Identification Number:
SI 00602 TN 6
Intended Audience:See Transmittal Sheet
Originating Office:ORDP OISP
Title:Abbreviated Application Process for Clear Technical Denials
Type:POMS Transmittals
Program:Title XVI (SSI)
Link To Reference:
 

PROGRAM OPERATIONS MANUAL SYSTEM
Part SI – Supplemental Security Income
Chapter 006 – The SSI Application Process
Subchapter 02 – Abbreviated Application Process for Clear Technical Denials
Transmittal No. 6, 11/20/2019

Audience

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

Originating Component

OISP

Effective Date

Upon Receipt

Background

This is a Quick Action Transmittal. These revisions do not change or introduce new policy or procedure.

Summary of Changes

SI 00602.001 The Abbreviated Application Process

Subsection C

  • We updated the position titles of staff who may use the ABAP process in Subsection C.3. We updated the position titles for Claims Representative, Field Representative, Technical Expert, Service Representative, Service Representative/data review technician, and Teleservice Representative to the following: Claims Specialist; Claims Technical Expert; and Customer Service Representative. We updated the position titles to align with the official DCO position title changes that went into effect in September 2015 which sought to combine the Position Descriptions (PDs) of front-line positions due to changes in the work environment.

  • We updated the link in Subsection C.4.b to MSOM MS 08108.003.

Subsection D

  • We updated the reminder to state that if the applicant is interested in applying for Supplemental Nutrition Assistance Program (SNAP) benefits, follow the guidelines in SI 01801.005C. SI 01801.005C was updated in 10/2019.

  • We corrected the typographical error in the acronym "ABAPs" in Subsection D.4.

  • We updated the link in Subsection D.4.b to MSOM MS 04422.003 and MSOM MS 04424.001.

  • We updated the link in Subsection D.5 to MSOM MS 06002.004 and MSOM MS 06002.005.

SI 00602.001 The Abbreviated Application Process

A. Introduction

We use the Supplemental Security Income (Supplemental Security Income (SSI) abbreviated application (ABAP) to formally deny Title XVI benefits for nonmedical reasons when the applicant alleges information that clearly results in ineligibility. A thorough pre-application interview is essential to determine if an ABAP is appropriate. An ABAP can be taken using the traditional paper SSI application forms (SSA-8001-BK and SSA-8000-BK (Application for Supplemental Security Income) or using the modernized SSI claims system (MSSICS), which is the preferred claims taking method.

The ABAP process:

  • creates a systems record of the denial,

  • generates an automated denial notice and

  • protects the claimant's appeal rights with minimal documentation.

B. Definitions

1. Technical Denial

A denial that is based on the applicant's allegation (or evidence presented) at the time of application, about a nonmedical factor of eligibility. A technical denial is appropriate when the individual's/couple's allegation indicates ineligibility for SSI a nd any federally administered State supplementation from the filing date through the end of the month after the month the claim is adjudicated.

2. Abbreviated Application (ABAP)

a. Paper ABAP

A partially completed SSA-8001-BK or SSA-8000-BK used to document a nonmedical factor(s) of eligibility that results in a technical denial.

                                    OR

b. MSSICS ABAP

The ABAP screen path used to document a technical denial; it’s shorter than the full claim path.

C. Policy

1. When to Use the ABAP Process

It is appropriate to complete an ABAP only if it is clear at the time of application that the claimant does not meet one or more of the nonmedical eligibility requirements through the end of the month after the month the claim is adjudicated.

2. When Not to Use ABAP Process

a. Question of Nonmedical Eligibility Exists

It is not appropriate to complete an ABAP if a question of nonmedical eligibility exists.

Aged claims

If eligibility is unclear complete a full application and all required development.

Disability/blindness claims

See SI 00603.001 through SI 00603.004.

NOTE: When a Title II disability application is pending and the only item that might preclude SSI benefits is the anticipated future Title II benefit amount, an ABAP is not the appropriate application to complete. (The Disability Determination Services (DDS) or Administrative Law Judge (ALJ) may determine a date of onset other than the date alleged at the time of the application, thereby affecting the Title II benefit.)

                    OR

b. Other Situations

It is not appropriate to complete an ABAP in the following situations:

  • E01 Claim--Claimant or Couple Appears Eligible But No Payment Due-This is not a denial situation.

    EXAMPLE 1: An individual residing in a Title XIX institution (in a state with no supplementation) with countable income of $200 per month is SSI eligible, but no payment is due.

    EXAMPLE 2: An individual has countable income exactly equal to the Federal benefit rate (FBR) and no federally administered optional State supplement applies from the filing date through the end of the month after the month the claim is adjudicated. He/she is SSI eligible, but no payment is due.

