TN 35 (10-96)
SI 00501.154 Determining When Couple Computation Rules Apply
1. Couple Computation Rules - Criteria
Effective 10/1/90, couple computation rules apply to two individuals for a month, if, as of the first moment of that month:
each is eligible for benefits;
they are married to each other (see SI 00501.150B.); and
they live in the same household as defined in SI 00501.154B.
2. Couple Computation Rules - Exceptions
The instructions in SI 00501.154A.2.a. through SI 00501.154A2.c. apply to applications filed prior to August 22, 1996. See SI 00501.155 for applications filed on or after August 22, 1996.
a. Month of Filing
Couple computation rules apply only if the criteria in SI 00501.154A.1.a., SI 00501.154A.1.b., and SI 00501.154A.1.c. are met as of the effective filing date.
b. Month of Request for Reinstatement of Benefits
Couple computation rules apply only if the criteria in SI 00501.154A.1.a., SI 00501.154A.1.b., and SI 00501.154A.1.c. are met as of the date of the request.
c. Separate Applications or Requests in a Month
If, in a month, the members of a couple file separate applications, or requests for reinstatement, or one files an application and the other a request for reinstatement, couple computation rules apply only if the criteria in SI 00501.154A.1.a., SI 00501.154A.1.b., and SI 00501.154A.1.c. are met as of the latest effective filing date.
3. Deeming Status When Separation Occurs in Month of Filing or Request for Reinstatement
a. When Not to Deem
If couple computation rules do not apply for the month based on SI 00501.154A.2.a., SI 00501.154A.2.b., or SI 00501.154A.2.c., and if both spouses would be eligible for the month as individuals without a spouse, both are treated that way and deeming does not apply.
b. When to Deem
If couple computation rules do not apply for the month based on SI 00501.154A.2.a., SI 00501.154A.2.b., or SI 00501.154A.2.c., and if one spouse is ineligible for any reason (except deeming), his/her income and resources are deemed to the other spouse for the month
A household is common living quarters and facilities under domestic arrangements that create one economic unit. Sharing a room in an institution is not living in the same household. The temporary absence of a couple member from a household does not affect the applicability of couple computation rules.
1. Payment Amount Considerations
Explain the following payment considerations to the members of a couple, if appropriate:
If one member of a couple could receive a higher payment as an individual with an ineligible spouse than both would receive as a couple, they have that filing option.
For applications filed prior to August 22, 1996, if members of a couple separate after filing, it may be advantageous for one of them to select a later effective filing date.
CAUTION: For applications filed on or after August 22, 1996 a person may not choose an effective filing date. See SI 00601.009.
Where title II offset is involved, it may be advantageous for one member of a couple (or an eligible individual with an ineligible spouse who becomes eligible), to withdraw his/her SSI application because of the offsetting. The FO should determine whether withdrawal is to be exercised before any payment is effectuated. Follow withdrawal instructions in SI 00601.050.
2. Medicaid Considerations
In each of the situations in SI 00501.154C.1., be sure to explain the Medicaid eligibility implications of any of the actions taken. See SI 01730.005 ff.
Document the couple's decision, if SI 00501.154C.1. or SI 00501.154C.2. applies, with a statement from each (or both), showing they understand the consequences of their decision.
D. Examples - Applications Filed Prior to August 22, 1996
1. Month of Filing
As of May 5, Mrs. Elliot is an eligible individual. Her husband is her ineligible spouse and deeming applies.
Mr. and Mrs. Elliot begin living apart on May 15, and Mr. Elliot applies for SSI on May 25. Mr. Elliot receives an employee pension in addition to a small VA pension.
Since Mr. and Mrs. Elliot are not living together on May 25 (the later effective filing date) couple computation rules do not apply for May.
One of the following situations may apply:
If Mr. Elliot would be eligible as an individual without a spouse, both he and Mrs. Elliot will be considered individuals without a spouse for May; or
If Mr. Elliot would not be eligible as an individual without a spouse (for reasons other than deeming), Mrs. Elliot's status remains the same for May; i.e., Mr. Elliot is her ineligible spouse and deeming applies. It is more likely that Mr. Elliot would not be eligible for May since he has other income. Therefore, the deeming situation applies.
