For claimants who are in Federal LA D, different information is obtained depending on whether:

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  a “full” monthly payment is due (the Federal Benefit Rate (FBR), limited only by the payment cap, plus any optional supplement); or

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  the claimant is eligible but countable income exceeds the payment cap plus any optional supplement.

In order to qualify for a limited LAD PERC, the record must show that the claimant has been in either situation as described in SI 00603.034B.1. for all months since the latest of the following:

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  the date of first eligibility (SI 00603.030A.5.),

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  the date the initial application was received, or

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  the date the SSA-8000-BK or the full MSSICS application was completed when the claim was switched from deferred to simultaneous development prior to receipt of a medical allowance.

If the information required for the limited PERC cannot be confirmed, you must conduct a full PERC.

Confirm (by phone, if possible) with a representative of the institution that since the reference date, the claimant has continuously resided at the institution and is expected to continue residing there, and

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  (if age 18 or over) had more than 50% of their cost of care paid for by Medicaid and this arrangement is expected to continue (see SI 00520.011E.2.b. if Medicaid is the only source of payment), or

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  (if a child under age 18) had more than 50% of their cost of care paid for by private health insurance alone or in combination with Medicaid, and

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  has not received income from any previously unreported source and does not expect to, and

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  has not earned more than $65 in any month and does not expect to, and

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  does not have conserved funds exceeding the statutory limit at the institution or in a financial establishment to the institution's knowledge.

  NOTE:If the recipient has conserved funds approaching the resource limit, diary the case to update the amount of funds the following year or earlier if you can predict when the resource limit will be reached.

Contact a representative of the institution (by phone, if possible) and confirm that:

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  the claimant has resided at the institution since the reference date and is expected to continue to reside there, and

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  no income decrease is expected.

In claims with certain profiled case characteristics, development consists of ascertaining if the claimant has moved and if so, determining if the subsequent LAs continue to meet the profile.

The claim must be a DDS allowance.

The record must show that since the latest of the following dates:

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  the date of first eligibility,

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  the date the application was received, or

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  the date the SSA-8000-BK or the full MSSICS application was completed when the claim was switched from deferred to simultaneous development prior to receipt of a medical allowance,

the claimant has no ineligible spouse and is:

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  in LA A and the claimant and/or eligible spouse receives only title II or assistance based on need (as defined in SI 00830.175), or

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  in LA B and neither the claimant nor the eligible spouse receives any earned income or countable unearned income other than title II.

If the claimant answers “no,” document the answer on an SSA-5002 for paper processing or use the DROC (Report of Contact) screen for MSSICS processing.

If the claimant answers “yes,” determine the subsequent LA(s).

For non-MSSICSprocessing, document the LAs on an SSA-5002, SSA-795 (Statement of Claimant or Other Person), or other appropriate form, e.g., Form SSA-8006 (Statement of Living Arrangements, In-Kind Support and Maintenance).

For MSSICS processing, document the LAs on the LA screens.

If the LA has changed such that the conditions for exclusion are no longer met, conduct a full PERC.

Ask the SNAP questions again, if appropriate. See Screening Individuals for Supplemental Nutrition Assistance Program (SNAP) Eligibility or Application Status (SI 01801.010).