TN 22 (12-02)

SI 02302.015 Section 1619 Related Policies

A. Introduction

This section discusses the relationship of the Section 1619 provisions with other SSI policies and work incentives.

B. Policy - work incentive issues

1. Impairment Related Work Expenses (IRWE)

IRWE's are excluded from the countable income of disabled individuals when performing payment and eligibility determinations under 1619(a) and eligibility determinations under 1619(b). IRWE's may also be excluded when performing an individualized threshold calculation under 1619(b). See SI 00820.540 and DI 10520.001 for more information on IRWE.

2. Blind Work Expenses (BWE)

Work expenses of recipients who are blind are excluded when determining eligibility, payment, and individualized threshold calculations. See SI 00820.535 for more information about BWE.

NOTE: See SI 01210.100 for information on the October 1972 State plan blind income disregards that may apply to the income of certain converted blind recipients.

3. Plans for Achieving Self-Support (PASS)

Income and/or resources set aside under an approved PASS are excluded when performing payment and eligibility determinations under 1619(a), and eligibility determinations under 1619(b). The PASS income exclusion is also applied when performing an individualized threshold calculation under 1619(b). See SI 00870.001 and SI 01320.140 for more information about PASS.

NOTE: The PASS provision does not apply to recipients over age 65 unless the recipient was eligible based on disability or blindness prior to turning 65.

C. Policy type of claim issues

1. Multi-category Eligibility

An individual may qualify for SSI benefits based on eligibility under more than one category, i.e., aged, blind, or disabled. Benefits under section 1619(a) will only be paid for months when eligibility is based on disability. Eligibility under 1619(b) is available to the individual only in those months when eligibility is based on disability or blindness. Use the category that is most advantageous to the individual, given his/her overall circumstances. See SI 00501.300 for more information on multi-category eligibility. SM 01005.010 shows how to properly code the type of claim.

2. Aged Case

The Supplemental Security Record (SSR) determines eligibility under section 1619(a) and 1619(b) based on the type of claim, i.e., DI or BI, not on the multi-category code. An aged individual must also be blind or disabled. The type of claim must be coded as DI or BI and the multi-category field coded as aged. See SI 02302.030C.5. to transmit the correct type code when establishing 1619(b) eligibility for an aged individual.

3. Couples Case

Eligibility for 1619(b) is normally determined on an individual basis. The SSR determines eligibility using the individuals own earned income. If one member of a couple is working, only that member is eligible for 1619(b). However, when both members of a couple work, the SSR will combine their earned income and apply the 1619(b) provision to both members. See SI 02302.030 for the 1619 process.

D. Policy - other related issues

1. Retrospective Monthly Accounting (RMA)

There are no special section 1619 rules regarding RMA. Section 1619(a) eligibility determinationsare based on earnings received in the computation month; 1619(a) payment computations are based on earnings received in the budget month. RMA is not a factor in section 1619(b) threshold computations since these involve annual amounts.

2. Goldberg/Kelly

If an individual in 1619(b) status is suspended because he/she does not meet the Medicaid Use Test or insufficiency of earnings test, that individual is entitled to continued 1619(b) coverage if he/she appeals the determination.


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