TN 30 (08-05)
NL 00804.270 Resource Worksheet for SSI Notices
Certain SSI notices dated July 25, 2005 and later, include resource computation worksheets. The worksheets will be attached to notices when a month or more of ineligibility due to excess resources (pay status of N04) occurs. They provide a detailed list showing what resources resulted in the determination of ineligibility.
This change was made in order to comply with the Ford et al. v. Apfel court case, which is a nationwide class action lawsuit.
B. List of Notices With Resource Worksheets
The affected notices are:
Notice of Award, SSA-L8025;
Notice of Disapproved Claim, SSA-L8030;
Notice of Change in Payment, SSA-L8151 and SSA-L8100;
Notice of Planned Action, SSA-L8155;
Important Information, SSA-L8165 and SSA-L8166.
Resource worksheets appear after the income computation worksheet in the notice.
C. Types of Resources That Can Appear On Resource Worksheets
1. Types of Resources
The following types of resources may appear separately or in combination on a worksheet:
b. Financial Accounts
promissory note or loan
written informal loan
oral informal loan
e. Real Estate
f. Burial Arrangements
life insurance policy
life insurance dividend accumulations
household goods and personal effects
contents of safe deposit box
2. Other Information on the Resource Worksheet
The worksheet also contains the following information:
who owns the resources
resources not counted by SSI
amount before and after dividing among eligible children
resources that we count
SSI resource limit for an individual or couple
amount over the resource limit
how we figured the beneficiary’s ineligibility
NL 00801.005, Systems Generated Notices
NL 00804.115, Titles, Lead-ins, and Payment Summary
SI 01110.000 ff., Resources, General
E. Example of Resource Worksheet
111-22-3333 Page 8 of 11
1. How We Figured Gary Kirk’s Ineligibility for October 2004
Gary Kirk was not eligible for SSI for October 2004 because his resources were worth more than the $2,000.00 resource limit. On the first day of October 2004 he and his parents owned the following items which count toward the resource limit.
2. Parents’ Resources That We Count
1988 GMC Automobile
Wachovia Checking Account
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Parents’ Resources Not Counted by SSI
Parents’ Resources That We Count
3. GARY KIRK’S Resources That We Count
Parents’ Resources that We Count
PNC Savings Account
GARY KIRK’S Resources That We Count
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SSI Resources Limit for an Individual
Amount Over Resource Limit
4. Important Reminders
We counted only the resources listed above. We generally do not count the value of a home, one vehicle, and a burial fund of up to $1, 500.00. Contact your local Social Security office if you have questioned about how we determined the value of GARY KIRK’s resources or wish to report that the value has changed.
If GARY KIRK’s resources shown above are reduced below $2,000.00, he may become eligible for SSI benefits. If he gives away or sells resources for less than they are worth, he could be ineligible for SSI for up to 36 months. Contact your local Social Security Office for information about how disposing of resources affects eligibility for SSI.