NC DEPARTMENT OF HEALTH AND HUMAN SERVICES EIS MANUAL

ELIGIBILITY INFORMATION SYSTEM EIS 1105

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STATE DATA EXCHANGE (SDX)

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EIS 1105 – STATE DATA EXCHANGE (SDX)


I. GENERAL INFORMATION

II. HOW SDX IS UPDATED

III. ON-LINE INQUIRY and online verification system

V. SDX INFORMATION SHEETS

VI. ADDITIONAL INFORMATION

VII. SDX HISTORY


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EIS 1105 – STATE DATA EXCHANGE (SDX)

REVISED 05/01/11 - CHANGE NO. 04-11

Top Of Page

I. GENERAL INFORMATION

Top Of Page

II. HOW SDX IS UPDATED

Top Of Page

III. ON-LINE INQUIRY and online verification system

    The on-line SDX contains the records of all SSI recipients in North Carolina. The on-line SDX is updated from the files submitted by SSA.

    A. ACCESSING SDX

      1. To access the OnLine Verification (OLV) User Manual, click on the link below:

      2. To access on-line SDX, the terminal screen must display the Banner Screen. Refer to EIS 4900 Appendix A for an example of the Banner Screen.
      3. On the Banner Screen, key “SCC4CICS”. Press ENTER. The message “WELCOME TO SCC4CICS 'EIS'” appears at the top of the next screen. This is the RACF screen.
      4. From the RACF screen, key your USER ID, BILLING CODE, and your PASSWORD. Press ENTER. A blank screen appears.
      5. Key “EIS3”. Press ENTER. The Primary Menu Screen appears.
      6. From the Primary Menu Screen, key Selection “05”. Press ENTER.
      7. The Interface Inquiry Menu appears.
      8. From the Interface Inquiry Menu, you may key Selection “02” and the individual's social security number (SSN) to access the SDX inquiry only.

REVISED 05/01/11 - CHANGE NO. 04-11

III. A. (CONT’D)

OR

      9. You may key Selection “04” and the SSN to access SDX, TPQY, and ESC by a single entry of the SSN. Refer to EIS 1107, III.
      10. Press PF1 to page forward within the inquiry. Press PF2 to page backward within the inquiry. Key in the screen number in the “PAGE” field to go directly to that screen. Press PF3 to return to the menu.
      11. Press PF9 to view SDX History. Use this function to view past SSI records. Refer to VII for details.
      12. To inquire on another individual's SDX information, key the individual's SSN in “KEY”.

    B. INFORMATION ON THE ON-LINE SDX

      Each field that appears on the On-Line SDX is listed below with the corresponding codes and definitions.

REISSUED 05/01/11 - CHANGE NO. 04-11

III. B. (CONT’D)

              SCREEN ONE

      1. TODAY’S DATE: The date on which you are performing the inquiry.
      2. PROCESS DATE: The date the current transaction was processed by SSA.
      3. RECIPIENT: The last name, first name and middle initial of the individual for whom the SDX record applies.
      4. SSN: The social security number of the recipient.
      5. CUR REC IND: This shows which record is the most current on file for a given day.
      6. OTHER NAME: Another last name used by the recipient.
      7. SSN CORR IND: (SSN Correction Indicator): A code indicating the status of a pseudo SSN or invalid SSN assigned to a recipient.

      A

      A pseudo or invalid SSN appears in the SSN field and a valid SSN in the last field of the Multiple SSNs is being initially transmitted to the State.

         

      B

      A valid SSN appears in the SSN field and the pseudo or invalid SSN is shown in the Multiple SSNs field.

