TN 35 (02-01)

SI 01120.204 Notices for Trusts Established on or after 1/1/00

A. Introduction

A manual notice is required whenever an individual:

  • is ineligible due to excess resources and those resources include a trust;

  • has excess resource, but is eligible for SSI based on an undue hardship waiver, or

  • has a change in eligibility or payment status due to trust/undue hardship involvement.

Use the instructions and notice paragraphs in this section to prepare manual notices for trust cases. Prepare these notices using the Document Processing System (DPS). 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.

NOTE: If an individual has a trust, but meets one of the Medicaid exceptions in SI 01120.203A., a manual notice is not required. However, a manual notice is required if the individual has a trust and is eligible based on the undue hardship waiver in SI 01120.203C.

B. Procedure — Award Letter

1. When to Use

Prepare a manual award letter (SSA-L8025) when the individual is ineligible due to excess resources which include a trust, but is awarded SSI benefits under the undue hardship waiver. The automated award notice must be suppressed.

2. Which Paragraphs to Use

From the DPS initial claims menu, select the Form SSA-L8025 and use these paragraphs in the following order:

  • Paragraph 1272 in NL 00804.180: provides language related to excess resources and definition of resources.

  • TST001: explains and defines undue hardship.

  • TST002: informs the individual whether he/she meets requirements for undue hardship.

  • TST003: tells the individual we will contact him/her to review undue hardship determination and gives date.

C. Procedure — Disapproved Claim Letter

1. When to Use

Prepare a notice of disapproved claim (SSA-L8030) when the individual has a period of ineligibility due to excess resources which include a trust and the individual is not eligible during the life of the application. A manual notice is always required when an individual is being denied SSI based on excess resources that include a trust.

Use this notice for an individual who does not qualify for undue hardship because his/her available funds exceed the limit. Also use this notice when the individual does not qualify for undue hardship because the trust does not have the required restrictive language on trust payments.

2. Which Paragraphs to Use

From the DPS initial claims menu, select the Form SSA-L8030 and use these paragraphs in the following order:

a. No undue hardship – individual's funds exceed the limit

  • Paragraph 1272 in NL 00804.180: provides language related to excess resources and definition of resources.

  • TST001: explains and defines undue hardship.

  • TST002: informs the individual that he/she does not meet the requirements for undue hardship.

  • TST004: notifies the individual to contact SSA if his/her income or resources change and he/she cannot afford food and shelter in a future month.

b. No undue hardship – trust does not have restrictive payment language

  • Paragraph 1272 in NL 00804.180: provides language related to excess resources and definition of resources.

  • TST001: explains and defines undue hardship.

  • TST011: informs the individual that he/she does not meet the requirements for undue hardship.

D. Procedure — Notice of Planned Action

1. When to Use

Prepare a notice of planned action (SSA-8155) in posteligibility situations when the individual has excess resources which include a trust, undue hardship does not apply, and it is necessary to stop the individual's SSI check.

Also use this notice when an eligible individual who has excess resources but has been receiving SSI based on undue hardship no longer qualifies for undue hardship.

2. Which Paragraphs to Use

From the DPS posteligibility menu, select the Form SSA-L8155 and use these paragraphs in the following order:

  • Use the caption “Why We Can't Pay You/Him/Her.”

  • Paragraph 1272 in NL 00804.180: provides language related to excess resources and definition of resources.

  • TST001: explains and defines undue hardship.

  • TST002: informs the individual that he/she does not meet requirements for undue hardship.

  • TST004: notifies the individual to contact SSA if his/her income or resources change and he/she cannot afford food and shelter in a future month.

E. Procedure — Notice of Change

1. When to Use

Prepare a notice of change (SSA-L8151) in posteligibility situations when an individual who had been ineligible due to excess resources that include a trust is now eligible for SSI. Use this notice when an individual becomes eligible because he/she qualifies for SSI based on the undue hardship waiver.

