PROGRAM OPERATIONS MANUAL SYSTEMPart SI – Supplemental Security IncomeChapter 006 – The SSI Application ProcessSubchapter 01 – General Applications and Interviewing PolicyTransmittal No. 26, 04/16/2020
We are updating this section of POMS to reflect the current process based on feedback we received from the Office of the Chief Administrative Law Judge (OCALJ). Specifically, we revised this section to clarify the instructions on handling requests for withdrawal when the Supplemental Security Income (SSI) claim is pending at the hearing level. This revision is consistent with instructions in HALLEX I-2-4-22 B.2. Additionally, we removed passive language, and applied plain language writing guidelines.
Summary of Changes
SI 00601.050 Withdrawal of Supplemental Security Income (SSI) Application
Updated the terms "MSSICS" to "SSI Claims System" and "Claims Representative" to "Claims Specialist" throughout the section, where appropriate. Updated headings to "sentence case", where appropriate, per guidelines in Policy Writer's Toolkit.
Added clarification that this section also describes cancellation of the withdrawal request and situations where consent is involved.
D.2.a. Added clarification to specifying the application filing date on the request for withdrawal.
D.2.c. Put requirements in bulleted format to clarify when a withdrawal can be approved without the acknowledgment statement.
D.2.d. Put requirements in bulleted format to clarify when a withdrawal can be approved without the detailed description.
E.3. Updated dates within examples to make them more current.
Listed items in bullet format for easier navigation.
I.2. Added clarification on generating the SSA-795 using MSSICS.
J.2. Changed heading from "Hearing filed" to "Claim pending at the hearing level" for clarification.
J.2. For claims pending at the hearing level, we added instructions for field office staff to process the request for withdrawal before forwarding the withdrawal request with the determination to the hearing office for further action, as necessary.
Alphabetized references and updated reference titles.
This section describes the policy and procedures for withdrawal of an SSI application, cancellation of the withdrawal request, and situations where consent is involved.
The systems payment status code for a withdrawn claim is N12.
When we approve a request for withdrawal of an application, we treat the application as though it was never filed.
A withdrawal request does not become effective until the Social Security Administration (SSA) approves it.
We raise the issue of withdrawal of an application with the individual when withdrawal provides some definite advantage to the individual. We raise the issue of withdrawal in the following situations:
There may be instances where voluntary termination is a more reasonable alternative to withdrawal of the claim. (See SI 02301.230 regarding voluntary termination.)
In this situation, two individuals have filed (or receive payments) as a couple, but one member's income is such that the other member would receive more as an eligible individual with an ineligible spouse than the "couple" would receive. (See SI
00601.050E.3., Example 1.)
In this situation, at least one member of a couple is subject to Title II offset and some SSI would be payable during the offset period to the member who does not withdraw, and the total Title II and SSI payable to the couple could be higher than if both remained eligible for SSI (consideration has to be given to the effect of SSI eligibility prior to and after the offset period). (See the Examples in SI
00601.050E. and SI 00501.154D.5.)
In this situation, an eligible child receives less than he or she otherwise would have because a parent has filed for or has been eligible for SSI; the eligible parent has unearned income; there is an ineligible child allocation greater than zero; the ineligible spouse has earned income greater than $65; and deemed income makes the parent/spouse ineligible. (See SI 01320.650 for a further explanation of this situation.)
The request for withdrawal must be signed and filed with SSA.
The claimant or proper applicant must sign the request. (See SI 00601.012 for a description of a proper applicant.)
A withdrawal request is considered filed with SSA when it is received at a Social Security office, another Federal or State office SSA has designated to receive applications, or with a person SSA has authorized to receive applications.
SSA considers a withdrawal request filed on the day it is received at a Social Security office. However, the U.S. postmark date may be used as the filing date if using the date the withdrawal request is received would result in a loss of payments or rights. If the postmark is unreadable or missing, use the date the request is signed or 5 days before the day it was received, whichever is later.
There is no time limit on when a request for withdrawal of an SSI application may be filed, but the date the withdrawal is filed could be material in determining whether other conditions for approving the withdrawal are met (see SI 00601.050D.3. and SI 00601.050D.4.).
