POMS Reference

SI 02305: Redeterminations of Eligibility and/or Payment Amount

Citations:

Social Security Act – Section 1611(c)(1) Social Security Act Amendments (1987) –Section 1619 (b)(2)(A) Public Law 99–643

Regulations – 20 CFR 416.204

TN 56 (10-07)

A. Definition

Redeterminations

A redetermination (RZ) is a review of a recipient's/couple's non-medical eligibility factors (i.e., income, resources, and living arrangements) to determine whether the recipient/couple is still eligible for and receiving the correct SSI payment.

B. Policy

In order to avoid payment errors and to identify existing payment errors as soon as possible, it is extremely important to:

  • Complete RZs accurately;

  • Maintain the required documentation; and

  • Update the Supplemental Security Record (SSR).

1. Scheduled RZs

Scheduled RZs are selected and conducted at periodic intervals. Intervals vary depending on the likelihood of payment error.

2. Unscheduled RZs

Unscheduled RZs are conducted based on a report of change in a recipient's/couple's circumstances that may affect eligibility and payment amount. Instructions for unscheduled RZs are in SI 02305.022.

C. Procedure

1. What to Review

Review all factors of eligibility

2. Exceptions

In general, the following eligibility factors are not reviewed.

  1. Age, unless the FO questions the previous determination.

  2. Citizenship, unless the recipient is identified on the SSR as a non-citizen (AR code is other than A, C, or D with a date of eligibility of 01/01/82 or later, or M, N, or Q) or if the previous determination is questionable.

  3. Disability/blindness, unless:

    • A disability redetermination is due per DI 11070.001.

      NOTE: A disability redetermination is always required upon attainment of age 18

    • Continuing disability/blindness is an issue per DI 13005.001, or

    • An aged individual potentially qualifies under 1619(b) per SI 02305.030C.5.1.

      NOTE: Section 1619 cases may require a continuing disability review (CDR). See DI 13005.018B to determine when a CDR is necessary.

3. Conducting RZ Interviews

Conduct RZ interviews using appropriate forms or by completing the appropriate RZ path in the Modernized SSI Claims System (MSSICS).

D. References

  • The Modernized System Operations Manual (MSOM) Modernized SSI Claims System (MSSICS), MSOM MSSICS 001.001 through MSOM MSSICSCOMPS 002.001

  • RZ Forms or MSSICS, SI 02305.032

  • Systems Processing for SSI Redeterminations, SM 01501.000 ff.

  • http://emis.ba.ssa.gov/emis/emisusers/mgmnt/dprv/dips_userguide/webhelp_published/index.htm

  • RZ for Non-qualified Grandfathered Aliens, SI 00502.153E.

  • Accessing PE ODS, PE ODS RZ/LI User's Guide