2. Which Paragraphs to Use

From the DPS posteligibility menu, select the Form SSA-L8151 and use these paragraphs in the following order:

  • TST005: explains SSA's initial determination of ineligibility due to excess resources.

  • TST001: explains and defines undue hardship.

  • TST006: explains SSA's initial determination that the individual did not qualify based on undue hardship.

  • TST010: explains that the individual is now eligible based on undue hardship.

  • TST003: tells the individual we will contact him/her to review undue hardship determination and gives date.

F. Procedure — Revised Determination Notice

1. When to Use

Prepare a manual notice of revised determination (SSA-L8100) when changing a determination for past months due to excess resources which include a trust and a reconsideration has not been filed.

Use this notice for an individual who was determined ineligible in the past due to excess resources that include a trust and we are now determining that he/she was eligible for that period. Also use this notice for an individual who was determined eligible in the past and we are now determining that he/she was ineligible for that period.

2. Which Paragraphs to Use

From the DPS menu, select the Form SSA-L8100 and use these paragraphs in the following order:

a. Change from ineligible to eligible

  • TST005: explains SSA's initial determination of ineligibility due to excess resources.

  • TST001: explains and defines undue hardship.

  • TST006: explains SSA's initial determination that the individual did not qualify based on undue hardship.

  • TST010: explains that the individual is now eligible based on undue hardship.

  • TST003: tells the individual we will contact him/her to review undue hardship determination and gives date.

b. Change from eligible to ineligible

  • Paragraph 1272 in NL 00804.180: provides language related to excess resources and definition of resources.

  • TST001: explains and defines undue hardship.

  • TST006: explains SSA's previous determination that the individual was eligible based on undue hardship.

  • TST002: informs the individual that he/she does not meet requirements for undue hardship.

  • TST004: notifies the individual to contact SSA if his/her income or resources change and he/she cannot afford food and shelter in a future month.

NOTE: In paragraph 6, in fill-in 7, use “could not” and in fill-in 11, use “did.” In paragraph 2, in fill-in 8, use “could” and in fill-in 11, use “cannot.”

G. Procedure — Reconsideration Affirmation

1. When to Use

Prepare a manual reconsideration notice (SSA-L8456) when the individual appeals a determination about excess resources that include a trust, undue hardship does not apply and we affirm that SSA's initial determination was correct

2. Which Paragraphs to Use

From the DPS posteligibility menu, select the Form SSA-L8456 and use these paragraphs in the following order:

  • TST005: explains SSA's initial determination of ineligibility due to excess resources.

  • TST001: explains and defines undue hardship.

  • TST006: explains SSA's initial determination that the individual did not qualify based on undue hardship.

  • TST007: notifies the individual that SSA still finds him/her ineligible due to excess resources.

  • TST008: notifies the individual that SSA still finds that he/she is ineligible because he/she does not qualify for undue hardship.

  • TST004: notifies the individual to contact SSA if his/her income or resources change and he/she cannot afford food and shelter in a future month.

H. Procedure — Reconsideration Reversal

1. When to Use

Prepare a manual reconsideration notice (SSA-L8455 for initial claims and SSA-8457 for posteligibility) when the individual appeals an excess resource determination, his/her resources include a trust and we determine that SSA's initial determination should be changed.

2. Which Paragraphs to Use

From the DPS posteligibility menu, select the Form SSA-L8455/SSA-8457 and use these paragraphs in the following order:

  • TST005: explains SSA's initial determination of ineligibility due to excess resources.

  • TST001: explains and defines undue hardship.

  • TST006: explains SSA's initial determination that the individual did not qualify based on undue hardship.

  • TST009: informs the individual that SSA now finds that he/she is eligible for SSI based on undue hardship.

  • TST003: tells the individual we will contact him/her to review undue hardship determination and gives date.

I. Exhibits of Notice Language

This section lists all of the paragraphs for the manual notices for cases involving trusts.

Paragraph TST001: This paragraph is used to inform the individual that, despite having excess resources because his/her resources include a trust, he/she may be eligible if not getting SSI would cause undue hardship. This paragraph also explains the term “undue hardship.”