A withdrawal request must contain the following elements.
An individual requesting to withdraw his or her SSI application may have more than one prior filing on SSA records. The request must specify which SSI application the withdrawal request is for (e.g., SSI application filed January 15, 2020).
The request must state the reason or purpose for the withdrawal.
The request must contain a statement acknowledging the effect withdrawal may have on Medicaid eligibility and a statement of the effect on interim assistance reimbursement, if applicable. The withdrawal can be approved without the acknowledgment statement if the file contains:
An explanation for not obtaining the acknowledgment statement, and
Documentation of the explanation provided to the claimant, recipient, or proper applicant.
Advise the individual to contact the State agency prior to withdrawing the SSI claim to determine if the State requires repayment of interim assistance.
If a withdrawal is clearly disadvantageous to an individual, the request must contain a detailed description of the effects of the withdrawal. The withdrawal can be approved without this description if the file contains:
An explanation for not obtaining the detailed description, and
Documentation of the disadvantages explained to the claimant, recipient, or proper applicant.
If a denial would serve the same purpose as a withdrawal but the individual insists on withdrawing, the request must state that the individual understands there is no need to withdraw the claim. A denial preserves appeal rights based upon that application, whereas a withdrawal does not; and a subsequent application will not be effective for the same period.
If an individual's desire for a withdrawal is based on the expected outcome of another event (i.e., the withdrawal is conditional), the request must contain an explicit explanation of the condition.
The claimant must be alive at the time of filing the request.
If the request for withdrawal is filed after a determination has been made on the application, in addition to meeting the requirements of SI 00601.050D.1., SI 00601.050D.2., and SI 00601.050D.3., the following conditions must be met:
Anyone who would lose eligibility to payments or whose payments would be reduced if the withdrawal is approved must consent in writing. A proper applicant who can sign an application for that individual may give the consent. (See SI 00601.012 for proper applicant policy.) If SSA cannot obtain consent, the withdrawal cannot be approved.
If another recipient refuses to give consent, try to obtain a statement of the refusal with the recipient's signature. If the other recipient will not cooperate in providing a statement, document the file.
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, certified or uncertified check. Inform the individual that he or she is responsible for payments lost in the mail.
If the withdrawal reduces another recipient's payment or makes him or her ineligible, any overpayment created by the withdrawal on this recipient's record need not be repaid in order to approve the withdrawal. (See SI
00601.050E. for further information on the effect of withdrawal on another.)
Although there is no time limit on withdrawing an SSI application, administrative finality rules limit the withdrawal's effect on another person's SSI eligibility and payment amount for past months. (See SI 04070.001 through SI 04070.080 for the rules of administrative finality.)
REMINDER for couple's cases: When one member of a couple withdraws and the other remains eligible, SSI payments already made to the couple are considered payments to the remaining eligible member. Compute the amount to refund by calculating the difference between what the couple received and what the remaining eligible member would have received as an eligible individual with an ineligible spouse.
Adjusting the amount of Title II payments that should have been withheld for Title II offset is not limited by the rules of administrative finality.
Type of income affects deeming computation
Mr. and Mrs. Simons filed for SSI as an aged couple. Both members were receiving Title II retirement benefits and Mr. Simons was receiving a Department of Veterans Affairs (VA) pension based on need. They were advised that Mrs. Simons would receive more as an eligible individual with an ineligible spouse than they would both receive as an eligible couple because neither Mr. Simon's VA pension nor his retirement benefits are deemed to Mrs. Simons. However, Mr. Simons decided to pursue his claim for the Medicaid coverage. Three years later, Mr. Simons inquired about changing his decision. The claims specialist (CS) advised Mr. Simons that although there was no time limit on filing a withdrawal request, withdrawal at this time would not affect his wife's payment back to her first month of eligibility because of administrative finality. A withdrawal would mean he would have to refund the SSI paid to him as a member of an eligible couple from the first month of eligibility to the first month we could change his wife's status based on administrative finality rules. (NOTE: Mr. Simons would only have to refund the difference between what the couple received and what Mrs. Simons would have received after the wife's status changed because the payments he received as a member of an eligible couple are deemed to have been paid to his wife.) As an alternative, the CS discussed with Mr. Simons the possibility of voluntarily terminating his SSI payments. (See SI
02301.230 for voluntary termination policy.)
