Identification Number:
SI 00870 TN 30
Intended Audience:See Transmittal Sheet
Originating Office:ORDP ORDES
Title:Plan to Achieve Self-Support
Type:POMS Transmittals
Program:All Programs
Link To Reference:
 

PROGRAM OPERATIONS MANUAL SYSTEM
Part SI – Supplemental Security Income
Chapter 008 – Income
Subchapter 70 – Plans to Achieve Self-Support for Blind or Disabled People
Transmittal No. 30, 09/17/2021

Audience

PSC: PASS SPECIALIST;
FO/TSC: CS, CS TXVI, CSR, CTE, DRT, FR, OA, OS, RR, TA, TSC-CSR;

Originating Component

ORDES

Effective Date

Upon Receipt

Background

Existing Field Office (FO) procedures require time and effort by numerous FO and Disability Determination Services (DDS) staff to process full Supplemental Security Income (SSI) disability applications from aspiring Plan to Achieve Self-Support (PASS) participants who receive a Social Security disability insurance benefit only. Some of the PASS applications are ultimately denied by the PASS Cadres for various reasons, which leads to a technical denial for the SSI application regardless of the DDS decision. The national PASS Work Group developed a sequencing change wherein the PASS Cadre would first examine the merits of a PASS plan before deciding to initiate an application for SSI benefits. The PASS Specialist will now advise the FO on the type of SSI application to take – abbreviated or full – depending on whether the applicant's PASS plan will be denied or tentatively approved by the Cadre. Also, the abbreviated application will improve documentation of PASS denials recorded on the Supplemental Security Income Record Query (SSR). Furthermore, the PASS appeals section was updated to delete, and incorporate the language of, a soon-to be-outdated POMS reference.

Summary of Changes

SI 00870.020 Plan to Achieve Self-Support (PASS) Field Office Procedures

Subsection D: Rearranged the sequencing of FO action steps. Included electronic methods for the intake and retention of PASS documents. Introduced the change that PASS Specialists would first examine the merits of a plan for an applicant who receives a disability insurance benefit only, before determining which type of SSI application the FO should take.

Subsection E: Created this section to address the common scenario in which the PASS Cadre receives an SSA-545 directly from an applicant or agency.

Subsection F: Moved the previous Subsection E here and consolidated the instructions from a soon-to-be-obsolete POMS section.

Subsection G: Created a PASS Hearing section.

SI 00870.020 Plan to Achieve Self-Support (PASS) Field Office Procedures

A. Handling PASS inquiries

When an individual inquires about a Plan to Achieve Self-Support (PASS) or is a likely PASS candidate per SI 00870.003B.1;

  • explain the role of the PASS Cadre, see SI 00870.001; and

  • give the individual the PASS Cadre’s contact information.

B. Responsibility for developing a PASS

Each region has a PASS Cadre with one or more PASS Specialist(s) or Area Work Incentive Coordinator(s) (AWIC). In most instances, a PASS Specialist or AWIC will be the Social Security Administration (SSA) employee who assists the individual to develop a PASS.

Field office (FO) staff who receive inquiries about a PASS or identify a likely PASS candidate will share information with the individual, accept documentation and forward information to the PASS Cadre as outlined in this section.

C. Field Office procedure for developing a PASS

If the individual has a work goal they wish to pursue and expresses interest in applying for a PASS:

  1. 1. 

    Provide the individual with:

    1. a. 

      form SSA-545-BK, Plan to Achieve Self Support, see Exhibit 1 in SI 00870.100.

    2. b. 

      the PASS Cadre contact information (follow regional procedures), and

    3. c. 

      a postage-paid business reply envelope.

  2. 2. 

    Provide the following web addresses to the individual when they can access the SSA-545-BK and PASS Cadre information electronically:

  3. 3. 

    Advise the individual to contact the PASS Cadre with questions regarding the completion of the PASS application.

  4. 4. 

    Inform the individual that the PASS Cadre member may contact them directly if additional information is needed to develop the plan.