If 1 resources include a trust, we will not consider the trust to be a resource if not getting SSI payments would cause 2 undue hardship. Under our rules, we will find undue hardship if there are certain restrictions on the trust and 3 would not be able to pay for ___4 food and shelter without SSI.

Paragraph TST001 Example:

If your resources include a trust, we will not consider the trust to be a resource if not getting SSI payments would cause you undue hardship. Under our rules, we will find undue hardship if there are certain restrictions on the trust and, you would not be able to pay for your food and shelter without SSI.

TST001 Fill-ins:

  1. Choice 1: your

    Choice 2: his

    Choice 3: her

  2. Choice 1: you

    Choice 2: him

    Choice 3: her

  3. Choice 1: you

    Choice 2: he

    Choice 3: she

  4. Choice 1: your

    Choice 2: his

    Choice 3: her

Paragraph TST002: This paragraph is used to inform the individual whether he/she meets the “available funds” criteria for SSI based on undue hardship. (This paragraph states that the individual's trust contains certain restrictive language on trust payments. If the trust does not contain the required restrictive language, paragraph TST011 is used instead.)

Based on the information 1 provided, we have determined under our rules that 2 a trust with certain restrictions on the payments of trust money and that 3 4 5 6 , 7____ ___8 pay for _____9 food and shelter without SSI. This means ___10 ____ 11 get SSI for 12 .

TST002 Examples:

Based on the information you provided, we have determined under our rules that you have a trust with certain restrictions on the payments of trust money and that starting in July 2000, you could not pay for your food and shelter without SSI. This means you can get SSI for those months.

Based on the information he provided, we have determined under our rules that he has a trust with certain restrictions on the payments of trust money and that in July 2000, he could pay for his food and shelter without SSI. This means he cannot get SSI for that month.

Based on the information you provided, we have determined under our rules that you have a trust with certain restrictions on the payments of trust money and that from July 2000 through October 2000, you could not pay for your food and shelter without SSI. This means you can get SSI for those months.

TST002 Fill-Ins:

  1. Choice 1: you

    Choice 2: he

    Choice 3: she

  2. Choice 1: you have

    Choice 2: he has

    Choice 3: she has

  3. Choice 1: from

    Choice 2: starting in

    Choice 3: in

  4. Month/year (first month in period of determination)

  5. Choice 1: through

    Choice 2: on

    Choice 3: null

  6. Choice 1: Month/year (last month in period of determination)

    Choice 2: null

  7. Choice 1: you

    Choice 2: he

    Choice 3: she

  8. Choice 1: could

    Choice 2: could not

  9. Choice 1: your

    Choice 2: his

    Choice 3: her

  10. Choice 1: you

    Choice 2: he

    Choice 3: she

  11. Choice 1: can

    Choice 2: cannot

  12. Choice 1: that month

    Choice 2: those months

Paragraph TST003: This paragraph informs an individual who is currently eligible for SSI based on undue hardship that he or she will be contacted in a future month to find out whether eligibility for SSI based on undue hardship continues. It also reminds them to contact SSA if their income or resources change. This paragraph is used only if there is current and continuing eligibility based on undue hardship. It is not used if the individual was only eligible for a period in the past.

1 may continue to be eligible for SSI based on undue hardship. We will contact 2 in 3 to find out if 4 to meet our rules on trusts from this month until 5 . We will also look to see if 6 will continue to need SSI to pay for 7 food and shelter. In the meantime, 8 should contact Social Security if _____9____ income or resources change.

TST003 Example:

You may continue to be eligible for SSI based on undue hardship. We will contact you in December 2000 to find out if you continue to meet our rules on trusts from this month until December 2000. We will also look to see if you will continue to need SSI to pay for your food and shelter. In the meantime, you should contact Social Security if your income or resources change.