Title II offset in a couple's case
In May 2018, Mr. and Mrs. Andrews were awarded SSI payments as an eligible couple based on an application filed in March 2018. In September 2018, Mrs. Andrews was awarded Social Security disability benefits with an entitlement date of March 2017. Her retroactive Title II check was offset by the amount of SSI she had been paid for March through August. SSI eligibility ended for the couple because of the Title II income.
In July 2018, Mrs. Andrews learned from her neighbor that virtually the same thing had happened to the neighbor, but the neighbor had been advised that withdrawal of his SSI application would prevent offset from being applied to the Title II benefits, while his spouse would still be eligible for SSI. Mrs. Andrews visited the field office (FO) within the next week and requested a withdrawal. Since there is no time limit on the filing of a withdrawal and the rules of administrative finality do not apply to the adjustment necessary to the amount of the Title II benefits already paid and there is no adjustment to be made to the SSI payments received by Mr. Andrews because of administrative finality, the FO approved the withdrawal. However, Mrs. Andrews would have to refund the SSI benefits paid to her.
Deeming to a spouse and child lowers payment to child
Mrs. Neal filed for SSI for her son, Jeff, and for herself. Mrs. Neal has unearned income, her husband has wages, there is an ineligible child allocation, and Mrs. Neal is ineligible due to deemed income from her husband. Jeff's disability was allowed and he began receiving SSI payments. At a redetermination a year later, the CS noted that Jeff's payment would be higher if Mrs. Neal was not on the record as a filer. (For an example of the computation involved, see SI 01320.650.) The CS explained the situation to Mrs. Neal and further explained that she could withdraw her application, as there was no time limit on doing so. She decided to withdraw her application. Applying the rules of administrative finality, the CS determined Jeff's payment could increase all the way back to his first month of eligibility.
A denial is preferable to a withdrawal if a claimant does not want to pursue the claim. A denial affords the claimant appeal rights.
The claimant may cancel a request for withdrawal. The cancellation request must:
Be filed while the claimant is alive;
Be signed by a proper applicant (see SI 00601.012);
Give a reason for the cancellation; and
Be filed with SSA within 60 days after the date of the notice of withdrawal approval. See SI
00601.050D.1. for an explanation of "filed with SSA".
EXCEPTION: The cancellation request may be honored if received after the 60-day time limit if the withdrawal was a conditional withdrawal and the condition did not materialize. (See GN 00206.055 for conditional withdrawal policy.)
An individual who gave consent to the withdrawal because it affected his or her payment may rescind consent within 60 days after the date of the notice of withdrawal approval. There is no exception to the time limit. A proper applicant must sign this request. (See SI 00601.012 for determining the proper applicant.)
When consent from an individual (or proper applicant on his or her behalf) is rescinded within the 60-day period, the FO must advise the claimant that the rescission will nullify the withdrawal approval.
A withdrawal nullifies all classes of benefits covered by that application unless the withdrawal request specifically states that the individual does not want to withdraw a certain class of benefits (e.g., Title II). An SSI application is also an application for:
Title VIII, if the eligibility requirements in VB 00102.001 through VB
00102.010 are met,
Title XIX in 1634 States as defined in SI
Federally administered State supplementation.
However, if a separate Title II or Title VIII application was filed, it is not withdrawn when the SSI claim is withdrawn.
There is no particular form for requesting a withdrawal of an SSI application.
If the individual submits a written request containing all the elements described in SI
00601.050D.2., do not request anything further.
If you have the opportunity to prepare a document for the individual's signature, prepare it on a SSA-795 (Statement of Claimant or Other Person). If possible, generate the SSA-795 using the Modernized SSI Claims System (MSSICS) by selecting "blank person statement" on the Claims Development Menu (DWME) screen.
No matter what form the withdrawal request takes -- a letter, SSA-795, etc., annotate "Withdrawal" at the top of the document and annotate "Approved" or "Disapproved" at the bottom. Annotate the reason for disapproval, if applicable, sign and date your determination at the bottom, and provide your position title.
