TN 13 (11-10)
The automated eIAR system cannot process IAR cases when the State and SSA both paid
a prorated benefit in the same month. The FO must process these cases manually using the instructions in this section
and in SI 02003.025 through SI 02003.050 to ensure that the State and the SSI recipient are paid correctly.
SSA no longer prorates SSI benefits for the first month of SSI eligibility on initial
claims. We do prorate SSI benefits following certain suspensions, which can occur
while an initial claim is pending or when we do a PE reinstatement following a period
of suspension. For a list of the suspensions that cause prorated SSI benefits, see
SI 02005.008, Proration after Period of Ineligibility.
Here is how to identify which cases need to be processed manually. If SSA:
prorates the SSI benefit and the State prorates the IA benefit for the same month, the eIAR system cannot compute the State reimbursement amount correctly for
that month. To avoid incorrect payments, you must process the case manually similar
to the processing required before implementation of eIAR;
prorates the SSI benefit for a month, but the State did not prorate the IA for that month or paid no IA for that month, eIAR can process the
claim to completion; and
does not prorate SSI for the month or does not pay SSI for the month, and the State prorates
the IA for that month, eIAR can process the claim to completion.
Example: The DDS approves Mr. Smith’s disability claim and the FO does a PERC to adjudicate
his claim in November 2010. During the PERC, the FO determines that Mr. Smith was
ineligible for SSI for May and June 2010 due to residence in public institution (N02).
The institution releases Mr. Smith on July 21, so he is eligible for prorated SSI
benefits for July 2010.
Analysis: If the State paid a prorated IA payment to Mr. Smith for July 2010, the eIAR system
cannot process the case because both SSA and the State would pay a prorated benefit
in July. If the State did not pay a prorated IA benefit in July, the eIAR system can
process the case to completion.
The FO adjudicates the SSI claim or PE reinstatement to establish a UPV: V on the
SSR. At this point, eIAR will transmit a message to notify the State to input IA payment
amounts for the months of the reimbursement period. For more information about UPV:
V, see SM 01311.660.
Upon receiving notification of the SSI allowance, the State IAR technician must review
the State’s IA payments made to the SSI claimant before inputting these payments on
the eIAR system. Prorated payments affect processing the case as follows:
If there are no prorated IA payments, the technician can proceed to input the IA payments in eIAR
system and eIAR will process the case to completion.
If the State made any prorated payments to the SSI claimant during the IAR reimbursement
period, the technician must call SSA’s IAR regional coordinator to notify SSA that
the State made a prorated payment.
SSA’s IAR regional coordinator will review the SSI claim to determine if SSA will
pay prorated SSI benefits for any month in the IAR reimbursement period.
If no prorated SSI payments will be paid, the claim can be processed to completion on eIAR
and the regional coordinator will advise the State technician to proceed with inputting
the IA payments on the eIAR system.
If any SSI payment will be prorated, but not in the same month that the State paid a prorated benefit, the claim can be processed
to completion on eIAR and the State technician can input the IA payments on the eIAR
If an SSI payment and a State IA payment will be prorated for the same month, the regional coordinator will notify the State technician that the case cannot
be processed on the eIAR system and that manual processing by SSA is required.
The IAR regional coordinator will notify the servicing FO by email or telephone that
the FO will need to process an IAR proration case manually.
After the regional coordinator notifies the FO of a proration case, process the IAR
reimbursement as follows:
The FO will immediately input a hold on the underpayment on the UOUP screen (select
Option 1, HOLD UNDERPAYMENT) to prevent eIAR from erroneously releasing SSI benefits
to the recipient due to the 25-day time limit established within the eIAR system.
This will build a UPV:U.
The FO will prepare an SSA-L8125-F6 (Notice of Interim Assistance Reimbursement) and
send it to the State IA agency.
The FO will tickle the case for 25 days from the date it sends the SSA-L8125-F6 to
the State. This starts the 25-day time limit for the State to request reimbursement.
The State IA agency will complete its portion of the SSA-L8125-F6 to provide information
about the IA payments made by the State. The State IA agency must return the SSA-L8125-F6
to the FO within 25 days of the date that SSA sent the form to the State. If the State
does not submit the completed SSA-L8125-F6 to SSA within 25 days, SSA is required
to pay the retroactive SSI benefits to the recipient using SSI payment rules.
After receiving the completed SSA-L8125-F6, the FO will review the form for completeness
and compute the reimbursement due.
The FO will delete the GR code from the SSR and issue the IAR reimbursement payment
to the State using option 6 = OTHER on the UPOT screen.
The FO will release the hold on the underpayment on the UOUP screen.
The FO completes the SSA-L8125-F6 with the following information. For more information
about completing this form, see SI 02003.040B.
On page 1 of the form, fill in the:
State IAR agency name and address; and
SSA FO address.
On page 3 of the form, fill in:
Whether the case is an initial claim or a posteligibility case;
Recipient’s name and SSN;
Representative payee’s name (if applicable);
Date of SSI eligibility or reinstatement;
Amount of SSI retroactive benefits due;
Amount and month of recurring SSI payment; and
The SSA FO’s mailing address.
On pages 4, 5, and 6 of the form, fill in:
Recipient’s name and SSN; and
List of SSI payments in the IAR period (including the From, Through, and Amount Each
The State will complete Page 3 of the SSA-L8125-F6 under the heading, “States Account
of Reimbursement Claimed” and sign the certification statement.
Because a proration case is processed manually, the State must determine the IAR period
and record on the form:
the amount of IA paid to the individual;
the amount of reimbursement claimed by the State; and
the first month for which the State paid IA due the interim IAR period.
After completing the form, the State will send it to the FO address shown on page
3 of the form.
Manual processing of proration cases requires the State to modify the notice it sends
to the recipient. The notice must include the information provided by the State’s
notices issued before the implementation of eIAR.
The State’s notice will explain the:
amount of IA paid to the individual and for which months;
amount the State claimed for reimbursement;
amount that SSA reimbursed the State for IA paid; and
individual’s right to a hearing before the State about any matter for which the individual
believes he or she has been aggrieved by an action taken by the State under section
1631(g) of the Social Security Act.
MSOM BUSSR 003.022, One Time Payment (UPOT)
MSOM BUSSR 004.018, Underpayment Processing (UOUP)
SM 01311.355, Withholding an Underpayment (U TAC)
SM 01311.360, Releasing a Manual Hold on an Underpayment
SM 01311.660, Processing an Underpayment