In a title XVI only claim, "past-due benefits" are the total amount of Federal and
Federally administered State payments accumulated to the claimant and his or her spouse
(i.e., Supplemental Security Income (SSI) couple’s case) because of a decision favorable
to the claimant, through the month of effectuation (GN 03920.030D defines "month of effectuation") of a favorable administrative decision, including
any amounts sent to a State/subdivision under an interim assistance reimbursement
(IAR) agreement, minus any benefits listed in GN 03920.031C. (See GN 03920.060B for policy on past-due benefits in court level cases.)
In a title XVI couple’s case, each member of the couple must establish whether he/she
is blind, aged or disabled. In addition, the couple is considered jointly eligible
and the income and resources for both members are considered in determining eligibility
and payment for both. The couple’s SSI benefit is computed as one amount, but divided
equally between the members of the couple for payment. Therefore, SSA includes in
the claimant’s title XVI past-due benefits those payments accumulated to the claimant
(first member of the couple) and his/her spouse (second member of the couple) if:
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•
SSA finds the second member of the couple eligible and subsequently finds the first
member eligible and the first member’s eligibility results in an increase in the second
member’s benefits; or
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•
SSA finds the second member ineligible due to an income/resource issue, and later
finds the second member eligible due to the first member’s eligibility.
Refer to GN 03940.052 for guidance on calculating past-due benefits in fee agreement SSI couples cases.