If the withdrawal can be processed in the SSI Claims System (see SI
00601.050K.), then you may document your determination of approval or non-approval by using the Report of Contact (DROC) screen in addition to the paper record.
If the claim is pending at the hearing level of administrative review when the individual files the request to withdraw the application, notify the hearing office immediately following standard local procedures (i.e., phone, email, or both) and confirm that an administrative law judge has not acted on the claim (e.g., by issuing a decision or dismissal). Obtain any necessary documentation per SI 00601.050D; process the request, either approving or disapproving the application withdrawal; and document the determination as outlined in SI 00601.050J.1. Forward the withdrawal request with the determination to the hearing office for further action, as necessary.
You may process the withdrawal through the SSI Claims system by entering a denial code of N12 on the Adjudicative Decision (DADJ) screen.
You must have a pending SSI Claims system file with a Pending File Begin Date equal to the effective filing date to properly effectuate the withdrawal.
See NL 00804.215 to view the paragraphs mentioned below.
If the claimant has received Title XVI payments based on the application being withdrawn, and the payments are not being refunded by a cross-benefit adjustment, you may request the refund on a SSA-L8165-U2 using paragraph WDWM 50.
Whether the withdrawal request is filed before or after effectuation of an initial claim, the notice of withdrawal approval is usually automatically generated by the system. However, if the system cannot process the action for some reason or if the withdrawal is conditional, issue a SSA-L8165-U2 with paragraphs 1500 and 1503 for an initial claim and paragraphs 2482 and 1503 for a post-eligibility withdrawal.
If the withdrawal is conditional, the notice must advise that the withdrawal was approved assuming a particular event would happen and describe the event. The notice should further advise the individual that if the event does not occur, the individual should contact SSA.
Send a SSA-L8155-U2 to anyone whose payment is adversely affected by approval of the withdrawal. Explain the reason for change in SSI eligibility or payment.
This individual may not appeal the issue of withdrawal. However, this individual may rescind consent (see SI 00601.050G.).
If the withdrawal request is filed prior to adjudication of an initial claim and it is disapproved, suppress the systems generated notice of award or denial and send a manual SSA-L8025-U2 (for an award) or an SSA-L8030-U2 (for a denial) and provide an explanation that the withdrawal request was disapproved and why. If the withdrawal request is filed after the claim is adjudicated, send a manual SSA-L8166-U2 with an explanation that the withdrawal request is disapproved and why.
If the cancellation request is filed before effectuation of an initial claim and the cancellation request is approved, the automatic notice of award or denial of the claim is sufficient notification of our determination on the case. There is no need to explain that the individual requested a withdrawal of the claim and then requested cancellation of the withdrawal and we are approving the cancellation request.
If the cancellation request is filed after effectuation of the initial claim, the action you take depends on whether a notice of withdrawal approval has been issued.
If a notice regarding the withdrawal's approval has not been issued, send a manual SSA-L8165-U2 with paragraph 2473.
If a notice regarding the withdrawal's approval has been issued, send a manual SSA-L8151-U2 with paragraph 2473.
If the cancellation request is filed before effectuation of an initial claim and the cancellation request is disapproved, issue a manual SSA-L8166-U2 with an explanation that the withdrawal request has been approved (paragraph 1500) and the cancellation request was disapproved.
If the cancellation request is filed after effectuation of an initial claim, the action you take depends on whether a notice of withdrawal approval has been issued.
If a notice regarding the withdrawal's approval has not been issued, send a manual SSA-L8166-U2 explaining that the withdrawal request is approved (paragraph 2482) and the cancellation request is disapproved.
If a notice regarding the withdrawal's approval has been issued, send a manual SSA-L8166-U2 with an explanation as to why the cancellation request was disapproved.
GN 00206.001 - GN 00206.145, Withdrawal of a Title II Benefit Application
NL 00804.100, Numerical Index of Automated and Manual Paragraphs
SI 02301.230, Voluntary Termination (N19)
VB 00201.070, Conditions for Acceptance of Withdrawal