TN 31 (02-07)

SI 02301.215 Summary of Posteligibility (PE) Suspension, Stop Payment and Termination Events by Payment Status Code (PSC)

A. Introduction

The chart describes each payment status code (PSC) by effective date of event/effective reinstatement date with relevant references and manual notice requirements. The explanation of suspension, stop payment and termination events is in SI 02301.201. Recipients generally have 12 consecutive months of suspension to regain eligibility and have benefits reinstated. Instructions on when a new application is required to reestablish eligibility are in SI 02301.205.

NOTE: With one exception, recipients cannot get State benefits based on SSI including Medicaid when their record is in a suspension, stop payment or termination status code. The exception is PSC N01 for Section 1619(b) eligibles. Medicaid based on SSI usually continues for 1619(b) eligibles.

B. Chart

PSC

Type of Event

Effective Date

Reinstatement Date

References

E01

Eligible- No Payment Due

PSC is System Generated

Stop Payment

The month the recipient is eligible based on the eligibility determination, but no payment is due based on the payment computation.

Any month countable income is less than the FBR or the combined Federal/State payment level.

Computations-

SI 02005.001E.3.

Systems-

SM 01305.001N.1.

MSOM ICFT16 001.002

N01

Excess Income

PSC is System generated

-OR-

Suspension

The month countable income is greater than the FBR or is equal to or exceeds the combined Federal/State payment level.

The month countable income is less than or equal to the FBR or less than the combined Federal/State payment level.

Computations-

SI 02005.001,

General rules-

SI 00810.001

Earned exclusions-

SI 00820.500

Systems-

SM 01305.001N.12.

N01

Section 1619(b) Eligible, No Payment Due

PSC is System Generated

Stop Payment

The month countable earned income exceeds the FBR and is equal to or exceeds the combined Federal/State payment level.

NOTE: Medicaid based on SSI usually continues.

The month countable income is less than the FBR or combined Federal/State payment level.

1619 Policy Work Incentives-

SI 02302.010

Systems-

SM 01305.001N.12.

MSOM MSSICS 014.001

MSOM MSSICS 015.001

MSOM MSSICS 016.001

N02

Resident of a Public Institution

PSC is FO Input

Suspension

The first full month a recipient is a resident.

Exceptions: Temporary Institutionalization (TI). Continued payments are possible up to 3 months for temporary stays and up to 2 months for 1619(b) eligibles.

Manual Notice Required in TI cases- SI 00520.141.

Exceptions to manual notice requirement in TI cases- SI 00520.140D.2.

The day the recipient is no longer a resident of a public institution.

Proration applies.

Institutionalization-SI 00520.001

SI 00520.140- TI

Proration-

SI 02005.008

SM 01305.001O.1.

SM 01305.760-

(TI field)

MSOM MSSICS 010.001

N03

Absence from the U.S.

PSC is FO Input

Suspension

The first full month the recipient is (or expects to be) outside the U.S.

NOTE: Absence begins the day after departure and ends the day before return.

The 31st consecutive day back in the U.S.

-OR-

The first day back in the U.S. if absent the full month of February and absent less than 30 days from the U.S.

Proration applies.

Residence and Citizenship Requirement-

SI 00501.410

Absence from the U.S.-

SI 02301.225

Proration-

SI 02005.008

Systems-

SM 01305.001O.2.

MSOM MSSICS 010.001

N04

Excess Resources

PSC is FO Input

Suspension

The month countable resources exceed the limit.

CAUTION: Consider conditional payments for a limited resource disposal period- SI 01150.200 - SI 01150.210.

The first day of a month countable resources are within the limit.

Resources-

SI 01110.001

First of the Month Rule/Counting Resources-

SI 01110.600

SM 01305.001O.3.

MSOM MSSICS 012.001

N05

Ineligible for a Past Nonpay Period

PSC is FO Input

-OR-

Suspension

Only for a past nonpay month (a closed period).

Manual Notice Required-

SI 02301.220C.

Manual Notice Required-

SI 02301.220C.

The first N05 month that evidence establishes eligibility/payment amount.

Ineligible for a Past Nonpay Period-

SI 02301.220

Systems-

SM 01305.001O.4.

