TN 4 (07-09)

PS 02105.053 Washington State

A. PS 05-113 Legal Opinion Re: Withdrawal of SSI Application

DATE: August 30, 2003

1. SYLLABUS

Withdrawal of SSI Application-Interim Assistance Reimbursement Agreement InvolvedIf the withdrawal request is filed before SSA makes a determination on the SSI claim, SSA will approve the request if the requirements in 416.355(a) are satisfied. SSA will not be involved in enforcing the claimant's obligation to reimburse the state for any interim assistance paid to the claimant while the SSI was pending.

If the withdrawal request is filed after SSA makes a determination on the SSI claim but benefits have not been paid, SSA will approve the request if the requirements in 416.355(a) are satisfied. SSA will not be involved in enforcing the claimant's obligation to reimburse the state for any interim assistance paid while the SSI was pending.

If SSA has made a determination on the SSI claim before the withdrawal request is filed and benefits have been paid by SSA, including reimbursement to the Department of Social and Health Services (DSHS) from the recipient's first payment, SSA will approve the withdrawal request if the requirements of section 416.355(a) are satisfied. The claimant must reimburse SSA for the SSI monies owed to DSHS for reimbursement of interim assistance and for all other SSI benefits.

2. OPINION

The "windfall offset" provision set forth in section 1127 of the Social Security Act, 42 U.S.C. § 1320a-6, applies to claimants who apply for both Social Security benefits and SSI benefits, and is designed to prevent duplication of retroactive payments under both programs. If the Title II claim is adjudicated first, SSA will pay the Title II current month accrual (CMA), but hold the Title II retroactive payments. When the Title XVI/SSI claim is adjudicated, SSA will pay the Title XVI/SSI retroactive payments, and reduce the Title II retroactive payments by the Title XVI/SSI retroactive benefits to protect Medicaid eligibility in the retroactive period. 20 C.F.R. §§ 404.408b, 416.1123(d); Program Operations Manual System (POMS) GN 02610.018.

Federal Law on Reimbursement of Interim Assistance

Section 1631 of the Social Security Act, 42 U.S.C. § 1383, provides:

(g)(1) Notwithstanding subsection (d)(1) and subsection (b) as it relates to the payment of less than the correct amount of benefits, the Commissioner of Social Security may, upon written authorization by an individual, withhold benefits due with respect to that individual and may pay to a State (or a political subdivision thereof if agreed to by the Commissioner of Social Security and the State) from the benefits withheld an amount sufficient to reimburse the State (or political subdivision) for interim assistance furnished on behalf of the individual by the State (or political subdivision).

42 U.S.C. § 1383(g)(1). For purposes of the foregoing section, the term "benefits" includes Title XVI benefits or State supplementary payments that are due "at the time the Commissioner of Social Security makes the first payment of benefits with respect to the period" described in the definition of "interim assistance". 42 U.S.C. § 1383(g)(2); 20 C.F.R. § 416.1902. "Interim assistance" means "assistance financed from State or local funds and furnished for meeting basic needs (A) during the period, beginning with the month following the month in which the individual filed an application for benefits (as defined in paragraph (2)), for which he was eligible for such benefits, or (B) during the period beginning with the first month for which the individual's benefits (as defined in paragraph (2)) have been terminated or suspended if the individual was subsequently found to have been eligible for such benefits." 42 U.S.C. § 1383(g)(3); 20 C.F.R. §§ 416.1902, .1904, .1906; POMS SI 02003.001.

DSHS and SSA have entered into an Agreement for Reimbursement to State for Interim Assistance Payments Pursuant to Section 1631(g) of the Social Security Act. See 20 C.F.R. § 416.1910 (requirements for interim assistance agreements).

DSHS provides general assistance unemployable (GAU) benefits to SSI claimants who meet the GAU eligibility requirements and enter into an Interim Assistance Reimbursement Authorization with DSHS. See WAC 388-400-0025 (describing the eligibility requirements and referencing WAC 388-448-0210). WAC 388-448-0210 provides:

Assignment and recovery of interim assistance.

You can get assistance to meet your basic needs from only one government source at a time. When you are approved for SSI, you may receive a payment going back to the date you applied for SSI. This means you are being paid a back payment for your basic needs. When you have received GAU during that time period, the amount paid to you in the form of GAU must be reimbursed to the state.

1. "Assign" means that the Social Security Administration (SSA) will pay DSHS directly from your reimbursement amount. The assignment will be up to the amount of interim assistance we provide to you.

2. "Interim assistance" means the state funds we provide to you to meet basic needs during:

a. The time between your SSI application date and the month recurring SSI payments begin; or

b. The period your SSI payments were suspended or terminated, and later reinstated for that period.

3. We pay up to twenty-five percent of the interim assistance reimbursement that we receive from the SSA to the attorney who has successfully represented you in your effort to receive SSI.