We cannot treat Mrs. Elliot as an eligible individual without a spouse for May unless Mr. Elliot is also eligible.
However, beginning June 1, Mrs. Elliot will be an eligible individual without a spouse regardless of Mr. Elliot's situation (since they are separated).
2. Month of Filing - Couple Member Opts to Change Filing Date
Mr. and Mrs. Daniels are both over age 65. Mrs. Daniels files for SSI on June 6. She says her husband is ill, but will come in to file a claim also. He files on June 14. On June 20, Mrs. Daniels notifies the teleservice center that her husband moved out that day.
Couple computation rules apply for June since as of the later effective filing date, i.e., June 14, couple criteria are met.
The CR explains to Mrs. Daniels that because of her husband's income they will receive a small SSI check for June. Mrs. Daniels complains that it is unfair to her that she is penalized because of her husband's income since they are separated.
The CR tells Mrs. Daniels that if her husband changes his filing date to a date after June 20, they both can be treated as individuals without a spouse for June, and she will get a higher SSI payment.
3. Month of Request for Reinstatement of Eligibility
Mr. and Mrs. Dunn are an eligible couple. In July, Mr. Dunn receives the first of what he believes will be a series of insurance payments. Since the amount makes both him and Mrs. Dunn ineligible if couple computation rules are used, the criteria for using couple computation rules are not met.
Because of certain deeming allocations, an individual computation with Mr. Dunn as Mrs. Dunn's ineligible spouse could permit eligibility for her.
Mr. and Mrs. Dunn begin living apart on August 5, when he finds out that the July insurance payment will be the last. He requests reinstatement on August 6.
Since Mr. and Mrs. Dunn were not living together as of the date of his request, individual rather than couple computation rules apply for August.
Since both Mr. and Mrs. Dunn would be eligible as individuals without a spouse for August, each will be treated that way.
Had Mr. Dunn been ineligible for August (e.g., because of resources), his income and resources would have been deemed available to Mrs. Dunn for August, and she would not have become an individual without a spouse until September.
Had Mr. Dunn delayed requesting reinstatement until September, couple computation rules would have applied for August because the criteria in A.1. above were met as of the first moment of August and no request for reinstatement was filed in August.
4. Couple Separated Prior to 10/1/90
Mr. and Mrs. Carroll are an eligible couple. On May 3, 1990, they began living apart. On August 20, 1990, they notified the field office of the separation.
The couple will be considered as two individuals beginning 10/1/90, the date the law eliminated the 6-month waiting period for eligible couples who separate.
5. Withdrawal of SSI Application - Title II Offset
Mrs. Trello has been receiving Social Security disability benefits since February 1989; as of 1/91 her benefit is $300 per month.
Mr. and Mrs. Trello filed for SSI as a couple on February 1, 1991.
Mrs. Trello's SSI claim was approved effective February 1, 1991. Mr. Trello was found not disabled (for both title II and title XVI).
Mr. Trello's claim was reversed on appeal in November 1991. Mr. Trello was found to be disabled for title II and title XVI as of February 1, 1991.
The case is a title II offset situation. Mr. Trello is due a retroactive SSI payment of $2,030 ($3,300 is due the Trello's as a couple for 2/91 through 11 /91 less $1,270 already paid to Mrs. Trello as an eligible individual).
Mr. Trello is also due $4,500 in retroactive title II benefits ($450 x 10 months) which will be offset by the $3,300 SSI benefits paid, leaving a title II retroactive amount of $1,200 after offset.
He will receive a total amount of $3,230 in SSI and title II benefits; whereas if he withdraws his SSI claim, he can receive $4,500 in title II benefits. There is no continuing SSI eligibility because of the couple's title II income.
In the absence of other considerations such as Medicaid, it will be to Mr. Trello's advantage to withdraw his SSI application.