TST003 Fill-Ins:

  1. Choice 1: You

    Choice 2: He

    Choice 3: She

  2. Choice 1: you

    Choice 2: him

    Choice 3: her

  3. Month/year (that individual will be contacted)

  4. Choice 1: you continue

    Choice 2: he continues

    Choice 3: she continues

  5. Month/year (same as fill-in 4)

  6. Choice 1: you

    Choice 2: he

    Choice 3: she

  7. Choice 1: your

    Choice 2: his

    Choice 3: her

  8. Choice 1: you

    Choice 2: he

    Choice 3: she

  9. Choice 1: your

    Choice 2: his

    Choice 3: her

Paragraph TST004: This paragraph is issued to individuals who are ineligible because they have excess resources that include a trust and do not qualify for SSI based on undue hardship. We notify them that they should contact SSA if their income or resources change and they cannot afford to pay for their food and shelter in a future month.

1 may qualify for SSI payments in future months based on undue hardship if 2 income or resources change. Contact Social Security right away if 3 income or resources change or 4 cannot pay for 5____ food and shelter.

TST004 Example:

You may qualify for SSI payments in future months based on undue hardship if your income or resources change. Contact Social Security right away if your income or resources change or you cannot pay for your food and shelter.

TST004 Fill-Ins:

  1. Choice 1: You

    Choice 2: He

    Choice 3: She

  2. Choice 1: your

    Choice 2: his

    Choice 3: her

  3. Choice 1: your

    Choice 2: his

    Choice 3: her

  4. Choice 1: you

    Choice 2: he

    Choice 3: she

  5. Choice 1: your

    Choice 2: his

    Choice 3: her

Paragraph TST005: This paragraph is used for reconsiderations and revised determinations when the individual was determined to be ineligible due to excess resources. This paragraph explains SSA's initial determination on the issue.

Previously, we determined that 1 2 not eligible for SSI ___3 ____ 4___ 5 6 because 7 resources worth more than $2,000. 8 resources include a trust.

TST005 Examples:

Previously, we determined that you were not eligible for SSI from June 2000 through September 2000 because you had resources worth more than $2,000. Your resources include a trust.

Previously, we determined that you were not eligible for SSI from June 2000 on because you have resources worth more than $2,000. Your resources include a trust.

Previously, we determined that you were not eligible for SSI in June 2000 because you had resources worth more than $2,000. Your resources include a trust.

TST005 Fill-Ins:

  1. Choice 1: you

    Choice 2: he

    Choice 3: she

  2. Choice 1: were

    Choice 2: was

  3. Choice 1: in

    Choice 2: from

  4. Month/year (first month of period of ineligibility)

  5. Choice 1: through

    Choice 2: on

    Choice 3: null

  6. Choice 1: Month/year (final month of period of ineligibility)

    Choice 2: null

  7. Choice 1: you have

    Choice 2: he has

    Choice 3: she has

    Choice 4: you had

    Choice 5: he had

    Choice 6: she had

  8. Choice 1: Your

    Choice 2: His

    Choice 3: Her

Paragraph TST006: This paragraph is used for reconsiderations and revised determinations when SSA previously determined that the individual is eligible/ineligible and did/did not qualify for SSI based on undue hardship. This paragraph explains SSA's initial determination.

In deciding whether to count 1 trust as a resource under our rules, we previously determined that 2 3 4 5 , 6__ ___7___ pay for 8 food and shelter without getting SSI for 9___ and 10____ ____11 qualify for SSI benefits based on undue hardship.

TST006 Examples:

In deciding whether to count your trust as a resource under our rules, we previously determined that starting in June 2000, you could pay for your food and shelter without getting SSI for those months and you did not qualify for SSI benefits based on undue hardship.

In deciding whether to count her trust as a resource under our rules, we previously determined that starting in June 2000, she could not pay for her food and shelter without getting SSI for those months and she did qualify for SSI benefits based on undue hardship.

