SI 00501.110 Loss of Essential Person Status - SSI

A. Policy Principles

1. EP Criteria Not Met

Individual loses EP status permanently if for any month after December 1973 does not meet each of the criteria in SI 00501.100B.2.

2. EP Becomes Eligible for SSI

No longer an EP beginning the month he/she becomes eligible for SSI.

3. Qualified Individual Chooses to Delete EP

  • A qualified individual may request in writing that SSA determine the FBR without the addition of an EP increment even if the deeming of income and resources from the EP does not cause a reduced payment or ineligibility.

  • SSA must explain to the individual how the EP increment works (i.e., it may either lower or increase the monthly payment depending upon what income the EP has).

  • The request is irrevocable and results in the permanent loss of EP status for any person excluded by the request.

  • The loss of EP status is effective the month following the month of the written request.

4. Temporary Absences from the Home

  1. EP remains an EP if:

    • Intends to return; and

    • Facts support intention; and

    • There is a likelihood of return; and

    • Absence does not exceed 90 days.

  2. If a qualified individual is temporarily absent from his/her home (e.g., hospitalization), the EP increment continues if:

    • Intends to return; and

    • Facts support intention; and

    • There is a likelihood of return; and

    • Absence does not exceed 6 months.

5. EP's Income and Resources Cause Loss of Eligibility

Determine eligibility without consideration of that EP. The EP loses that status permanently and the increment no longer applies.

B. Operating Policy

1. Loss of EP Increment Due to Absences

A qualified individual loses the EP increment(s) effective with the earlier of the month following the month in which:

  • Qualified individual's absence exceeds 6 months; or

  • EP's absence exceeds 90 days; or

  • EP or qualified individual changes intent and the absence becomes permanent; or

  • EP or qualified individual indicates prior to leaving the home he/she will not return to it.

2. Qualified Individual Loses Eligibility

If a qualified individual becomes ineligible (e.g., because of his/her own excess income or resources) and subsequently reestablishes eligibility, EP status may resume as well, if he/she meets all requirements.

C. Operating Procedure

1. Absence of Qualified Individual

  1. Contact the qualified individual and the EP or authorized representative to see whether the qualified individual intends to return to reside with the EP. (Use telephone contact whenever possible.)

  2. Record the information on a report of contact (RC).

  3. Control the case via diary or listing procedures (see SM 01301.200 ff.) for recontact with the individual prior to the expiration of the time period (i.e., 6 months for the qualified individual and 90 days for the EP).

  4. Recontact the individual before the expiration of the time period (see SI 00501.110B.). If the absence will exceed the time period, document the file and make input to end the EP increment the following month. (See SM 01301.525F.4.)

2. Absence of EP

The same procedures explained above apply.

3. EP Becomes Eligible Spouse (ES)

  1. Any month or months the qualified individual receives an EP increment and we subsequently determine the EP is an ES is not an overpayment.

  2. No underpayment is due the newly determined ES.

  3. Any payment made to the eligible (qualified) individual for the month represents payment to both the individual and eligible spouse.

  4. Make payments to the eligible couple in accordance with SI 02001.005.

    CAUTION: An overpayment may exist in a. above if we otherwise pay the qualified individual too much.

4. Notice Requirement

When a person is no longer an EP, notify the qualified individual or the representative of the proposed reduction in the payment amount. Suppress the systems-generated notice following SM 01301.675 a