REVISED 05/01/11 – CHANGE NO. 04-11

III. B. (CONT’D)

      8. RACE: The race of the recipient.

      A

      Asian, Asian-American, or Pacific Islander

         

      B

      Black

         

      H

      Hispanic

         

      I

      Northern American Indian or Alaskan Native

         

      O

      Other

         

      U

      Not determined

         

      W

      White

      9. SEX: The sex of the recipient.

      M

      Male

         

      F

      Female

         

      U

      Unknown

         

      *

      Data transmitted in error

      10. BIRTH DATE: The date of birth of the recipient in month, day, century and year format.
      11. DEATH DATE: The date of death of the recipient in month, day, century and year format. The actual death date will be shown when it is available. However, if the date of death is posted from a returned check, the day will be shown as "01" or the date the returned check was processed.
      12. DEATH SRC CD: This shows the source of the death notice.

      1

      The SSA District Office notification or manual adjustment

         

      2

      Hospital Insurance notification

         

      3

      MBR (Master Beneficiary Record)

         

      4

      Treasury returned check notification

         

      5

      Treasury returned check with no death date shown (Death date will show the date of the transaction.)

         

      6

      State notification

         

      0

      Initialized value

REISSUED 05/01/11 – CHANGE NO. 04-11

III. B. (CONT’D)

      13. RECIPIENT TYPE: The type of recipient, or other individual, involved in the record. If a recipient initially became eligible due to disability, this code will not change at age sixty-five.

      AI

      Aged individual

         

      AS

      Aged Spouse

         

      BI

      Blind individual

         

      BC

      Blind child

         

      BS

      Blind spouse

         

      DC

      Disabled child

         

      DI

      Disabled individual

         

      DS

      Disabled spouse

         

      XP

      Essential person (see SI 02601.527 for SDX information applicable to the essential person)

         

      XS

      Ineligible Spouse

         

      XF

      Ineligible Father

         

      XM

      Ineligible Mother

REISSUED 05/01/11 – CHANGE NO. 04-11

III. B. (CONT’D)

      15. HEAD OF HOUSEHOLD: Indicates if the recipient was the head of household for Title XVI purposes at the time the SSR was established. In addition, it is also used to indicate that one spouse was determined eligible for SSI while a disability determination was pending for the other spouse.

      Y

      Head of Household

         

      N

      Not head of household

         

      R

      Member of a couple for which disability determination is/was pending

         

      S

      Member of a couple that is/was being paid as an individual while disability was being determined for the other member of the couple

         

      U

      Identifies the months included in the computation of and offset of underpayment to one member of an eligible couple against an overpayment of the other member of the couple

      16. STUDENT INDICATOR: Indicates if the recipient is a student.

      Y

      Student

         

      N

      Not a student

         

      *

      Erroneous data

      17. PAYEE CODE: Identifies who receives the check.

      AGY

      Social Agency

         

      CHD

      Natural, adoptive or stepchild(a payee for parent)

         

      ESP

      Essential person is representative payee

         

      FDM

      Federal non-mental institution

         

      FDO

      Federal non-mental institution

         

      FIN

      Financial organization

         

      FTH

      Natural or adoptive father

         

      GPR

      Grandparent

         

      INP

      Legally incompetent, but no representative has been selected

         

      MTH

      Natural or adoptive mother

         

      NPM

      Non-profit mental institution

         

      NPO

      Non-profit non-mental institution

         

      OFF

      Public official

REISSUED 05/01/11 – CHANGE NO. 04-11

III. B. 17. (CONT’D)

         

      OTH

      Other

         

      PRM

      Proprietary mental institution

         

      PRO

      Proprietary non-mental institution

         

      PYE

      Payee has custody

         

      REL

      Other relative (includes in-laws)

         

      RPD

      Payee is being developed

         

      SEL

      Beneficiary is own payee

         

      SFT

      Stepfather

         

      SLM

      State/local mental institution

         

      SLO

      State/local non-mental institution

         

      SMT

      Stepmother

         

      SPO

      Spouse is payee

      18. CUSTODY CODE: Indicates who has physical custody of the recipient.

      AGY

      Under the custody of a social agency

         

