Effective Dates: 12/10/2024 - Present Previous | Next

TN 78 (12-24)

SI 02301.230 Voluntary Termination (N19)

A. Process

FOs input N19 in the PS field on the SSR to terminate benefits at the request of a recipient, their legal guardian or representative payee. See SM 01305.001 and SM 01301.450 for coding the PS field in non-MSSICS cases and MS 08125.008 for coding the Payment Status page for MSSICS cases.

NOTE: N19 is an exception to systems GK processing. This means that FOs can input N19 through the day of the monthly recurring payment tape cutoff to stop the following month's benefit and have the system automatically issue the notice. See SI 02301.301 about systems processing based on certain monthly cutoff dates.

B. When to use N19

Use N19 to effectuate a voluntary termination:

  • •

    the first month after a dated written request that the system can actually stop benefits based on the monthly recurring payment tape cutoff, or

  • •

    the month that the individual requests only when they pay back or assure that they will pay back all payments made for months after SSI eligibility ends.

SYSTEMS LIMITATION: The system cannot accept an N19 input to terminate SSI for a member of an eligible couple. The FO must T30 the couple's record, establish a SD record for an eligible individual with an ineligible spouse and issue manual notices. See E.4, below for notice instructions.

CAUTION: Do not use N19 when a recipient wishes to voluntarily withdraw from the SSI program and pay back all payments received since entitlement began. Instructions on voluntary withdrawal (N12) are in SM 01305.001O.11. and SI 00601.050.

C. List of reasons for N19

These are some of the reasons why recipients may choose to terminate SSI eligibility:

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    SSI eligibility prevents them from receiving more money (or benefits) from other programs such as Aid to Families with Dependent Children (AFDC) and private pensions

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    They have political or religious objections to receiving public assistance funds

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    They no longer wish to comply with requests for information and pursue continuing SSI eligibility for a small SSI payment or for personal reasons

D. Procedure explaining effects of termination

When a recipient or their legal guardian or payee no longer wishes to pursue SSI eligibility and/or requests termination, ask the reason and explain fully the effects of termination as it applies to the recipient.

1. Loss of benefits contingent on SSI

Explain that the recipient may lose benefits contingent on SSI eligibility such as State supplementation, State buy-in of Supplementary Medical Insurance Benefits (SMIB), Medicaid, food stamps, public housing and services available under the Ticket to Work Program.

2. Other considerations

Explain the following as applicable:

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    A converted recipient from the State welfare rolls permanently loses additional benefits such as minimum income level protection (SI 01410.001) and an essential person increment (SI 00501.100 through SI 00501.110 and SI 02001.015).

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    Members of eligible couples should consider carefully the most advantageous termination date when revising the eligibility status to an eligible individual with an ineligible spouse.

    IMPORTANT: Apply the rules of administrative finality in SI 04070.001 when revising eligibility status for the individual who remains eligible.

  • •

    SSA will not terminate SSI for any month for which payment has been or will be made unless the recipient pays back or assures that they will pay back or return the payment.

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    Without SSI and associated benefits, the recipient sometimes may not be able to meet living expenses and obtain necessary medical care.

E. Procedure recipient, parent, or legal guardian requests termination

Follow the instructions below to effectuate a termination request from a capable recipient, a legal guardian, or a payee who is the parent with custody of a minor recipient.

NOTE: If a payee who is not the legal guardian or parent with custody requests termination, follow instructions in F., below.

1. Obtain a written request

Before terminating SSI, obtain a signed and dated request on a Statement of Claimant or Other Person (form SSA-795) or the Person Statement that:

  • •

    states the reason for the request,

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    states the effective date,

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    describes the possible effects of termination and states that they understand them (including the intent to pay back/return payments when applicable),

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    explains that if they file an appeal or new application in the 60-day appeal period, it will cancel the termination request, and

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    explains that if they file a new application to reestablish eligibility after the 60-day appeal period expires, benefits would begin with the new application and no earlier.

2. Request repayment

Before terminating SSI, request a full refund of any payments received for months after the effective date or, if applicable, request a returned check. If the recipient is unable to refund the amount, discuss the possibility of recovery from title II benefits when appropriate. See instructions on cross-program adjustment in SI 02220.020.

