TN 40 (12-00)

SI 00810.035 Unstated Income

Citations:

Social Security Act, as amended, section 1612(a) ;

20 CFR 416.1102

A. Definition

Unstated income is income not reported or otherwise known to SSA but determined to exist because an individual’s (or couple’s) living expenses exceed income from known sources. Claimants, recipients, and deemors may be found to receive unstated income.

B. Policy

REMEMBER: Income is anything received in cash or in kind that can be used to meet an individual’s needs for food, or shelter.

1. Amount of unstated income

The amount of unstated income to be charged is the difference between stated (or known) monthly income and monthly living expenses.

2. When to consider unstated income

Whenever the information in file, including statements of the claimant/recipient, deemor or third parties, creates questions as to how living expenses are met, explore the existence of unstated income. Adjudicators are responsible for deciding whether the information in file creates such questions and to what extent unstated income must be explored.

C. Procedure

1. Unstated income indicators

Failure to disclose income may be due to a lack of understanding of reporting responsibilities and types of income that affect SSI eligibility and payment amounts. Misunderstandings may arise when income is received in kind, including in-kind income derived from third-party payments on behalf of the individual. There also may be a reasonable explanation for a discrepancy between income and living expenses; e.g., savings are being used, work ended recently, debts have been incurred, outstanding bills have not been paid.

a. Common situations that may point to unstated income

  • Stated income is insufficient to pay costs normally associated with resources owned (e.g., gas, maintenance, insurance and licensing of an automobile).

  • Stated income is insufficient to provide for known living expenses.

  • No income is alleged and the individual (or couple) does not live in a setting in which food and shelter are provided (such as a public institution or the household of another).

b. No indication of unstated income

If, based on the allegations and other information available at the time of the interview, there is no reason to believe that unstated income exists, no further development or documentation is required. In evaluating the case facts, do not make assumptions that are not supported by those facts.

c. Possible indication of unstated income

If insufficient or conflicting evidence exists, question the individual or deemor about possible unstated income and allow the individual or deemor the opportunity to explain how expenses are met.

REMEMBER: There may be a reasonable explanation for a discrepancy between income and living expenses. Careful interviewing is needed to ascertain if the person is receiving help from a local church, food bank, community service center, or other sources.

If a satisfactory explanation is provided, obtain the explanation on a Report of Contact (SSA-5002 or DROC screen) or other form (e.g., the “Remarks” section of the SSI application, redetermination form, MSSICS screens).

If the explanation is inadequate, query the Office of Child Support Enforcement’s National Directory of New Hires (NDNH) database to determine if the individual has earned wages or has received unemployment compensation he or she did not report. See SI 00810.550 for instructions on using the NDNH query. If the query does not show any undisclosed income, obtain the explanation of how expenses are met over the individual’s or deemor’s signature, and determine the amount of unstated income per SI 00810.035C.2. (See GN 04111.000 if fraud is suspected.) If the query indicates the individual or deemor may have undisclosed income, see SI 00810.550C.

2. Determining chargeable unstated income

Once unstated income is found to exist, determine the amount by comparing usual monthly living expenses with total monthly income. Be aware of the tendency to overlook expenses, but do not assume expenses that may not exist.

Obtain a signed allegation of usual monthly living expenses for the following items:

  • rent or mortgage, including property tax;

  • food;

  • clothing;

  • utilities;

  • miscellaneous household expenses;

  • insurance;

  • medical and dental care;

  • automobile and other transportation expenses;

  • other expenses (such as newspapers, barber, toilet articles, etc.);

  • installment loans;

  • illegal drugs, if the file shows that the individual uses them.

Whenever possible, obtain evidence of alleged expenses, using receipts, payment stubs, canceled checks, contacts with knowledgeable sources, etc.

Document the file with a Report of Contact showing the comparison of living expenses with income (including any income detected by querying the NDNH). Charge the difference as unstated income. For MSSICS cases, use the IOTH screen to enter unstated income. For non-MSSICS cases, enter the amount as type “S” income in the UM field of the SSA-1719B or SSA-450SI. Enter the word “UNSTATED” in the “Claim or ID No.” portion of the field. Suppress the automated notice and prepare a manual notice (see SI 00810.035C.3.).

NOTE: Never input unstated income as type “H” income (in-kind support and maintenance).

3. Notices

NOTE: If the individual is blind or visually impaired, see instructions at NL 01001.010 for more information on the special blind or visually impaired notice options.

The SSI system is unable to issue an automated notice that explains unstated income. Therefore, the automated notice must be suppressed and a manual notice issued. Sample notice paragraphs for the most common situations involving unstated income are located in NL 00804.175. However, field offices may expand upon the paragraphs to fit the particular circumstances of the case. The paragraphs may be used in an initial award or denial notice, or in any posteligibility notice.

D. Examples

1. Satisfactory explanation received — no unstated income charged

Mrs. Janet Anderson, who lives alone, applies for benefits, alleging monthly rent of $300 and an income of $400 per month plus food stamps. Ms. Anderson also reports owning a current model car, which is excluded from resources. Ms. Anderson happened to mention during the interview that her mother paid the lender for all her car payments so far, and the CR, therefore, finds no reason to believe that unstated income exists. No further development of unstated income is needed, and no proof of the mother’s payments on the car is required to resolve the unstated income issue. Document the file with the explanation.

If, on the other hand, Ms. Anderson did not mention during the regular interview that her mother paid the lender for her car payments, the CR might wonder how she could pay for the car and its expenses along with her $300 rent and other living expenses. If the CR judged that unstated income should be explored, he would ask Ms. Anderson to explain how she was meeting her expenses. Ms. Anderson’s satisfactory explanation, coming in response to questions about unstated income, would need to be recorded on a Report of Contact (SSA-5002 or DROC screen) or other form.

2. Inadequate explanation received — unstated income charged

Five months ago, Mrs. Cynthia Williams had to stop working due to a disabling condition. Today, she filed for SSI benefits. She reported as her only income a $300 monthly disability check from her former employer. Mrs. Williams lives with her unemployed husband and their three young children, none of whom has any income. The family receives food stamps worth $150 each month.

The couple has no bank accounts. Monthly mortgage payments are $575.

The CR asks Mrs. Williams how she is meeting her expenses on an income of $300 per month plus food stamps. She replies that she pays “one bill now and another bill later” but has been able to keep the mortgage and utilities up to date.

Finding this explanation unsatisfactory, the CR queries the NDNH database. The query uncovered no additional sources of income. Failing to uncover another source of income or support, the CR completes an SSA-795 (or DPST in MSSICS) with Mrs. Williams, containing her explanation of how she meets expenses and listing her usual monthly expenses, which total $900. The CR determines that she has monthly unstated income of $600 ($900 expenses minus $300 stated income), making her ineligible. The CR prepares a Report of Contact comparing expenses with income and explaining the determination of chargeable unstated income. The CR then inputs this income via the IOTH screen on MSSICS. For non- MSSICS cases, the CR would input this as type “S” income, coding it as “UNSTATED,” suppress the automated notice and issue a manual denial notice.


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http://policy.ssa.gov/poms.nsf/lnx/0500810035
SI 00810.035 - Unstated Income - 02/22/2017
Batch run: 02/22/2017
Rev:02/22/2017