      CHD

      Under the custody of a child (as payee for the parent) essential person

         

      ESP

      Under the custody of an essential person

         

      FDM

      Under the custody of a Federal mental institution

         

      FDO

      Under the custody of a Federal non-mental institution

         

      FIN

      Under the custody of a financial institution

         

      FTH

      Under the custody of a natural or adoptive father

         

      GPR

      Under the custody of a Grandparent

         

      INP

      Legally incompetent, but no representative has been selected

         

      MTH

      Under the custody of the natural or adoptive mother

         

      NPM

      Under the custody of a non-profit mental institution

         

      NPO

      Under the custody of a non-profit, non-mental institution

         

      OFF

      Under the custody of a public official

         

      OTH

      Under the custody of some other individual, institution, or agency.

REISSUED 05/01/11 – CHANGE NO. 04-11

III. B. 18. (CONT’D)

      PRO

      Under the custody of a private, for profit, mental institution

         

      PYE

      Under the custody of a private, for profit representative payee

         

      REL

      Under the custody of another relative (includes in-laws)

         

      RPD

      The representative payee is being developed

         

      SEL

      The recipient is living by himself/herself

         

      SFT

      Under the custody of a stepfather

         

      SLM

      Under the custody of a State/local mental institution

         

      SLO

      Under the custody of a State/local non-mental institution

         

      SMT

      Under the custody of a stepmother

         

      SPO

      Under the custody of the spouse

      19. COMPETENCY CODE: The representative payee's status as to legal guardianship and/or competency of the recipient.

      A

      Recipient is competent and the representative payee is the legal guardian

         

      B

      Recipient is competent and there is no legal guardian

         

      C

      Recipient is competent and the legal guardian is someone other than the representative payee

         

      D

      Recipient is incompetent and the representative payee is the legal guardian

         

      E

      Recipient is incompetent and there is no legal guardian

         

      F

      Recipient is incompetent and the legal guardian is someone other than the representative payee

         

      L

      Representative payee is a financial institution with whom the recipient has entered into a living trust agreement

         

      N

      There is no legal guardian

         

      O

      Someone other than the representative payee is the legal guardian

         

      Y

      The representative payee is the legal guardian

      20. DRUG ADDICTION: This information is no longer available from Social Security.
      21. RSDI CLAIM NUMBER: This is the Title II (RSDI) Claim Number on which the recipient is potentially entitled or insured.

REISSUED 05/01/11 – CHANGE NO. 04-11

III. B. (CONT’D)

      22. COUNTY: This is the individual's county of residence and county number. If the individual’s state jurisdiction is something other than ‘34’ (North Carolina) and the transaction code on the record is not ‘05’ (indicating individual moved to another state), the following message will display in the ‘county’ field: OUT OF STATE. Contact the SSA to determine if the recipient should receive Medicaid from the state of North Carolina.
      23. RESIDENCY: The date the recipient began living in the current state and county.
      24. TELEPHONE: The recipient's area code and telephone number.
      25. RECIPIENT: This reflects the recipient’s name.
      26. MAILING ADDRESS: The mailing address that appears on system generated correspondence. The SSI check and Medicaid card are mailed to this address unless a payee exists.
      27. RESIDENCE: The address where the recipient lives if the address is different from the recipient's mailing address. Otherwise, it will be blank.

REISSUED 05/01/11 – CHANGE NO. 04-11

III. B. (CONT’D)

              SCREEN TWO

      28. SSI APPLIC DATE: The date the claimant filed an application for SSI benefits or the date the individual is deemed to have filed the application.
      29. SSI APP FILE DATE: The actual filing date of the application if it differs from the application date. The actual filing date usually would be later than the application date if the individual filed an application after making written or oral inquiry to the SSA office which indicated the intent to file an SSI application.
      30. SSI ELIGIBLE DATE: The date the recipient was first determined eligible or most recently redetermined eligible after a period of ineligibility. This is the effective date of the first SSI payment. SSA also calls this the Application Effective Date.
      31. DISABILITY ONSET: The date of disability onset as alleged by the claimant during the period in which the case is awaiting a medical determination, or if the case has been medically denied. After a final disability/blindness determination has been made, the date of onset will be either:

        The date of disability onset established for Title II (RSDI) purposes in a concurrent Title II/Title XVI allowance.

