions if the person appears to be cooperating.
2. When more time is required
If a person has less than 5 calendar days to comply after a personal contact (telephone or face-to-face) or would have less than 5 calendar days to comply after the written followup request, extend the due date to:
5 calendar days after the personal followup contact; explain the new due date to the person, or
10 calendar days after the date on a written followup request (SI 02301.235F.3 in this section).
EXAMPLE: The recipient returns your telephone message 2 days before the period to comply ends. You explain that he has until (month/day/year that gives him 10 additional business days after the initial due date) to comply or his SSI payments may stop.
I. Procedure before suspending SSI - N20
Exhaust efforts to locate and contact recipients and obtain needed information. Contact any source you believe may have contact with the recipient or who could provide the information such as a financial institution, employer, benefit source, medical treatment source or a homeless shelter.
Develop capability if it appears that a recipient may not be managing benefits and meeting needs (GN 00502.020).
Consider the need for a change in payee if it appears that the payee is missing, no longer acting for the recipient or is uncooperative (GN 00504.100, GN 00504.105).
Discuss voluntary termination (N19) if a recipient, legal guardian or payee does not want to pursue SSI benefits (SI 02301.230).
J. Procedure to document and suspend SSI - N20
Document N20 suspensions on the Report of Contact (DROC) screen in MSSICS (MSOM MSSICS 022.010) or on a paper report of contact (SSA-5002) faxed into the NDRed in non-MSSICS cases.
Document what happened with the:
date of the initial written request,
date the period to comply ended (include extensions), and
result of followup attempts (for example, contact on month/day/year, refused to cooperate or no response to mail on month/day/year).
Obtain approval to suspend N20 from a management support specialist (MSS) or above.
Document approval to suspend N20 with the:
name and job title of the approving staff member,
date of the approval, and
-
effective date of the N20 suspension. That is, the systems current computational month (CCM) on the approval date.
Suspend N20 in MSSICS – Payment Status (CPAY) (MSOM MSSICSCOMPS 001.003) or 1719B in non-MSSICS (SM 01305.001).
Suspend N05 if the recipient is a blind or disabled child of military personnel stationed overseas (SI 02301.220).
K. References
SI 00501.415, Blind or Disabled Children of Military Personnel Stationed Overseas - Overview
SI 02301.205, Suspension and Reestablishing Eligibility
SI 02301.220, Ineligible for A Past Nonpay Period (N05)
SI 01310.030, Reporting Events in Deeming Cases
MSOM MSSICSCOMPS 002.002, Goldberg/Kelly (DBGK)