HI 00815.048 Establishing Buy-In Eligibility for Persons Who Refuse to Cooperate — CMS Accretions
Under SSI Program
If an individual eligible for SSI payments refuses to file an application under title
XVIII the DO/BO will complete a HCFA-4040 to enroll the individual. Once evidence
as to age, U.S. citizenship (or lawful alien status), and residence in the U.S. is
obtained (using Title II Rules), forward the file for processing (see HI 00815.045B). Each file must also be documented to show that the individual was requested to
apply for HI and SMI but refused to do so. Complete the award form in accordance with
HI 00815.045D.
If the individual also fails to cooperate in establishing that all SMI eligibility
requirements are met, the State must assume the burden of proving the Individual’s
SMI eligibility. If, after all sources of evidence have been exhausted, it has not
been established that the eligibility requirements are met, the file should be forwarded
for disallowance.