DISCUSSION

The SSI claimant signs DSHS Form 18-235, Interim Assistance Reimbursement Authorization, agreeing to the following terms:

What am I authorizing the State to do by signing this authorization?

If I am found eligible to receive Supplemental Security Income (SSI) benefits, I understand I am authorizing the Commissioner of the Social Security Administration (SSA) to send:

· My first retroactive payment of SSI benefits to the State; or

· If Federal law restricts the way my SSI money is released to me, send to the state only an amount equal to the amount of reimbursable public assistance I received from the State.Form 18-235 states how long the Interim Assistance Reimbursement Authorization is effective:

This authorization is binding on the State and me for one calendar year from the date the State receives it. This authorization must be signed and dated by both a State representative and me to be a valid authorization. SSA will keep this authorization on file for one year.

This Form does not address what is to happen if the SSI claimant later withdraws his/her SSI application.

Withdrawal of SSI Application and Effect on Interim Assistance Reimbursement

A SSI claimant may withdraw his/her application for SSI benefits either before or after SSA makes a determination on the SSI claim. The regulation at 20 C.F.R. § 416.355 states:

(a) Request for withdrawal filed before we make a determination. If you make a request to withdraw your application before we make a determination on your claim, we will approve the request if the following requirements are met:

(1) You or a person who may sign an application for you signs a written request to withdraw the application and files it at a place described in § 416.325.

(2) You are alive when the request is filed.

(b) Request for withdrawal filed after a determination is made. If you make a request to withdraw your application after we make a determination on your claim, we will approve the request if the following requirements are met:

(1) The conditions in paragraph (a) of this section are met.

(2) Every other person who may lose benefits because of the withdrawal consents in writing (anyone who could sign an application for that person may give the consent).

(3) All benefits already paid based on the application are repaid or we are satisfied that they will be repaid.

(c) Effect of withdrawal. If we approve your request to withdraw an application, we will treat the application as though you never filed it. If we disapprove your request for withdrawal, we will treat the application as though you never requested the withdrawal.

POMS SI 00601.050C instructs SSA to raise the issue of withdrawal when there is some definite advantage to the claimant. POMS GN 02610.018A3 (governing windfall offset) instructs SSA to "obtain a withdrawal of the SSI claim" if the claimant "insists that retroactive title II benefits should be paid without delay and he/she understands the effect on Medicaid, etc." The withdrawal request "must contain a statement acknowledging the effect withdrawal may have on Medicaid eligibility." POMS SI 00601.050D.2c.

Your inquiry did not state when the claimants are requesting the withdrawal of their SSI applications at Mr. S~' advice. If the withdrawal request is filed before SSA has made a determination on the SSI claim, SSA will approve the request if the requirements in section 416.355(a) are satisfied. SSA would not be involved in "enforcing" the claimant's obligation to reimburse DSHS for any interim assistance paid while the SSI application was pending.1_/

If the withdrawal request is filed after SSA has made a determination on the SSI claim, but benefits have not yet been paid, SSA will approve the request if the requirements of section 416.355(a) are satisfied and those who may lose benefits have consented to the withdrawal. SSA would not be involved in "enforcing" the claimant's obligation to reimburse DSHS for any interim assistance paid while the SSI claim was pending or before any SSI was paid.2_/

If SSA has made a determination on the SSI claim before the withdrawal request is filed, and benefits have been paid by SSA, including reimbursement to the DSHS from the recipient’s first payment, section 416.355(b) explains that SSA will approve the request if the requirements of section 416.355(a) are satisfied, those who may lose benefits have consented to the withdrawal, and “[a]ll benefits already paid based on the application are repaid or we are satisfied that they will be repaid.” Thus, the claimant would need to reimburse SSA for the SSI monies owed to DSHS for reimbursement of interim assistance and for all other SSI benefits.[3_/]

Repayment

All benefits already paid based on the withdrawer’s application must be repaid or SSA must be satisfied that they will be repaid. One method of assuring repayment is by a one-time adjustment to a title II underpayment (cross-program adjustment). See instructions on cross-program adjustment in SI 02220.020. Accept repayment in the form of cash, money order, cashier’s check, or uncertified check. Inform the individual that he/she is responsible for payments lost in the mail.

[1_/] A withdrawal request must contain "a statement of the effect on interim assistance reimbursement, if applicable." POMS SI 00601.050D.2c. SSA is instructed to "[a]dvise the individual to contact the State agency prior to withdrawing the SSI claim to determine if repayment of interim assistance is required." Id.
[2_/] OGC's Office of Program Law and policy staff concur.
[3_/] POMS SI 00601.050D.4b states.


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http://policy.ssa.gov/poms.nsf/lnx/1602105053
PS 02105.053 - Washington State - 07/15/2009
Batch run: 04/25/2016
Rev:07/15/2009