              OR

        The date of onset established for Title XVI only medical allowances. This date will be no earlier than the effective month of the SSI application unless information in the medical file supports an earlier onset.

REISSUED 05/01/11 – CHANGE NO. 04-11

III. B. (CONT’D)

      32. DISABILITY PAY: An indicator of the status of SSI disability and blind cases.

      F

      Final determination-allowance

         

      P

      Presumptive finding

         

      R

      Referred to State agency. Code indicates pending determination or final denial determination

         

      S

      State determination (conversion cases only) - allowance

         

      T

      Presumptive finding - state conversion record

         

      X

      No disability determination made (claim denied on basis of non-disability issues)

         

      ‘*’

      Data transmimtted in error

         

      Blank

      Not applicable

         

      NOTE

      ‘F’ or ‘S’ only exists for disability allowance cases. The data element is left as ‘R’, ‘P’, or ‘T’ for initial disability denials.

      33. MEDICAID EFF DATE: The most current period of eligibility or referral for Medicaid.

      WHEN

      Then Medicaid Effective Date Shows

         

      Initial denial (‘Nxx’ in the Denial Code data element)

      Month, day, century and year of application

         

      Initial determination of eligibility (Payment Status Code data element is equal to ‘C01’ or ‘M01’ with payment)

      Month, day, century and year of eligibility

         

      Eligibility changes

      Exact month, day, century and year the change is effective

         

      Payment suspended

      First day of the month, century and year of suspension

         

      Move between 1634 non-1634 States

      First day of the month, century and year for which residence in the current State is established

         

      Move between two 1634 States

      Date of the last change in Medicaid Eligibility Code. It is necessary in these cases to compare to date residency regan to establish a date of Medicaid responsibility in the current State

      Goldberg-kelly is involved

      First month, century and year for which Goldberg-Kelly payments are being continued

REISSUED 05/01/11 – CHANGE NO. 04-11

III. B. (CONT’D)

      34. UNPAID MED EXP: This reflects whether the claimant was incurred any medical expenses during the three months before the application filing date.

        Y

        Unpaid medical bills exist (1634 States only)

           

        N

        Unpaid medical bills do not exist (1634 States only)

           

        “”

        Blank

        Not applicable (initialized value)

      35. REDETERMINE DATE: The completion date of the last redetermination.
      36. DENIAL CODE-DATE: The reason and date a claimant was initially denied for SSI. The date may precede the Record Processing Date, the Last Transaction Date, and the Record Establishment Date because SSA's system applies it as soon as it is transmitted.

      BLANK

      Applicant was not initially denied.

         

      N01

      Non-pay - Recipient's Countable income exceeds Title XVI payment amount.

         

      N02

      Non-pay - Recipient is inmate of public institution.

         

      N03

      Non-pay - Recipient outside of the U.S.

         

      N04

      Non-pay - Recipient's non-excludable resources exceed Title XVI limitations.

      N05

      Non-pay – Recipient’s gross income from self-employment exceeds Title XVI limitations.

         

      N06

      Non-pay - Recipient failed to file for other benefits.

         

      N07

      Non-pay - Cessation of the recipient's disability.

         

      N08

      Non-pay - Cessation of the recipient's blindness.

         

      N09

      Non-pay - Recipient refused vocational rehabilitation without good causes.

         

      N10

      Non-pay – Recipient refused, without good cause, treatment for drug addiction.

         

      N11

      Non-pay - Recipient refused treatment for alcoholism.

