States receive information about SSI recipients at least once a week via the State Data Exchange (SDX) created from the Social Security Record (SSR).

States use the SDX data primarily to help administer their Medicaid and State supplementation programs.

When comparing State data to the information on the SDX, States may uncover discrepancies that could affect State programs and/or the SSI program.

Although local procedures may be established for reporting these discrepancies to SSA, States may opt to use the National Correction Procedure.

On an individual case basis, States may report discrepancies in the following list of data items:

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  Individual recipient identification (ID code)

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  Individual's name

• •

  Sex code

• •

  Date of birth (month/year)

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  Date of death (month/year)

• •

  Marital status code

• •

  Payee name and/or mailing address (including ZIP)

• •

  Residence address (including ZIP)

• •

  Federal LA code

• •

  Optional State Supplement LA code

• •

  State and county code

• •

  Third party liability code and date

• •

  Resources

• •

  Unearned income type code

• •

  Unearned income start date

• •

  Unearned income stop date

• •

  Unearned income amount

• •

  Unearned income frequency

• •

  Unearned income claim/ID number

• •

  Earned income period

• •

  Earned income wage estimate

• •

  Net earnings from self-employment estimate

• •

  Medicaid eligibility code (i.e., for Medicaid qualifying trusts)

• •

  Transfer of assets start date

The State is responsible for:

1. a. 

   Completing Parts I and II of Form SSA-3911-U4, “Report of Change—SSI Data” (see SI 02306.703 for an exhibit);

2. b. 

   Mailing copies of form SSA-3911-U4;

   • •

     The original and one copy to the servicing FO, and

   • •

     One copy to the RO.

3. c. 

   If a recipient report is the source of the discrepancy:

   • •

     Submitting supporting documentation, if available, to SSA.

   • •

     Advising the recipient to report the change to SSA immediately. SSA will also request the recipient to submit supporting documentation, if necessary ; and

4. d. 

   Following up with the servicing FO in 60 days if it does not receive notification that the discrepancy was resolved.

The FO is responsible for:

1. a. 

   Resolving issue(s) reported by the State on the SSA-3911-U4. FO may contact the originating State component to resolve minor matters; e.g., need for additional information on the SSA-3911-U4.

2. b. 

   If the issue will not be resolved in 30 days, advising the RO of the reason for the delay and the estimated time needed to complete development.

3. c. 

   Notifying the State and RO of discrepancy resolution by annotating Part III of the SSA-3911-U4 and mailing:

   • •

     The original to the responsible State component; and

   • •

     One copy to the RO.

The RO is responsible for:

1. a. 

   Setting up a pending file upon receipt of the SSA-3911-U4 from the State.

2. b. 

   Following up with the FO if discrepancy has not been resolved in 30 days.

3. c. 

   Following up with the FO Management after an additional 15 days if the discrepancy has not been resolved.

4. d. 

   Closing pending file upon receipt of SSA-3911-U4 with Part III completed by the servicing FO.