If the individual does not have a work goal but expresses interest in pursuing a PASS, refer them to a Work Incentive Planning and Assistance (WIPA) agency, Ticket to Work Program Employment Network (EN), or the State Vocational Rehabilitation (VR) agency. Provide the individual with information about WIPA and EN organizations through https://choosework.ssa.gov .

D.  Individual submits a PASS to the Field Office

When an applicant submits a PASS to the field office, take the following steps:

Step

Action

1

Review the material submitted. Ensure that the applicant has completed the form SSA-545-BK and has signed pages 9 and 10. If the applicant has a representative payee, ensure that the payee has signed in the designated section on page 10. See SI 00870.023 for completion of the SSA-545-BK.

2

Accept any relevant documentation presented at the time of the interview. Scan the SSA-545-BK and accompanying PASS material into WorkTrack on the day you receive it or the next working day. Store the SSA-545-BK in the Electronic Viewer (eView) or Non-Disability Repository for Evidentiary Documents (NDRed) for future reference. Email the PASS Specialist to inform them that an individual has submitted a PASS application, indicating the applicant’s Social Security Number (SSN) and where the application is electronically stored.

3

Give the individual the toll-free telephone number for the servicing PASS Cadre. If your region only has one PASS Cadre member, inform the individual that the PASS Cadre may be located in another state.

4

When the PASS applicant already receives Supplemental Security Income (SSI), or did so in the last 12 months,

Stop Here and do not take further action in the FO.

5

When the applicant does not receive SSI benefits or is technically ineligible for SSI without a PASS exclusion of income or resources, the FO should wait to take an application for SSI until the PASS Specialist instructs the field office to take the claim. Since the SSA-545-BK is a protective writing for determining the SSI application date, the FO should create a lead in the Enhanced Leads and Appointments System (eLAS). Within the lead, the FO should choose the appropriate SSI claim type, enter the Onset Date as the date the SSA-545-BK was received, select No to Disability Form Sent, and type “PASS Applicant” in Remarks. They then should select No to Issue Informal Denial?, No to Make an Appointment?, Yes to Suppress Confirmation Notice?, and No to Print Referral?.

6

Once the PASS Cadre makes a decision, and if the applicant does not receive SSI benefits, then the PASS Cadre will alert the FO on the next steps per SI 00870.020E2.

If the PASS decision is a denial, the Cadre will instruct the FO to take an abbreviated application and include a Supplemental Security Record (SSR) Special Message with the denial rationale. The FO should then adjudicate the case, suppress the notice, and email the PASS Cadre that the application has been completed. The PASS Specialist will notify the claimant, via letter, of the PASS decision.

However, if the Cadre would approve the PASS application if the applicant were eligible for SSI, the Cadre will instruct the FO to obtain a full SSI application.

When a full SSI application is filed, follow the collateral estoppel instructions in DI 11011.001:

  • Complete full front-end development;

  • Inform the claimant that a new claim could result in a denial or potentially raise a continuing disability review (CDR) on the existing entitlement. Include their acknowledgment in the claims path, by adding an SSR Special Message or a remark to the SSI application page. For example, “I understand that SSA will make a determination for this application, which could be favorable or unfavorable. I also understand that SSA may need to review continuing eligibility for my current disability benefits. SSA will notify me if they need to review my current benefits.”;

  • Use the “Potential Collateral Estoppel Issues Apply” flag in the Electronic Disability Collect System (EDCS); and

  • Notify the PASS Cadre when the application is complete.

7

Request any additional necessary documentation for the SSI initial claim (e.g., bank records and pay stubs). Upon receiving a disability determination, adjudicate the case to a technical denial for income or resources (as applicable) and suppress the notice. Alert the PASS Cadre by email once adjudication is complete.

NOTE: If the Disability Determination Services (DDS) renders an unfavorable determination, then add the following SSR Special Message, "MM/DD/YY PASS denied due to unfavorable DDS determination for SSI". If DDS makes a favorable determination, the Cadre will reopen the denied claim in order to apply the PASS exclusions.

