20 CFR 416.1001, 416.1005, and 416.1185
The 72-year-old claimant for supplemental security income was living with an ineligible spouse. An initial determination was made that the claimant was not eligible for payments because his income, when considered with that portion of the income of his spouse which was deemed to the claimant, was in excess of that permitted in order to be eligible for SSI payments. The claimant contended he was separated from his spouse even though they lived at the same residence address. Held, the claimant and his ineligible spouse were living together in the same household and her income must be deemed to be the income of the claimant.
The general issue for decision is whether the claimant is entitled to supplemental security income benefits under Title XVI, Section 1611 of the Social Security Act, as amended. More specifically, the issue to be decided is whether the claimant's income was exceeded that permitted by section 1611 of the act since the January 1974 calendar quarter when considered in the light of section 1614(f)(1) of the act pertaining to the deeming of income of an ineligible spouse. In order to determine the issues in this case, specific findings will be made as to whether this claimant and his spouse are currently living together in the same household.
With respect to the issue of the living arrangements of the claimant and his spouse and whether or not they are in fact separated, he indicated in his application for supplemental security income benefits dated December 6, 1974, "My wife rents me a room in her half of the house. I've had this since January 1973."
Based on the claimant's description of the house as contained in his testimony and the spouse's description of the house, the home apparently might be described as a nine room duplex with five rooms on one side and four on the other. There are apparently two rooms down and two rooms up at the address know as 318 M Street, and three rooms down and two up at the address known as 316 M Street. In addition, 316 M Street has a bathroom upstairs and a kitchen downstairs.
The claimant stated that he had one room at the 318 part of the house. To get from 316 to 318 one was required to go outside and to reenter the home. The claimant stated that he could only use the kitchen which was at 316 when his wife was away. He stated that he intended to move out to 312 M Street. The claimant stated in a document addressed to the Social Security Administration dated December 6, 1974, that, "My wife and I had a disagreement in January 1974 and decided to live separately . . . I moved out of my room to a room downstairs. She allows me to use the kitchen to cook for myself . . . We don't even 'swap' much . . . (food). I have my own cupboard to store my food in."
The claimant later stated that in January 1974 he did not have an argument as such with his wife, but since he was ineligible for supplemental security income payments with their living arrangements at the time, that he would move to another part of the house. So that it was not so much an argument with his spouse but an agreement that they would "live separately." The claimant testified that he now lives at 316 M Street; that he never did, in fact, move to 318 M Street; that the spouse lives at 316 M Street and that she never lived at 318 M Street; that there is a door between the two sections of the home which at one time was sealed closed, but is now open and was not sealed close during any of the periods of time involved in this claim.
The claimant further testified that mail which is sent to him is addressed to 316 M Street and that mail sent to his spouse is sent to the same address. The claimant further testified he lives upstairs at 316 M Street, where he has a small bedroom and stores his clothing; that his spouse lives upstairs at 316 M Street in a larger bedroom where she keeps her clothing; and that further, they both share the same bathroom and same kitchen at the 316 address.
The claimant testified that he does purchase his own food and that the spouse purchases her own food and they shop at separate grocery stores. The claimant, however, testified that when the food is brought back to the house, that contrary to the earlier statement that the claimant had his own cupboard to store food in, that in fact they never had separate cupboards; that they use the same cupboards and they sometimes share the food which is in the cupboards.
The claimant testified that insofar as his other bills are concerned: medical, clothing, hospital, dentist, etc., that prior to January 1974 the date of the application, his spouse would assist the claimant in paying these bills, and that she would at the present time, except for the fact that she is not financially able to do so.
The claimant further testified that there were some house expenses which it was his practice to pay; for example, water bill and the bill for the cable television.
Section 416.1001 of the Social Security Regulations provides in part:
(a) Marital relationship. In determining whether an aged, blind, or disabled individual may receive payments under Title XVI of the Social Security Act, the income and resources tests which such individual must meet may depend in part on whether such individual has a spouse, whether such individual and such spouse are living in the same household (or have been separated for less than 6 months) and whether such spouse is also an aged, blind, or disabled individual. . .
Section 416.1005 provides in part:
(a) Two individuals may be considered to be husband and wife for the purpose of determining that one is the spouse or the other under Title XVI of the Act if at the time the application for payments is made or at any later date:
(1) The individuals are living together in the same household, and hold themselves out to the community in which they reside as husband and wife. . .
Regulations 416.1003 provides in part:
(b) Household. For purposes of this subpart, the term 'household' means one or more individuals living as a family unit in a single place of abode.
From evidence in this case as recited above, it is abundantly clear that the claimant and his spouse are presently living together as husband and wife in the same household and have lived as such since January 1974; that is, as a family unit in a single place of abode.
Therefore, Section 416.1185 of the Social Security Regulations must be considered. This regulation provides in essence that:
(a) Individuals with spouse. In the case of an individual who is living in the same household with a person not eligible for benefits under this part who is or who is considered to be such individual's husband or wife . . . such individual's income shall be deemed to include any income . . . of such spouse whether or not such income is available to such individual.
However, in the case of earned income . . . of such spouse, such earned income will be reduced by $65 a month . . . for all expenses attributable to the earning of such income. In addition, such spouse's income is reducible by the sum of $70 a month for periods of time prior to July 1974 and by the sum of $73 a month for periods of time after June 1974 . . . Income deemed to the eligible individual will be treated as unearned income.
Evidence indicates that the ineligible spouse's income for the January through March 1974 quarter was $1,242. Deducting the quarterly work exclusion referred to above or $65 a month or $195 a quarter, we arrive at a figure of $1,047. Deducting the further exclusion of $70 a month of $210 a quarter, we arrive at the figure of $837, which is income deemed to the claimant. Eight hundred and thirty seven dollars per quarter is the same as $279 per month, and is further reducible under section 416.1165 by the amount of $60 per quarter or $20 a month, leaving a balance of $259 per month. However, an income of $259 per month is in excess of that permitted under Title XVI of the Social Security Act, as amended, for an individual to be eligible for supplemental security income benefits.
Furthermore, the same approximate computations would be made for subsequent periods in 1974 and for the current quarter in 1975 based on the evidence contained in the claim file and the testimony given at the hearing.
It is therefore the decision of the Hearing Examiner that the claimant in this case is not currently eligible for supplemental security income benefits nor has he been eligible at any time during the pertinent period of time involved, that is, since January 1974.
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