TN 10 (04-99)
SI 01320.450 Deeming - Change of Status - Couples
Act, Sec. 1614(f), as amended.
Regulations 20 CFR 416.1163
There are several events which can change deeming status. All such changes affect deeming the month after the month the change occurs, except as described below. The rules that apply when there is a change of status follow.
NOTE: The changes of status described in the policy principles below are listed in the Regulations. There are other status changes in addition to the five described in B. These other status changes are effective, for deeming purposes, the month after the month the change occurs. For example, if an ineligible child moves out of the household in May, no allocation is given for that child beginning with June (for purposes of determining eligibility).
B. Policy Principles
1. Ineligible Spouse Becomes Eligible
If an ineligible spouse becomes eligible, the individual and spouse are treated as an eligible couple effective with the month after the spouse’s E02 month. Both eligibility and payment amount are based on the couple's income for that month. In the second month, the payment amount is also based on the couple's income in the first month of eligibility (the month the spouse becomes eligible).
2. Spouses Separate or Divorce
If an ineligible spouse and eligible spouse separate, or their marriage ends in divorce, the ineligible spouse's income is no longer deemed to determine eligibility effective with the month after the month of separation or divorce. Deemed income in the budget month continues to affect payment if deeming applied in the budget month.
NOTE: If an application is filed in the month of separation or divorce, deeming applies that month even if the application is filed on or after the date of separation or divorce.
3. Eligible Individual Begins Living With an Ineligible Spouse
If an eligible individual begins living with an ineligible spouse, deeming of the ineligible spouse's income begins effective with the month after the month they begin living together. If eligibility continues, payment amount is determined according to regular RMA rules, using income from the budget month.
4. Ineligible Spouse Dies
If an ineligible spouse dies, deeming stops for purposes of determining eligibility effective with the month following the month of death. The payment amount beginning with the month following the month of death is determined using only the eligible individual's own income from the budget month. Any income deemed from the ineligible spouse that month is excluded.
5. Eligible Individual Becomes Subject to $30 Payment Limit
If an eligible individual moves into a medical care facility and the $30 payment limit applies (SI 00520.001), deeming stops for purposes of determining eligibility effective with the first month for which the $30 payment limit applies. The payment amount beginning with the first month for which the $30 payment limit applies is determined using only the eligible individual's own income from the budget month. Any income deemed from the ineligible spouse that month is excluded.
1. Ineligible Spouse Becomes Eligible
In May 1988, Mrs. Martha Lawton, a disabled individual, lives with her ineligible spouse. Mrs. Lawton has no income and Mr. Lawton receives a monthly Social Security retirement benefit of $310. Mrs. Lawton is eligible for an SSI payment in May, and the amount of her payment is determined using deemed income from Mr. Lawton in the budget month (March 1988). On June 1, 1988, Mr. Lawton becomes age 65 and files for SSI. Effective with June, the deeming rules no longer apply. The Lawtons are an eligible couple. Both eligibility and payment are determined using their combined income in June. (See SI 02005.005 for examples of computations in these cases.)
2. Ineligible Spouse and Eligible Individual Separate
On September 15, 1988, Mrs. Ellen Bowers, a disabled individual, and her ineligible spouse separate. Mrs. Bowers' only income is a title II benefit of $150 per month. Mr. Bowers works and is paid a salary of $850 per month. To determine Mrs. Bowers' eligibility for September, the couple's unearned income is reduced by the general exclusion ($150 - $20 = $130). The couple's earned income is reduced by the earned income exclusion ($850 - $65 = $785 - 1/2 remainder = $392.50). The couple's total countable income ($130 unearned + $392.50 earned = $522.50) is compared to the FBR for an eligible couple ($532.00 in September 1988). Mrs. Bowers is eligible in September. Her SSI payment amount is determined based on the couple's income in the budget month (July). Effective with October, the deeming rules no longer apply when determining her eligibility. However, her payment for October is determined using countable income in August, including any deemed income from Mr. Bowers. In November, Mrs. Bowers' payment amount is determined using countable income in September, including any deemed income from Mr. Bowers. Since the couple's countable income in September is $522.50, Mrs. Bowers' November payment is $9.50 ($532.00 FBR - $522.50). In December, Mrs. Bowers' payment amount is determined using only her own income received in October ($354.00 FBR - $130.00 countable income = $224.00 SSI benefit).
3. Eligible Individual Begins Living With Ineligible Spouse
On August 2, 1988, Mrs. Barbara Rogers, an ineligible spouse, returns to live with her husband. She is working and earns $700 per month. In August, Mr. Rogers is eligible for SSI based on his own unearned income of $68, and his payment is determined using his countable income in June. Effective September, the deeming rules are applied to determine eligibility. Mr. Rogers' $68 unearned income is reduced by the $20 general income exclusion, leaving $48. Mrs. Rogers' earned income is reduced by the earned income exclusion ($65 plus one-half the remainder), leaving $317.50. The total countable income ($365.50) is less than the FBR for a couple in September ($532), so Mr. Rogers is eligible. His payment amount for September is determined based on his own countable income received in July. If he is eligible in October, his payment amount is determined using his countable income in August. If he is eligible in November, his payment amount is determined using countable income (including deemed income from Mrs. Rogers) in September.
4. Ineligible Spouse Dies; Policy Effective December 1985
Mrs. Pauline Pinot is a disabled recipient who receives $150 a month in worker's compensation. She lived with her ineligible husband until he died on June 15, 1988. He had been working part-time and received gross wages of $400 in May and $200 in June. The DO determines that deeming no longer applies beginning with July and redetermines Mrs. Pinot's eligibility and payment amount. Effective July 1988, Mrs. Pinot is eligible as an individual without a spouse and the FBR for an individual ($354 in July) applies. In determining her July payment amount, the DO uses only Mrs. Pinot's own countable income of $130 ($150 worker's compensation minus the $20 general income exclusion). The deemed income from Mr. Pinot in the budget month (May) is not used in determining the payment amount for July. The payment amount for August is also determined using only Mrs. Pinot's own countable income in the budget month (June). Mrs. Pinot's SSI payment for July and August is $224.
5. $25 ($30) Payment Limit Applies
Mr. Malaga was admitted to a nursing home on January 5, 1988, and Medicaid pays the cost of his care. His ineligible spouse is working and receives gross wages of $900 a month. The DO determines that the $25 payment limitation applies to Mr. Malaga beginning with February 1988 and that January is the last month for which deeming applied. Since deemed income in a prior budget month is not used to determine payment amount once the $25 rate becomes effective for the computation month, and since Mr. Malaga has no income of his own for the budget months of December and continuing, his SSI payment is $25 beginning with February. (If Mr. Malaga remains eligible, his SSI payment increases to $30 effective July 1, 1988, because of an increase in the payment limit.)