E. Individual submits a PASS directly to the PASS Cadre

When an individual, or an agency on behalf of an individual, submits a PASS directly to the PASS Specialist:

The PASS Specialist will contact the applicant or designated representative for further development if needed, analyze the plan for feasibility and viability, and decide on a course of action.

  1. 1. 

    If the individual receives SSI, or did so within the last 12 months, the PASS Cadre will evaluate the PASS and make the appropriate systems input according to the instructions in SI 00870.025A.

  2. 2. 

    If the individual does not receive SSI or is technically ineligible for SSI without a PASS and:

    1. a. 

      the PASS Cadre will approve the plan upon a favorable DDS determination, they will contact the applicant to set up an appointment to file for SSI with the servicing field office. The PASS Specialist will add lead remarks in the existing eLAS record, with a reminder to use the onset date as the protective filing date and with instructions for the FO to follow SI 00870.020D, Steps 6 and 7.

    2. b. 

      the Cadre will deny the plan, they will add an appointment in the existing eLAS record for the FO to process an abbreviated application for SSI, with a technical denial for excess income or resources (as applicable). In the lead remarks, the PASS Cadre will instruct the FO to add an SSR Special Message with the denial rationale, such as "MM/DD/YY PASS plan denied for not being feasible." Once informed by the FO that the application has been adjudicated, the PASS Specialist will issue the PASS denial notice to the claimant.

NOTE: Either the full or abbreviated application for SSI will serve to close out the lead for protective filing.

F. Request for reconsideration processing instructions

Denial of a PASS application is an initial decision and is subject to appeal. If the FO receives an SSA-561-U2, Request for Reconsideration, or documentation requesting an appeal on a denied PASS application, store the appeal form in the Certified Electronic Folder (CEF) or NDRed, and take the following steps:

1. Request for a case review

If the individual requests a case review, forward an SSA-561-U2, along with any material submitted, to the servicing PASS Cadre via WorkTrack. Advise the individual that a PASS Specialist or AWIC, other than the one who made the initial decision, will review the case.

2. Request for a conference

If the individual requests an informal conference, determine whether a teleconference would be acceptable. If acceptable, determine the best time and phone number to contact the individual . Forward this information -- along with the Request for Reconsideration and any other material submitted -- to the servicing PASS Cadre via WorkTrack. Advise the individual that a PASS Specialist or AWIC, who did not make the initial decision, will contact them by mail or telephone.

When the applicant has pertinent material to submit, a PASS Specialist may ask them to submit the material to the servicing FO. If the individual submits the material to the FO, fax the documents into WorkTrack on the day you receive it or the next working day. Alert the PASS Cadre by email that the individual submitted the appeal documentation, indicating the individual's SSN and where the appeal is electronically stored. After the conference, just as with any case review, the PASS Specialist will document their decision, make the corresponding system inputs, and issue the notice to the individual.

If the individual insists on an in-person conference and there is not a PASS Specialist available within the service area, refer the matter to the manager of the servicing FO. The manager may delegate the handling of the matter to an FO employee who is at least equal in grade to the employee who made the initial decision. This FO employee will:

  • conduct the conference;

  • make the decision;

  • make any corresponding changes to the SSR;

  • issue the notice to the individual; and

  • send a copy of the notice and any other materials to the PASS Cadre via WorkTrack.

NOTE: Management may designate a lower-graded employee to assist with these activities, but this employee may not make the reconsideration decision.

G. Request for hearing processing instructions

If the individual wishes to appeal an unfavorable PASS reconsideration decision, forward the HA-501-U5, along with any material submitted, to the servicing PASS Cadre via WorkTrack. Advise the individual that a PASS Specialist or AWIC, who did not make the reconsideration decision, will establish the request for the hearing, to be decided by an Administrative Law Judge (ALJ).


SI 00870 TN 30 - Plan to Achieve Self-Support - 9/17/2021