TN 3 (05-92)

NL 00803.092 Chart for Completing the SSA-L8166-U2 for Computer Matching

A. Procedure

If you must issue a manual SSA-L8166-U2 in a computer matching case, use the following chart to find the captions and paragraphs appropriate for the recipient's situation.

NOTE: We labeled the captions with capital letters in alphabetic order as a place-keeping device due to the length of the chart.

B. Why your record changed

(Use this caption if the individual is a 1619(b) participant.)

NL ReferenceParagraphUse
NL 00804.17512391619(b) participant has excess income other than earned income.

C. Information about medicaid

(Use this caption only when paragraph 2057 below applies.)

NL ReferenceParagraph 
NL 00804.25020571619(b) participant will retain 1619(b) status.

D. Information about your payments

(Mandatory caption when individual is not a 1619(b) participant.)

NL ReferenceParagraphUse
NL 00804.2402525Tells recipient that this action does not change the payment amount.

E. Your (payment/SSI) is based on these facts

(Mandatory caption - Replace “Payment” with “SSI” when individual is a 1619(b) participant.)

NL ReferenceParagraphUse
NL 00804.1751231Lead-in preceding list of monthly income in paragraph 1232 below.
1232Describes type, period and amount of countable income.
1253Recipient received one-time income payment other than SSI.
1248Describes type, period and amount of income deemed from spouse or parent(s).
1254Spouse or parent(s) has one-time income payment other than SSI.
1249Spouse or parent(s) receives public assistance - No deemed income.
1257Special income disregards apply.
1252Overpayment withheld from income other than SSI. (Do not use in the Ninth Circuit.)
NL 00804.2502058Tells recipient to check computer matching data within 30 days. (Mandatory paragraph for this caption.) Use paragraph 2056 (NL 00804.250) instead, when individual is a 1619(b) participant.

To Link to this section - Use this URL:
http://policy.ssa.gov/poms.nsf/lnx/0900803092