TST006 Fill-Ins:

  1. Choice 1: your

    Choice 2: his

    Choice 3: her

  2. Choice 1: in

    Choice 2: starting in

    Choice 3: from

  3. Month/year (first month in period under consideration)

  4. Choice 1: null

    Choice 2: through

  5. Choice 1: null

    Choice 2: Month/year (last month in period under consideration)

  6. Choice 1: you

    Choice 2: he

    Choice 3: she

  7. Choice 1: could

    Choice 2: could not

  8. Choice 1: your

    Choice 2: his

    Choice 3: her

  9. Choice 1: that month

    Choice 2: those months

  10. Choice 1: you

    Choice 2: he

    Choice 3: she

  11. Choice 1: did

    Choice 2: did not

Paragraph TST007: This paragraph is used for reconsiderations when the individual appeals the period of ineligibility and SSA affirms the initial determination. This paragraph informs the individual that SSA still finds that he or she is ineligible due to excess resources.

Based on the information provided for this reconsideration, we have determined that 1 2 not eligible for SSI 3 ___4___

5 6 because 7 resources worth more than $2,000. 8 resources include a trust.

TST0007 Examples:

Based on the information provided for this reconsideration, we have determined that you are not eligible for SSI from June 2000 through September 2000 because you have resources worth more than $2,000. Your resources include a trust.

Based on the information provided for this reconsideration, we have determined that you are not eligible for SSI from June 2000 on because you have resources worth more than $2,000. Your resources include a trust.

Based on the information provided for this reconsideration, we have determined that she is not eligible for SSI in June 2000 because she has resources worth more than $2,000. Her resources include a trust.

TST0007 Fill-Ins:

  1. Choice 1: you

    Choice 2: he

    Choice 3: she

  2. Choice 1: were

    Choice 2: was

    Choice 3: are

    Choice 4: is

  3. Choice 1: in

    Choice 2: starting in

    Choice 3: from

  4. Month/year (first month of period of ineligibility)

  5. Choice 1: null

    Choice 2: on

    Choice 3: through

  6. Choice 1: Month/year (final month of period of ineligibility)

    Choice 2: null

  7. Choice 1: you have

    Choice 2: he has

    Choice 3: she has

    Choice 4: you had

    Choice 5: he had

    Choice 6: she had

  8. Choice 1: Your

    Choice 2: His

    Choice 3: Her

Paragraph TST008: This paragraph is used for a reconsideration when the individual appeals the period of ineligibility and SSA affirms the initial determination. This paragraph informs the individual that SSA still finds that he/she is ineligible for SSI because he/she does not qualify based on undue hardship.

Based on the information provided for this reconsideration, we have determined that from 1 through 2 , under our rules, 3_ not qualify for SSI benefits based on undue hardship. This means ___4 ____ cannot get SSI for 5 .

TST008 Example:

Based on the information provided for this reconsideration, we have determined that from June 2000 through the date of this determination, under our rules, you do not qualify for SSI benefits based on undue hardship. This means you cannot get SSI for those months.

TST008 Fill-Ins:

  1. Month/year (first month that the individual was not eligible for SSI, e.g., month of filing, or first month of period of ineligibility)

  2. Choice 1: the date of this determination

    Choice 2: Month/year (last month in period that the individual was not eligible for SSI)

  3. Choice 1: you do

    Choice 2: he does

    Choice 3: she does

  4. Choice 1: you

    Choice 2: he

    Choice 3: she

  5. Choice 1: that month

    Choice 2: those months

Paragraph TST009: This paragraph is used for reconsiderations when the individual appeals the determination of ineligibility and SSA reverses the initial determination. This paragraph informs the individual that SSA now finds that he/she is eligible for SSI based on undue hardship.

Based on the information provided for this reconsideration, we have determined that 1 2 eligible for SSI 3    4              5      6 because, under our rules, 7 faced with an undue hardship if we count 8 trust as a resource for 9 .

TST009 Examples:

Based on the information provided for this reconsideration, we have determined that you are eligible for SSI starting in June 2000 because, under our rules, you are faced with an undue hardship if we count your trust as a resource for those months.

