TN 24 (12-94)
NL 00804.125 Interim Assistance Reimbursement
1046. Situation Where Used:
IC or PE: When recipient's first (retroactive) payment is being sent to a public assistance
agency under the terms of an interim assistance reimbursement agreement, and recipient
is due a portion of the retroactive payment from the State or local agency.
We are sending (your) first Supplemental Security Income (SSI) check of (1) to the
(2) . You agreed in writing to have your first SSI check sent to that agency because
they paid you for (3) (4) .
If the (5) paid you less than (6) for that (7) , they will pay you the difference shortly. If you do not receive the difference
within 2 weeks from the date you receive this letter, please contact that agency.
(1)
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$$$.¢¢ (amount of the retroactive SSI underpayment)
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(2)
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(State Assistance Agency)
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(3)
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Choice 1 -
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Month/Year
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Choice 2 -
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all or part of the period from (Month/Year) through (Month/Year)
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(4)
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while (you) were waiting for SSI payments (Use in initial claims only; otherwise, leave blank.)
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(5)
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(State Assistance Agency)
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(6)
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$$$.¢¢ (amount of the retroactive SSI underpayment)
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(7)
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Choice 1 -
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month
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Choice 2 -
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period
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1069. Situation Where Used:
IC: The retroactive title XVI check is sent to the local government which provided
interim assistance while the title XVI claim was being adjudicated. Used for retroactive
title XVI payments made after September 30, 1984. Use Paragraph IARM01 when a manual
notice is sent for underpayments issued after September 30, 1989.
We will not count the difference (you) receive, if any, as (your) resource for (1) months after the month it is received. If the difference is not spent within (2) after (you) receive the check from (3) , we will count any money left over as part of (your) resources. But things bought with this money may count as resources the month after
they are bought. Your Social Security office can tell (you) which things count as resources. In (4)
(you) cannot get SSI if the resources we count have a value of more than (5) . (6) .
(1) |
Choice 1 - 6 |
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Choice 2 - 9 (for use 10/1/87 through 9/30/89) |
(2) |
Choice 1 - 6 |
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Choice 2 - 9 (for use 10/1/87 through 9/30/89) |
(3) |
(Name of State) |
(4) |
(Year) |
(5) |
Choice 1 - $1,900 |
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Choice 2 - $2,850 |
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Choice 3 - $2,000 |
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Choice 4 - $3,000 |
(6) |
Choice 1 - For 1989, the limit on resources is $2,000. |
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Choice 2 - For 1989, the limit on resources is $3,000. |
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Choice 3 - Null |
1070. Situation Where Used:
Notice to State agency that made interim assistance payments. Claimant found ineligible.
(Individual's name) application for Supplemental Security Income payments has been
denied. Our records indicate that an interim assistance reimbursement authorization
has been filed by or for this individual. We will notify you if there is a change
in this decision due to an appeal.
1071. Situation Where Used:
Notice to the State agency paying interim assistance.
Our records indicate that an interim assistance reimbursement authorization has been
filed for or by (individual's name). We will notify you when Supplemental Security
Income payments are paid for this individual.
1072. Situation Where Used:
Interim assistance reimbursement agreement received after payment certified. Notice
to State agency.
Our records indicate that Supplemental Security Income payments have already been
paid for (individual's name) and no decision is pending. Therefore, no payment can
be made to you on the interim assistance reimbursement filed on this case.
MANUAL PARAGRAPHS
IARM01. Situation Where Used:
IC and PE: The retroactive title XVI check is sent to a local government agency which
provided interim assistance while the title XVI claim was pending. The excess payment
the State returns to the recipient does not count toward his resource limit for 9
months after receipt. This replaces paragraph 1069 for underpayments issued after
September 30, 1989 and a manual notice is sent.
We will not count the difference (you) receive if any, as (your) resource for (1) months after the month (you) receive it. (We call this money a back payment.) In this case, it will not count
as a resource until (2) .
Resources are things (you) own such as cash, bank accounts, life insurance, automobiles and anything else (you) own that could be changed into cash and used to buy food, clothing, or shelter.
Not all resources count for SSI. Examples of resources that donot count are:
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•
The home (you) live in and the land it is on;
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Up to $2,000 worth of household goods and personal property;
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•
Up to $4,500 of the value of a car, or, under certain conditions, the entire value
of the car;
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One wedding ring and one engagement ring;
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Burial spaces for (you) , and (your) immediate family;
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Burial funds, up to a limit, for (you) , and (your) spouse; and
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•
Life insurance policies with a combined face value of $1,500 or less.
We can tell you about other resources that do not count.
After (3) months, we will add any unspent money from the back payment to the amount of (your) other countable resources. If the total is more than the (4) limit on resources, we may not be able to pay (you) SSI.
But things (5) with the back payment may count as resources the month after (6) .
There are certain things (you) can do to make sure (your) resources will be under the limit after (7) months. For example, (you) can pay debts or buy something that will not count as a resource. We can give you
more information about this.
(1) |
Choice 1 - 9 |
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Choice 2 - NULL |
(2) |
(month/day/year) |
(3) |
Choice 1 - 6 |
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Choice 2 - NULL |
(4) |
Choice 1 - $2,000 |
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Choice 2 - $3,000 |
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Choice 3 - NULL |
(5) |
Choice 1 - you buy |
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Choice 2 - bought |
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(Use Choice 1 when there is no representative payee and deeming is not involved. Use
Choice 2 for all other situations.)
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(6) |
Choice 1 - you buy them |
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Choice 2 - they are bought |
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(Use Choice 1 with Choice 1 in fill-in 5. Use Choice 2 with Choice 2 in fill-in 5.) |
(7) |
Choice 1 - 6 |
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Choice 2 - NULL |