MSOM MSSICS 025.001

N05

Failure to Provide Information for Children Overseas

PSC is FO Input

-OR-

Suspension

The first month that the system can stop benefits under G/K processing.

Manual Notice Required- SI 00501.417.

The first N05 month that evidence establishes eligibility/payment amount.

Manual Notice Required-

SI 00501.417

NOTE: Effective 1/06/06, children overseas have 24 months (not 12 months) to have payments reinstated.

Blind/Disabled Children of Military Personnel Overseas-

SI 00501.415
Systems-

SM 01305.001O.4.
SZ field-

SM 01301.450

MSOM MSSICSCOMPS 001.001

N05

Failure to Give Permission to Contact Financial Institutions

PSC is FO Input

Suspension

The first month that the system can stop benefits under GK procedures.

Manual Notice Required-

SI 00515.001D.1

The month after the month permission is given.

Requirement to Give Permission to Contact Financial Institution-

SI 00515.001

Systems -

MSOM MSSICS 008.025

N06

N06 Failure to File for Title II Benefits or Other Benefits

PSC is FO Input

Suspension

The month the recipient received the written notice (SSA-L8050–U3 or SSA-L8051–U3) to file for/pursue title II or other benefits.

NOTE: The recipient has 30 days from receiving the notice to file for the other benefits in the notice.

The earliest day in a month that the recipient takes appropriate steps to obtain other benefits. Proration applies.

-OR-

the month after the month the other benefit is no longer available.

Filing for Other Program Benefits-

SI 00510.001

Proration-

SI 02005.008

Systems-

SM 01305.001O.5.

MSOM MSSICS 019.001

MSOM MSSICS 025.001

N07/

N08

Cessation of Disability N07/Blindness N08

PSCs are FO Input

Termination

The third month after the month of cessation.

The month of termination

-OR-

a later month or day in a month when the cessation is reversed or reopened.

Proration applies.

Continuing Disability-

DI 13001.000

Proration-

SI 02005.008

Systems-

SM 01305.000O.6.

SM 01305.000O.7.

MSOM MSSICS 025.001

N09

Refusal to Accept Vocational Rehabilitation

Suspension

Obsolete – Before repeal on 1/1/01, benefits were suspended for failure to accept or cooperate with vocational rehabilitation (VR) services.

 

VR Services-

DI 13501.000

N10/

N11

Failure to Comply with Treatment for Drug Addiction or Alcoholism

Suspension

Obsolete – Before repeal on 1/1/97, drug addicts and alcoholics were required to comply with treatment requirements and failure resulted in suspension, N10. If they agreed to comply again, they had to comply for certain sanction periods, N11, before benefits could resume.

 

DAA Provisions-

DI 90070.000

N13

Loss of U.S. Citizenship, Eligible Alien Status or Residency

PSC is FO Input

Suspension

The first full month the recipient loss eligible status.

The day the recipient meets eligible status again (and no earlier than the 31st day back in the U.S. if outside for a full month or 30 consecutive days).

Proration applies.

SSI Alien Eligibility-

SI 00502.000

Residence and Citizenship Requirement-

SI 00501.400

Proration-

SI 02005.008

Systems-

SM 01305.001P.11.

MSOM MSSICS 008.001

N19

Voluntary Termination

PSC is FO Input

Termination

The first month the system can stop benefits based on the recurring tape cutoff (event is not subject to GK procedures)

-OR-

The month the recipient selects if he/she pays back or assures to pay back all payments received.

Manual Notice Required in Couples Cases, SI 02301.230E.4.

The month of termination

-OR-

a later month the termination request is cancelled by an appeal or reopening.

Voluntary Termination-

SI 02301.230

Systems-

SM 01305.001O.13.

MSOM MSSICS 025.001

N20

Failure to Provide Information

PSC is FO Input

Suspension

The first month the system can stop benefits under GK procedures.

The first month of suspension or a later month that evidence establishes eligibility/payment amount.

Failure to Provide Information-

SI 02301.235

Systems-

SM 01305.001O.14.

MSOM MSSICS 025.001

N22

Inmate of a Penal Institution

PSC is FO Input

Suspension

The first full month that the recipient is a resident of a penal (public) institution.