Based on the information provided for this reconsideration, we have determined that you are eligible for SSI from June 2000 through September 2000 because, under our rules, you are faced with an undue hardship if we count your trust as a resource for those months.

Based on the information provided for this reconsideration, we have determined that you are eligible for SSI in June 2000 because, under our rules, you are faced with an undue hardship if we count your trust as a resource for that month.

TST009 Fill-Ins:

  1. Choice 1: you

    Choice 2: he

    Choice 3: she

  2. Choice 1: are

    Choice 2: is

  3. Choice 1: in

    Choice 2: starting in

    Choice 3: from

  4. Month/year (in past period that individual started to be eligible for SSI)

  5. Choice 1: null

    Choice 2: through

  6. Choice 1: null

    Choice 2: Month/year (last month that individual was eligible for SSI)

  7. Choice 1: you are

    Choice 2: he is

    Choice 3: she is

  8. Choice 1: your

    Choice 2: his

    Choice 3: her

  9. Choice 1: that month

    Choice 2: those months

Paragraph TST010: This paragraph is used when SSA revises a determination for a past period. Previously SSA had determined the individual was ineligible due to excess resources and there was no undue hardship. SSA's revised determination is that the individual was eligible for that past period based on undue hardship.

Based on new information, we have determined that 1     2     eligible for SSI   3     4       5          6 because, under our rules, 7____ faced with an undue hardship if we count 8___ trust as a resource for  9   .

TST010 Examples:

Based on new information, we have determined that you were eligible for SSI starting in January 2000 because, under our rules, you are faced with an undue hardship if we count your trust as a resource for that month.

Based on new information, we have determined that you were eligible for SSI in January 2000 because, under our rules, you are faced with an undue hardship if we count your trust as a resource for that month.

Based on new information, we have determined that you were eligible for SSI from January 2000 through July 2000 because, under our rules, you are faced with an undue hardship if we count your trust as a resource for those months.

TST010 Fill-Ins:

  1. Choice 1: you

    Choice 2: he

    Choice 3: she

  2. Choice 1: were

    Choice 2: was

    Choice 3: are

    Choice 4: is

  3. Choice 1: in

    Choice 2: starting in

    Choice 3: from

  4. Month/year (first month that individual was eligible for SSI)

  5. Choice 1: null

    Choice 2: null

    Choice 3: through

  6. Choice 1: null

    Choice 1: null

    Choice 3: Month/year (last month that individual was eligible for SSI)

  7. Choice 1: you are

    Choice 2: he is

    Choice 3: she is

  8. Choice 1: your

    Choice 2: his

    Choice 3: her

  9. Choice 1: that month

    Choice 2: those months

Paragraph TST011: This paragraph is used to inform the individual that he/she is not eligible for SSI based on undue hardship because his/her trust does not contain the required restrictive language on payments from the trust.

Based on the information 1 provided, we have determined under our rules that 2 a trust, but the trust does not contain certain restrictions on the payment of trust money. This means that 3___ cannot get SSI 4____ 5 6 7 .

TST011 Example:

Based on the information you provided, we have determined under our rules that you have a trust, but the trust does not contain certain restrictions on the payment of trust money. This means that you cannot get SSI from April 2000 on .

TST011 Fill-Ins:

  1. Choice 1: you

    Choice 2: he

    Choice 3: she

  2. Choice 1: you have

    Choice 2: he has

    Choice 3: she has

  3. Choice 1: you

    Choice 2: he

    Choice 3: she

  4. Choice 1: from

    Choice 2: starting in

    Choice 3: in

  5. Month/year (first month in period of determination)

  6. Choice 1: through

    Choice 2: on

    Choice 3: null

  7. Choice 1: Month/year (last month in period of determination)

    Choice 2: null


To Link to this section - Use this URL:
http://policy.ssa.gov/poms.nsf/lnx/0501120204
SI 01120.204 - Notices for Trusts Established on or after 1/1/00 - 05/30/2014
Batch run: 05/30/2014
Rev:05/30/2014