TN 13 (11-10)

SI 02003.023 Processing eIAR Exception Cases

The electronic Interim Assistance Reimbursement system (eIAR) and the FO intervention process cannot process a small number of complex reimbursement cases. These eIAR exception cases require manual processing similar to the processing required for IAR payment pending cases before implementation of eIAR.

A. Description of the eIAR exception cases

An eIAR exception is a case that eIAR or the FO intervention process cannot process.

Generally, eIAR exceptions occur with couple’s cases with a start date record and no underpayment on the start date record. Exception cases occur when the timing of the start date record and initiating of SSI payments results in no underpayment being computed on the SSR and no UPV: V being built on the SSR.

NOTE: If the system builds an underpayment greater than $0.99 for at least 1 month on the start date record and there is a UPV: V on the SSR, the case is not an eIAR exception and it can be processed using eIAR or the FO intervention process. For more information about UPV: V and processing underpayments see SM 01311.660.

B. Determining if the case is an eIAR exception

Due to the complexity of these cases, the specific cause of the eIAR exception may be difficult to identify. Assume that the case is an eIAR exception case if it has the following characteristics:

  • IAR reimbursement is due the State;

  • the system cannot build a UPV: V and there is no U2 diary on the SSR and no U TAC on the SSR;

  • eIAR has not processed the reimbursement to the State; and

  • the system did not generate an I-9 alert.

The FO may learn of the exception when the State IAR agency contacts the SSA regional office to inquire about an unreimbursed case. The FO may identify the exception by reviewing the SSR for the following factors:

  • the case has a start date;

  • the first SSI payment was released in the start date month; and

  • no underpayment was built for the start date record.

C. Examples of IAR exception cases

Here are two examples of where an eIAR exception can occur.

Example 1: The individual files a subsequent claim which the CR start-dates while a prior claim is pending, and IAR is involved for the prior claim. When this happens, the SSI system does not build an underpayment on either SSR. You must use an A-OTP to pay all SSI payments due for the period prior to the start date. Posting the GR code would only affect the subsequent claim.

Example 2: An ineligible spouse files a claim and IAR is involved. The CR establishes a couple start date record upon receipt of the medical determination. The CR establishes the start date record using the CCM as the start date month and immediately processed to C01 status. In this situation, there is no underpayment on the start date SSR record. If the CR posts a GR code, the input will generate an “L” for late or an “N” for no underpayment.

D. Procedure for processing IAR exceptions

For eIAR exception cases, the State cannot correctly record the reimbursement months on eIAR. The eIAR system will not be able to provide the State with the SSI payments due for the months in the IAR period. Therefore, the FO needs to process exception cases manually using an SSA-L8125-F6 (Notice of Interim Assistance Reimbursement) to share information about the case with the State. To process eIAR exceptions manually, follow the instructions in SI 02003.025 through SI 02003.050.

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SI 02003.023 - Processing eIAR Exception Cases - 11/19/2010
Batch run: 05/09/2011