NOTE: Before 11/97, N02 was the PSC for this event.

The first day that a recipient is no longer a resident of a penal (public) institution.

Proration applies.

Title XVI Prisoner/ Inmate Suspensions-

GN 02607.050

PUPS Processing and Related Issues-

GN 02607.705

Proration-

SI 02005.008

Systems-

SM 01305.001O.15.

MSOM MSSICS 008.021

N23

Not a U.S. Resident

PSC is FO Input

Suspension

The first full month in which a recipient is no longer a resident.

The first day in a month that the recipient meets both the U.S. residency requirement and 30-day presence requirement (no earlier than the 31st day back in the U.S. if outside the U.S. for a full month or 30 consecutive days or longer).

Proration applies.

Not a U.S. Resident-

SI 02301.225

Proration-

SI 02005.008

Systems-

SM 01305.001O.16.

MSOM MSSICS 008.001

N24

Administrative Sanction

PSC is FO Input

Suspension

The second month after the month the reconsideration period ends when a recipient makes a false or misleading statement.

the month after:

6 months for the first occurrence,

12 months for the second occurrence, or

24 months for each subsequent occurrence.

Systems-

SM 01305.001O.17.

N25

Effective 8/1/96-

Fugitive Felon or Parole/ Probation Violator

PSC is FO Input or System Generated (PUPS)

Suspension

The first day of a month of whichever is earlier:

The month in which an unsatisfied arrest warrant or similar order was issued for a felony crime or parole/probation violation

-OR-

The first month, if indicated in an arrest warrant or similar order, that the recipient fled to avoid prosecution, custody or conviction, or violated a condition of parole/probation.

The month following The month the appropriate agency indicates in writing that the recipient does not have an active warrant for a felony crime or a violation of a condition of parole.

NOTE: See SI 00530.800 for residents of Connecticut, New York, and Vermont under the Fowlkes Court Case. N25 can be input through the FFAP process.

Exchange of Information with Law Enforcement Officials-

SI 00501.055

PUPS Processing-

GN 02607.705

Systems-

SM 01305.001O.18.

S06

Whereabouts Unknown

PSC is FO Input or System Generated Due to a Check Returned for Address Reasons

Suspension

The first month the system can stop benefits based on the recurring tape cutoff (event is not subject to GK procedures).

The effective month of suspension or a later month that there is a correct address and/or living arrangement information.

Whereabouts Unknown-

SI 02301.240

Systems-

SM 01305.001O.23.

S07

Check Returned for a Miscellaneous Reason Other Than Address

PSC is System Generated

Suspension

The first month the system can stop benefits based on the recurring tape cutoff (event is not subject to GK procedures).

The effective month of suspension or a later month when the recipient is SSI eligible.

Check Returned for Miscellaneous Reasons-

SI 02301.245

Systems-

SM 01305.001N.16.

S08

Developing for Representative Payee

PSC is FO Input

Stop Payment

The first month the system can stop benefits based on the recurring tape cutoff (event is not subject to GK procedures).

IMPORTANT: Generally, do not stop payments for payee development. Unless direct payment is prohibited, pay benefits to the recipient while developing for a suitable payee, GN 00504.105 and GN 00504.110.

The first month benefits stopped.

Determining the Need for, Developing and Selecting a Representative Payee-

GN 00502.000

Systems-

SM 01305.001O.24.

S09

Temporary Institutionalization (TI)

PSC is System Generated

Stop Payment

The system automatically defaults to S09 when it does not receive data in the TI and/or RS field on whether the recipient remains or leaves the institution.

The effective month of suspension when the FO inputs the resolution (see SM 01305.760F.4.).

Residence in an Institution-

SI 00520.001

Section 9115 Continued Benefits Provision- TI-

SI 00520.140

SI 02301.201B.2.

Systems-

SM 01305.001N.17.

T01

Death of a Recipient

PSC is System Generated due to input in the DH field

Termination

The month after the month of death. Eligibility ends the month after death.

NOTE: For instructions when an individual deceased on SSA records is alive, see GN 02602.055.

Death of a Recipient-

<