  • E02 month f ollowed by ineligibility during remaining months of the evaluation period (SI 00601.009C.3.).

  • Earned income is below the break-even points (SI 00810.350) but above the SGA level (DI 10501.015). See DI 10501.025, Responsibilities and Procedures-Work Issue Cases.

  • Prerelease Claims-Complete a full application if prerelease procedures in SI 00520.900 apply.

  • Oral Inquiry Resulting from Title II Application – See SI 00601.027 for the policy regarding when a Title II application constitutes an oral inquiry for SSI benefits and GN 00201.005 F.2. for the procedures to close out the inquiry.

3. Who May Use ABAP Process

The following staff may use the ABAP process:

  • Claims Specialist;

  • Claims Technical Expert;

  • Member of Social Security Administration (SSA) management; or

  • Customer Service Representative.

4. Methods of Documenting Technical Denials

a. Paper Application Forms

There are two paper applications that can be used to document technical denials:

  • Form SSA-8001-BK

    The preferred paper form to document clear technical denials.

  • Form SSA-8000-BK

    Use only in the following situations:

    • You discover ineligibility after partially completing an SSA- 8000-BK; or

    • You decide the SSA-8000-BK can better document the denial (e.g., deeming is involved); or

    • An SSA-8001-BK is unavailable at the time of the interview (e.g., contact station interview).

b. MSSICS Application

Select function #3 (New Claim) from the SSI Menu (Teleservice representatives select #16 (New Claim/Abbreviated). On the Supplemental Security Income Application page, select the reason for denying the claim. That selection determines which additional screens will appear in the path (MSOM MS 08108.003).

5. General Documentation Requirements

Review appropriate queries to determine if an SSI or Title II application has ever been filed for the claimant and the status of any prior claim.

a. For Paper Applications

Answer the mandatory questions (listed in SI 00602.010) and only those questions material to the denial. In most cases, this will suffice to document ineligibility. (MSSICS applications however, currently require more information. See SI 00602.010A.2. and SI 00601.015A.2.)

NOTE: It is not necessary to add statements such as "No children" to document when deeming is not a factor in the denial.

See SI 00602.020 if the answers to pertinent questions on the application fail to document a material allegation or otherwise raise an issue that bears directly on the denial.

b. For MSSICS Applications

The reason ("type" selected on the ACLM screen) for taking an ABAP determines which screens will appear in the path. Currently, MSSICS requires answers to all questions on some screens. For example, if the ABAP type selected is #4 (excess resources), all the questions on the RMEN (resource) screen must be asked.

D. Procedure

1. Interview

Follow the guidelines in SI 00601.060. Conduct a thorough pre-application interview. REMINDER: If the applicant is interested in applying for Supplemental Nutrition Assistance (SNAP) benefits, follow the guidelines in SI 01801.005C.

2. Before Denying Claim

Consider whether the individual is ineligible from the filing date through the end of the month after the month the claim is adjudicated. Explore all basic eligibility issues. Before denying a claim for excess income (N01) or excess resources (N04), consider all income or resource exclusions, including less common exclusions such as:

  • Income or resources excluded under a plan for achieving self-support (PASS) (SI 00870.001)

  • Impairment-related work expense (IRWE) and blind work expense (BWE) (SI 00870.010)

  • Exclusion from income of an ineligible spouse or parent's public income maintenance payments (SI 01320.141)

  • Any impending SSI benefit increases; e.g., cost of living adjustment; and

  • Any expected decrease in income or resources.

  • The possibility of entitlement to conditional benefits if the claimant meets the criteria in SI 01150.200.

3. Transfer of Resource Notice Requirement

Follow the instructions in SI 01150.010C. for notifying the claimant about the effect of transferring a resource. Provide a reproduction of the language in SI 01150.010D. in addition to any other automated or manual notice.

4. Signature

A signature is required from all applicants. Alternative signature methods (GN 00201.015) apply to ABAPs.

a. In Person Interview

Follow procedures in SI 00604.111C.

b. Teleclaim

Follow procedures in SI 00604.111D.

Mail the unsigned application with a cover notice SSA-L305-U3 (Application Cover Notice) to the individual following the procedures in SI 00601.040C.5.b.

NOTE: If the application is not returned, the SSA-L305-U3 closes out the claimant's filing protection the day after the date entered in the letter's third paragraph.

See MSOM MS 04422.003 and MSOM MS 04424.001 for applications taken through MSSICS.

5. Systems Input

Use the SSA-462 (SSI Abbreviated Application Data Input Form) to establish a systems record per SM 01010.010 for paper applications.

See MSOM MS 06002.004 and MSOM MS 06002.005.


SI 00602 TN 6 - Abbreviated Application Process for Clear Technical Denials - 11/20/2019