SSR 80-16: Title XVI: Alerting Title II Applicants to Possible Title XVI Eligibility
To set out a new policy insuring that title II (social security) applicants potentially entitled to supplemental security income (SSI, title XVI) are made aware of their rights to SSI.
Sections 202, 205, and 1631 of the Social Security Act; Regulations No. 16, section 416.336a; Action Memorandum dated August 11, 1977, approved by the Commissioner on August 17, 1977.
The current policy is that an application for SSI is an application for all social security benefits. On the other hand, the scope of an application for title II social security benefits has been limited to title II and health insurance benefits, but has not been an application for SSI benefits. Where an individual applies for title II benefits and appears to be eligible for SSI, district court office personnel have been instructed to explain to the individual the advantages of filing for SSI. However, district office interviewers have not been required to document the fact that eligibility requirements for SSI benefits have been explained to title II applicants; therefore, no record of the explanation has been available. Consequently, under prior procedures, where an individual subsequently returned to the district office in a month after his or her original inquiry regarding social security benefits and filed for SSI, the individual might have lost benefits because SSI could not begin before the month the application form was filed.
Various public service organizations proposed that social security applications be made concurrent applications for SSI benefits. The basic concern of these organizations was that title II applicants, who are also potentially eligible for SSI, be informed of their rights under title XVI and afforded an opportunity to apply. However, if all applications for title II benefits were deemed to be concurrent applications for SSI benefits, a ponderous and unnecessary workload would be created. Since nondisabled persons under age 65 applying for title II benefits cannot be eligible for SSI, the time taken to formally deny their unproductive SSI claims could delay benefit payments to eligible SSI applicants.
The best protection that can afford those individuals who are potentially eligible for SSI is to give them a proper explanation of the program and to have a signed statement serve as evidence that the explanation was given. If the applicant does not file for SSI, his or her signature attesting to the fact that an explanation of SSI was given, will establish that the individual's decision not to file was an informed one. Annotation of the file by the interviewer would cover the situation where the applicant refused to sign a statement indicating that the SSI explanation was given.
- Applicants for title II benefits, potentially eligible for SSI, will be informed of the requirements that must be met for SSI, and will be given an opportunity to file an application for SSI benefits.
- A title II applicant is considered to be potentially eligible for SSI if the applicant alleges that he or she is within 2 months of age 65 or older, or alleges blindness or disability, and it is not clear that the amount of the title II benefit precludes the payment of SSI including any State supplement handled by the Social Security Administration.
- If the applicant does not file for SSI, usually because of ineligibility, he or she will be advised of the reason for ineligibility and asked to sign a statement that he or she has received an explanation of the program.
- Should any applicant refuse to sign such a statement after being given the opportunity to do so, the interviewer will annotate the file accordingly.
- When an SSI application is not filed, the title II application will be treated as an oral inquiry. The applicant will be given a written notice containing an explanation of the reason for his or her apparent ineligibility. The notice will also advise the claimant that, if an application form is filed within 60 days, the date of inquiry will be the filing date of the SSI application.
These policies are effective July 2, 1979, the date of publication of final regulations in the Federal Register (44 FR 38456).
See paragraphs 3 and 4 of Policy Statement.
If the potential SSI claimant dies, either before a written notice is sent, or within the 60-day period mentioned in the notice, the notice will be sent to the individual's eligible spouse, if any.
This notice will advise the spouse of the potential SSI claimant that if an application form is filed on behalf of the deceased within 60 days of the date of the notice, the date of initial inquiry will be considered as the filing date.
Claims Manual section 2003(e); Program Policy Statement No. 47, Title XVI: Establishing the Filing Date of a Supplemental Security Income Claim Based on an Oral Inquiry; Establishing Uniform Time Limits for an Oral or Written Inquiry.