When the case involves a systems limitation or the GR code cannot be posted on the SSR, prepare an SSA-L8165 (SSI Important Information) upon receipt of the IAR authorization. Fax the manually prepared SSA-L8125 (Notice of Interim Assistance Reimbursement) to the appropriate electronic folder, then send the SSA-L8125 to the component handling IAR in the RO if an OTP or force payment is involved.

NOTE: When multiple checks are involved, make sure the SSA-L8125 includes multiple check information.

The SSA-L8125 is the manual form the FO must prepare for cases involving:

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  A manual dedicated account, installment, an attorney or eligible non-attorney fee;

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  A systems limitation;

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  eIAR exception cases; and

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  proration cases.

NOTES:

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  The State agency staff completes the “State’s Account of Reimbursement Claimed” section and sends the form to the SSA FO that will issue an A-OTP to the agency, for the exact amount of IAR. Once the FO issues the A-OTP, the CR must complete the bottom of the form, fax it to the appropriate electronic folder, and send the form to the component handling IAR in the RO.

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  The manual SSA-L8125 is available on eforms. For information on completing the accounting forms, see SI 02003.040.