TN 12 (08-00)
SI 01150.120 Exceptions to the Ineligibility Period—General
Sections SI 01150.121-SI 01150.125 provide instructions for determining whether an individual meets one of the exceptions to the period of ineligibility for transferring a resource at less than fair market value. If an individual meets one of the exceptions, the period of ineligibility does not apply.
Section SI 01150.126 provides instructions for determining whether an individual qualifies for SSI benefits based on the undue hardship exception. Undue hardship is developed only if the individual has a period of ineligibility due to a resource transfer and does not meet one of the other exceptions.
Section SI 01150.127 is a guide to assist interviewers in determining whether one of the exceptions applies.
The following definitions should be used for purposes of determining whether the exceptions to the period of ineligibility apply:
A transferor is the person who has ownership interest in a resource and transfers the ownership to another person. A transferor can be an individual filing for SSI or a recipient, the spouse of the filer or recipient, or a co-owner of the resource.
An individual of any age who meets the medical requirements to be considered disabled for purposes of the SSI program.
An individual of any age who meets the medical requirements to be considered blind for purposes of the SSI program.
For purposes of determining whether an exception applies, child means biological child, adopted child, or stepchild of any age and of any marital status unless otherwise stated.
For purposes of determining whether an exception applies, sibling means full sibling, stepsibling, or halfsibling.
For purposes of determining whether an exception applies, spouse includes a holding-out spouse. (See SI 00501.152.)
An individual's home is property in which he or she has ownership interest and that serves as his or her principal place of residence. (See SI 01130.100.)
8. Sole Benefit
A transfer is considered to be for the sole benefit of a person if the transfer is arranged so that no other person or entity can benefit from the transferred resources at the time of the transfer or for the remainder of that person's life. This rule applies to transfers made to:
C. Policy—sole benefit of another individual
A transfer is considered “for the sole benefit” of another individual only if established using a written agreement that legally binds the parties and clearly expresses that the transfer is for the sole benefit of that individual. Without such a document, a transfer cannot be determined to be for the sole benefit of the individual. Without the document, there is no way to establish that only the specified individual will benefit from the transfer.
Examples of legally binding written agreements are a trust, a deed that establishes that the person getting the resource is the sole owner, or a legally enforceable contract that shows that the transfer is for the sole benefit of the individual. The sole benefit requirement is applicable to certain of the exceptions in SI 01150.121 and SI 01150.123.
D. Procedure—determining whether an exception applies
Use the following procedure when the individual has transferred a resource for less than fair market value on or after 12/14/99:
Discuss the exceptions with the individual to find out if an exception applies. Use the interviewer's guide in SI 01150.127 as a tool to identify exceptions.
If one of the exceptions in SI 01150.121-SI 01150.125 does apply, process the case normally (i.e., the period of ineligibility does not apply.
If no exception applies, follow the instructions in SI 01150.111 for computing the period of ineligibility and the instructions in SI 01150.126 for determining whether the individual qualifies for benefits under the undue hardship exception.
Notify the State Medicaid agency about the transferred resource unless the SSI claim is denied (SI 01150.012).
Home as principal residence, SI 01130.100
Notifying State Medicaid agency, SI 01150.012
Computing period of ineligibility, SI 01150.111
Interviewer's guide to exceptions, SI 01150.127