TN 54 (11-06)
SI 02305.095 Developing Earned Income – RZs
This section provides procedures for developing recipient allegations about earned income during the RZ interview.
B. Description of RZs completed on MSSICS screens
Opening a “REDETERMINATION with or without RECAPs” event creates a MSSICS “path” that will guide the interviewer to the appropriate screens to document allegations and evidence relating to earned income.
C. Description of Form SSA–8202–BK – Question 5
Question 5 on the SSA–8202–BK is a two-part question:
Since the date above, have you, or your spouse living with you, earned money from working or do you expect to earn money from working in the next 14 months? (DO NOT COUNT earnings from self-employment.)
If you have earned money from working, please give the following information:
D. Description of Form SSA–8203–BK – Question 12
Question 12 on the SSA–8203–BK is a two-part question:
Since the date on page 1, have you (or your spouse living with you) worked or do you expect to work in the next 14 months? If “yes,” please give:
E. Kinds of earned income
Kinds of earned income to be developed are:
Wages, including the first 6 months of sick pay (SI 00820.100 and SI 00820.005, respectively);
I-kind remuneration (SI 00820.010);
Sheltered workshop payments (SI 00820.300);
Net earnings from self-employment (SI 02305.096); and
Royalties earned by an individual in connection with any publication of his/her work and any honoraria received for services rendered (SI 00820.450)
F. Procedure – work incentives
See SI 02302.006 for instructions on informing recipients about work incentives.
G. Procedure – developing/documenting allegations of earned income
Develop allegations about earned income as follows:
1. Recipients allege no earned income – other information
If recipients allege no earned income and other information in SSA records agrees, do not develop wages any further.
2. Recipients allege no earned income - wage information
If recipients allege no earned income and wage information is on the SSR:
Verify termination of wages (unless already verified).
Document and verify all previously unverified wages up through the date of termination.
If wages were not terminated, develop per instructions in SI 00820.130A.6.
3. Recipients allege earned income
If recipients allege earned income:
Document and verify, per SI 00820.125 – SI 00820.145, all unverified wages on the SSR, and alleged wages not on the SSR. If verified earnings do not agree with prior estimate, see SI 02305.094H.
Document estimates of future income for the current month and the next 14 months per SI 00820.150.
EXCEPTION: If one of the exceptions in SI 00810.600 applies, estimate to the next RZ or review of income. When periodic wage reporting is in place, the estimate can be based on the verified wage data on the SSR (SI 00820.150).
See SI 02305.094I. for instructions on determining the effective dates for estimates of income. See SI 00810.610 for instructions on how to estimate income.
Document and verify any alleged (i.e., previously unverified) termination of wages during the review period.
Input estimates of future income to the SSR as soon as possible after the RZ is initiated.
If the recipient's earnings will cause eligibility for section 1619(b), ask the Medicaid-use test questions (SI 02302.040) and develop the threshold test (SI 02302.045).
Input verified income.
4. Prior estimates and verified earnings do not agree
If prior estimates and verified earnings do not agree:
Reopen the prior determination within the rules of administrative finality (SI 04070.000).
Input the verified earnings for the prior period as change items; include effective dates and verification codes.
H. Procedure – automated netting
The system will, in most cases, automatically compute the net amount for all periods where there are excess payments and additional amounts due for the period(s) under review. If the net result is an overpayment, the system will create an overpayment sequence for the period under review. The system will, in most cases, notify the individual of the net result either by sending a post eligibility notice (and issuing an underpayment) or by sending an initial overpayment notice. If the system cannot perform automated netting and/or cannot send an automated notice, it will set a B3 diary.
If the system cannot perform automated netting and/or cannot send an automated notice, the (FO) is required to manually net the period under review and/or issue the appropriate initial overpayment notice or underpayment notice (and underpayment). See SI 02201.015 and SI 02220.015
For cases requiring manual netting:
I. Procedure – disabled or blind recipient
If the recipient is disabled and has earned income, develop IRWE per SI 02305.097. If the recipient is blind and has earned income, develop blind work expenses per SI 00820.535.
Discuss the possibility of establishing a Plan for Achieving Self Support per SI 00870.000. Information on the PASS can also be found on SSA's official Work Site at http://www.ssa.gov/work/ResourcesToolkit/pass.html
SI 00820.001 Earned Income