A valid IAR authorization form must include language that explains:
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the effective life of the authorization;
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when the effective life of the authorization can be extended beyond 12 months;
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that the State will send the individual a written notice explaining the amount of
IA payments paid to the recipient;
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that SSA will send the individual a notice about how any remaining SSI benefits will
be released by SSA after reimbursing the State;
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that the individual has the right to a hearing before the State; and
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that the authorization must contain protective filing language when used for an initial
claim.
NOTE: All IAR States use authorization forms approved by SSA so the authorizations contain
all the required language.
See details:
SI 02003.006, Effective Life of an IAR Authorization
SI 02003.007, IAR Authorization Used as Protective Filing