The Social Security Administration (SSA) uses an SSA-L991 notice to document a potential
claimant's decision not to file for SSI payments only if they request it or choose
not to file during their scheduled SSI appointment.
If the potential claimant appears ineligible based on other factors of eligibility,
indicate such in the notice.
The SSA-L991 does not include protective filing dates, as closeout language was already
provided either online or by an SSA technician.
EXCEPTION: The SSA-L991 will contain closeout language if closeout language was not previously
provided (e.g., online, verbally, manual closeout notice).
Use the following chart to determine when to send the SSA-L991:
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If
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Then
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T2-only appointment or walk-in interview
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Oral inquiry applies only if the claimant is within 2 months of age 65 or older, or
alleges disability or blindness AND the claimant's Title II benefits would not prevent
him or her from receiving SSI or any State supplement.
When appropriate, discuss SSI and enter the filing decision on the IDEN screen in
MCS or the SSI Eligibility and Intent to File page in CCE.
If the claimant does not want to file for SSI, close out the oral inquiry by sending
an SSA-L991 including closeout language.
NOTE: The response of "No" by itself does not replace the documentation requirement to provide
the SSA-L991.
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T16-only or T2/T16 concurrent appointment or walk-in interview
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Closeout was provided at the time of scheduling the appointment.
If the claimant changes his or her mind and does not want to file for SSI during the
appointment, send an SSA-L991 stating the claimant does not want to file, but do not
include closeout language.
NOTE: For walk-in interviews, include closeout language in the SSA-L991 if none was previously
provided.
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Claimant misses the appointment, cannot be recontacted, or the appointment cannot
be rescheduled.
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No action is necessary - closeout was provided at the time the appointment was scheduled.
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SSA receives a written statement inquiring about SSI (with no prior closeout notification)
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If unable to contact the individual to take the claim or schedule an appointment,
do not send an SSA-L991.
Send a manual notice from the Document Processing System (DPS) (Closeout letter (General))
to close out the protective filing created by the oral inquiry.
Refer to T16 closeout language NL 00804.245
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Individual submits claim online
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Do not send the SSA-L991 to individuals who file a claim online, since closeout language
was already provided on-screen.
EXCEPTION: If you subsequently have contact with the claimant and they inform you that they have
changed their mind and no longer want to file for SSI, document the pending claim
and send the claimant an SSA-L991. In this situation, do not include closeout language
in the SSA-L991.
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