TN 1 (11-96)
SI 01220.100 Criteria for Application of State Resource Limitations and Exclusions
(See SI 01210.000 for Special Blind Income Provision and SI 01330.400 for Deeming of Resources of an Essential Person.)
The special resource limitation was applied during conversion of State public assistance rolls to the SSI program. All recipients who were eligible under the State plan for December 1973 were automatically deemed to meet the SSI resource limitation provided the State had not increased its resource limitation since October 1972. Where there had been such an increase, it was necessary to determine whether the individual could have met the October 1972 limits, and, if so, it is the October 1972 limits which set the upper bounds on resources (provided they exceed the SSI limits).
The special resource limits and exclusions do not apply to individuals who initially apply for SSI payments in January 1974 or later.
In some instances, while the State plan resource limits may be higher than the SSI limits, the State plan includes items as resources that are excluded from resources under the SSI program. Conversely, some State plans have lower resource limits but exclude items that are countable resources under the SSI program.
1. Eligibility for State Plan
Certain individuals may be entitled to either the resource limits and exclusions under the State plan or the resource limits and exclusions under the SSI program (but not a combination of the two), whichever is more advantageous. In order to be eligible for the use of State plan resource limits and exclusions, a recipient must have:
been eligible for and received assistance for the month of December 1973 under a State plan (approved under titles I, X, XIV, or XVI of the SSACT) in effect in October 1972; and
transferred to the SSI rolls and been eligible to receive a payment for January 1974; and
continued to reside in that same State (see item 2. below) since December 31, 1973; and
had continuous eligibility (except for periods not in excess of 6 consecutive months) for an SSI benefit. (See SI 01220.100B.3.)
NOTE: E01 status is not considered eligibility for a Federal SSI benefit.
If any one of the requirements is not met, the resource exclusions (SI 01110.210) and limitations (SI 01110.003) under the SSI program must be used.
2. State Residency
For purposes of item 1.c. above, a recipient has continued to be a resident of the same State since December 1973 unless he/she left the State at any time with the intention of abandoning his home there. There is a regulatory presumption that, absent evidence to the contrary:
A recipient who leaves the State for 90 days or less is temporarily absent and continues to reside in the State; and
A recipient who leaves the State for more than 90 days is no longer a resident there.
3. SSI Benefit Defined
For purposes of item 1.d. above, an “SSI benefit” is defined, effective September 1, 1987, as a Federal benefit only; it does not include any State supplement. Previously, the regulation did not define “SSI benefit” and could be interpreted to include a federally administered State supplement only.
For cases which involve only State supplementary payments, begin counting consecutive months of ineligibility for an SSI benefit with the first such month occurring September, 1987, or later. However, the individual will lose eligibility for use of the State plan rules due to the revised interpretation no earlier than the month following the month of the first redetermination which occurs on or after September 1, 1987,
EXCEPTION: “PROTECTED” CASES—Converted recipients who were considered entitled to use of the State resources rules despite being in federally administered State-supplement only status for more than 6 consecutive months prior to September 1987 are “protected.” They continue to be eligible for use of the State resources rules as long as they remain eligible for either Federal or federally administered State supplementary benefits and continue to reside in that same State.
Where both members of a couple were converted from the State rolls and the special resource limitation applies to both, the State plan resource limit and exclusions for a couple (or two people) are used.
When an individual/couple eligible to use the State plan limits acquires resources which result in the SSI and State limits being exceeded, he need only dispose of resources sufficient to meet the State resources limits. (See SI 01150.200 for conditional payments in this situation.)
1. Identify Protected Cases
When redetermining converted recipients, determine whether the case is protected.
2. State Disregards “Protection”
In a redetermination involving a converted individual or couple, when eligibility for State plan resource limits and exclusions is material, request a complete payment history (see SM 01601.175) to ascertain whether the individual or couple was, prior to September, 1987, in federally administered State-supplement-only status for a period of more than 6 consecutive months without loss of grandfathered rights (and so is protected as described in SI 01220.100B.3.). In some cases, it will be necessary to obtain offline queries (see SM 01601.310).
If, after reviewing both the payment history and the offline query, you are unable to establish whether protected status applies, assume that the individual or couple had a period of federally administered State supplementary payments only for more than 6 consecutive months prior to September, 1987, and is therefore “protected.”
When it is determined that an individual/couple should be given “protected” status, input RE82 to the CG field (see SM 01301.785) to identify that fact. If grandfathered rules are being applied to real property in the form of land input RE80 to the CG field. When applying grandfathered rules to real property other than land use CG code RE81 to document the determination.
3. No State Disregards “Protection”
When an individual/couple does not have protected status, input RE 83 to the CG field (SM 01301.785) to identify that fact.
For converted individuals or couples who enter State-supplement-only status and are not “protected,” diary for the anticipated fourth consecutive month of State-supplement-only payments.
If State disregards are being used in the resources computation, send a manually prepared notice of planned action (see SI 01220.100C.4.) and take appropriate steps to adjust payments beginning with the seventh consecutive month of non-eligibility for Federal SSI benefits. In cases where overpayments result from this change, see SI 02220.001 for instructions.
4. Notice Procedure
If the nonprotected individual's resources exceed the Federal limit and State disregards can no longer be applied:
Suppress the automated notice (SM 01301.675).
Prepare a manual SSA-L8155 and include manual paragraph RESM08 per NL 00804.180.