Identification Number:
SI 02309 TN 17
Intended Audience:See Transmittal Sheet
Originating Office:ORDP OISP
Title:Critical Birthday and Insured Status Diaries
Type:POMS Transmittals
Program:
Link To Reference:
 

PROGRAM OPERATIONS MANUAL SYSTEM
Part SI – Supplemental Security Income
Chapter 023 – Posteligibility Events
Subchapter 09 – Critical Birthday and Insured Status Diaries
Transmittal No. 17, 10/05/2020

Audience

OCO-OEIO: CR, FCR, FDE, RECONE;
FO/TSC: CS, CS TXVI, CSR, CTE, DRT, FR, OA, OS, RR, TA, TSC-CSR;

Originating Component

OISP

Effective Date

Upon Receipt

Background

The KP diary alert requires Claims Specialists to determine potential entitlement to Title II spouse’s benefits of a member of an eligible Supplemental Security Income (SSI) couple at ages 62 to 64. Effective October 2020, Systems is expanding the selection criteria for the KP diary to include an SSI claimant with an ineligible spouse when:

  • The claimant is age 62 - 64, in current pay status (C01), not receiving Title II benefits; and

  • The ineligible spouse receives Title II benefits.

We updated our instructions to incorporate the new criteria.

Summary of Changes

SI 02309.001 Critical Birthday Diaries - Supplemental Security Income (SSI)

Section A - corrected the age threshold for the KC diary

Section B - included the new selection criteria for the KP diary

Section C - moved content under Section B and deleted section

SI 02309.001 Critical Birthday Diaries - Supplemental Security Income (SSI)

A. Introduction

The system identifies critical birthdays to:

  • Change the type of master record of a disabled or blind child who will attain age 18 from DC/BC/DM/DF/DB/BM/BF/BB to that of a disabled or blind individual (DI/BI);

  • Determine potential entitlement of ineligible individuals at age 65 to Title XVI and/or Title II benefits (diary development may also result in Title II entitlement for the eligible individual);

  • Determine potential entitlement of a member of an eligible couple at age 62 or older to Title II spouse’s benefits;

  • Initiate development of multi-category eligibility for disabled individuals who will attain age 65 and reside in Nevada (see SI 00501.300);

  • Determine if Title XVI recipients age 90 or older are alive and develop any additional posteligibility issues (e.g., capability, change in payee, living arrangements, income and resources).

For an overview on redetermination-related diaries and alerts, see SI 02305.023 and SM 01501.250

NOTE: Critical birthday diaries do not establish protective filing for benefits. For more information, see SI 00601.015 (Protective Filing - General).

B. Process

1. Setting and Maturation of Critical Birthday Diaries

At the beginning of the fiscal year (FY) in which an individual attains a critical birthday age,

  1. a. 

    The system sets a critical birthday diary (KB, KC, KE, K8, K9, or KP) on records in current payment status (i.e., PSY: C01). The KB diary is also set for individuals attaining age 18 within the FY. The diary is set in the monthly redetermination merge runs.

  2. b. 

    Diaries mature in the month of age attainment. Attainment occurs on the day preceding the recipient's birthday (see GN 00302.400).

2. Selection of a KB Diary

The Post Entitlement Operational Data Store (PE ODS) system selects a record with a KB diary as a middle-error profile (MEP) scheduled redetermination (RZ), profile K, in the month a recipient attains age 18. However, a KB diary does not preclude selection of a record as:

  • A profile D RZ, either prior to or at the time the system would normally select the case as a profile K RZ; or

  • A limited-issue diary case before the month of age attainment.

Follow procedures in SI 02309.003.

3. Selection of a KC Diary

The system selects a KC diary as a limited issue or an RZ when a recipient attains age 90 in the FY or is already over age 90. Determine if Title XVI recipients age 90 or older are alive and develop any additional post eligibility issues (e.g., capability, change in payee, living arrangements, income and resources). Follow procedures in SI 02309.006.

4. Selection of a KE Diary

The system selects a KE diary as a limited issue or an RZ when certain eligible individuals who reside in either Massachusetts (see SI 01415.035F) or Nevada (see SI 01415.035I) attain age 65 (see SI 00501.300).

5. Selection of a K8/K9 Diary

When an ineligible individual attains age 65, the system selects a K8/K9 diary as a limited issue or an RZ and we must make a determination for potential entitlement .

  • A K8 is set when the ineligible individual is a father, spouse, or essential person.

  • The K9 is set when the ineligible individual is a mother or essential person. Prior to 10/93, a diary was set when the ineligible individual received a Veterans Affairs pension based on need (type E income).

6. Selection of a KP Diary

The KP diary sets in October at the beginning of the FY when:

  • One member of an eligible couple attains age 62 to 64 in the FY and does not receive Title II benefits, but the other member of the couple does receive Title II benefits. Both members of the couple must be in current pay status (C01); OR

  • A claimant in current pay status (C01) attains age 62 to 64 in the FY, and does not receive Title II benefits, but their ineligible spouse does receive Title II benefits.

The diary matures in the month before the month of age attainment. Follow procedures in SI 02309.007.


SI 02309 TN 17 - Critical Birthday and Insured Status Diaries - 10/05/2020