IMPORTANT: The waiver provisions in GN 02250.001 and GN 02250.002 do not apply to overpayments resulting from voluntary termination.

3. Terminate SSI

Input to terminate SSI effective:

  • •

    the first month that the system can actually stop benefits based on the monthly recurring payment tape cutoff , or

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    the month that the recipient selects only if the recipient has paid back payments when applicable or states that they intend to on the written request.

4. Manual notice instructions

a. Eligible couples cases

Issue manual notices to both members of an eligible couple to terminate SSI for one and establish the other as an eligible individual with an ineligible spouse. For systems instructions, see SM 01801.001. Follow these manual notice instructions:

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    Issue an SSA-L8155-U2 to the terminating member. Select appropriate voluntary termination paragraphs from NL 00804.215 for the caption “Why Your Payments Changed.”

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    Issue an SSA-L8151-U2 for an increase in payment to the eligible individual on the new record. Select appropriate paragraphs from NL 00803.025. Also tailor language (under “Why Your Payments Changed”) that explains the change in payment is due to the spouse's request to terminate their own SSI.

b. No assurance of repayment

Issue an SSA-L8155-U2 to a recipient who requests a termination month for which payment has been made or will be made and does not pay back payment or state that they intend to on the written request. Tailor language (under “Why Your Payments Changed”) that explains SSI will be terminated for a different month than requested because the recipient did not agree to pay back/return payments.

F. Procedure payee requests termination

Follow these steps when a payee requests termination on behalf of the recipient and the payee is not the legal guardian or the parent with custody of a minor recipient:

STEP ACTION
1 Would termination clearly advantage the recipient?
​ IF YES, follow instructions in E., above to terminate SSI. Obtain the written request from the payee, not the recipient. STOP.
​ IF NO, go to Step 2.
2 Does the payee actually want to discontinue serving as payee rather than terminate SSI?
​ IF YES, do not terminate SSI. Develop for a new payee (see GN 00502.001). STOP.
​ NOTE: A payee may be having difficulty obtaining information or evidence to establish the recipient's continuing eligibility and payment amount. Offer to help obtain the needed information. If the payee still wishes to stop serving, develop for a new payee.
​ IF NO, go to Step 3.
3 Does the payee have personal reasons for the request such as political or religious objections to the SSI program?
​ IF YES, do not terminate SSI. Consider the need for a new payee. STOP.
​ IF NO, go to Step 4.
4 Would termination clearly disadvantage the recipient? Determine this by contacting the recipient (only if a legally competent adult) and any individuals who may have responsibility for the recipient's care and/or act for the recipient such as a legal guardian or relative.
​ IF YES, do not terminate SSI. Consider the need for a new payee. STOP.
​ IF NO, go to Step 5.
5 Does the legally competent adult recipient want SSI or are they unsure?
​ IF YES, consider the need for a new payee. STOP.
​ IF NO, follow instructions in E., above to terminate SSI. Obtain the written request from the payee and a legally competent adult recipient. STOP.

NOTE: When determining the need for a new payee, reevaluate the recipient's capability if there is an allegation or indication that the recipient may be capable (GN 00502.020A.4.).

G. Procedure - reestablishing eligibility

Reinstate benefits effective the month of termination (or a later month) when the recipient meets all eligibility requirements and:

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    the recipient cancels the termination request by filing a timely appeal, or

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    SSA reopens or revises the determination under the rules of administrative finality in SI 04070.001. Otherwise, the individual must file a new application to reestablish eligibility.

Follow reinstatement instructions in SI 02301.210.

H. References

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    Suspension and Reestablishing Eligibility, SI 02301.205

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    Systems Input Instructions, SM 01305.001O.14.

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    Systems Input Instructions, SM 01305.001O.13.

To Link to this section - Use this URL:
http://policy.ssa.gov/poms.nsf/lnx/0502301230
SI 02301.230 - Voluntary Termination (N19) - 12/10/2024
Batch run: 12/10/2024
Rev:12/10/2024