         

      N12

      Non-pay – Recipient voluntarily withdrew from SSI program.

         

      N13

      Non-pay - Not a citizen or an eligible alien.

         

      N14

      Non-pay – Aged claim denied for age

         

      N15

      Non-pay – Blind claim denied. Applicant not blind. (No longer applicable).

REISSUED 05/01/11 – CHANGE NO. 04-11

III. B. 36. (CONT’D)

      N16

      Non-pay Recipient has voluntarily terminated participation in the SSI program.

         

      N17

      Non-pay - Failure to pursue claim by the applicant.

         

      N19

      Non-pay - Recipient has voluntarily terminated participation in the SSI program.

         

      N20

      Non-pay - Recipient failed to furnish required evidence.

         

      N22

      Non-pay - Inmate of a penal institution.

         

      N23

      Non-pay - Not a U.S. resident.

         

      N24

      Non-pay – Claimant has provided false or misleading statements affecting benefit eligibility or amount and administrative sanction is imposed.

         

      N25

      Non-pay – Claimant is fleeing to avoid prosecution for, or custody or confinement after conviction for a crime which is a felony (or in New Jersey, a high misdemeanor) under the laws of the place from which he/she flees, or is violating a condition of probation or parole imposed under Federal or State law.

         

      N27

      Non-pay - Disability terminated due to Substantial Gainful Activity (SGA).

         

      N30

      Non-pay - Slight impairment - medical consideration alone, no visual impairment.

         

      N31

      Non-pay - Capacity for SGA - customary past work, no visual impairment.

         

      N32

      Non-pay - Capacity for SGA - other work, no visual impairment.

         

      N33

      Non-pay - Engaging in SGA despite impairment, no visual impairment.

         

      N34

      Non-pay - Impairment is no longer severe at time of adjudication and did not last twelve months, no visual impairment.

         

      N35

      Non-pay - Impairment is severe at time of adjudication but not expected to last twelve months, no visual impairment.

         

      N36

      Non-pay - Insufficient, or no, medical data furnished, no visual impairment.

         

      N37

      Non-pay - Failure, or refusal, to submit to consultative examination, no visual impairment.

         

      N38

      Non-pay - Applicant does not want to continue development of the claim, no visual impairment.

         

      N39

      Non-pay - Applicant willfully fails to follow prescribed treatment, no visual impairment.

         

      N40

      Non-pay - Impairment(s) does not meet or equal listing (disabled child under age eighteen only), no visual impairment.

REISSUED 05/01/11 – CHANGE NO. 04-11

III. B. 36. (CONT’D)

      N41

      Non-pay - Slight impairment - medical condition alone, visual impairment.

         

      N42

      Non-pay - Capacity for SGA - customary work, visual impairment.

         

      N43

      Non-pay - Capacity for SGA - other work, visual impairment.

         

      N44

      Non-pay - Engaging in SGA despite impairment, visual impairment.

         

      N45

      Non-pay - Impairment no longer severe at time of adjudication and did not last twelve months, visual impairment.

         

      N46

      Non-pay - Impairment is severe at the time of adjudication, but not expected to last twelve months, visual impairment.

         

      N47

      Non-pay - Insufficient or no medical evidence furnished, visual impairment.

         

      N48

      Non-pay - Failure, or refusal, to submit to consultative examination, visual impairment.

         

      N49

      Non-pay - Applicant does not want to continue development of the claim, visual impairment.

         

      N50

      Non-pay - Applicant willfully fails to follow prescribed treatment, visual impairment.

         

      N51

      Non-pay - Impairment(s) does not meet or equal listing (disabled child under age eighteen only), visual impairment.

         

      N52

      Non-pay - Deleted from the State rolls before December 1973 payment.

         

      N53

      Non-pay - Deleted from the State rolls after December 1973 payment.

         

      N54

      Non-pay - SSA District Office unable to locate client.

         

      N55

      Impairment due to DAA (no visual impairment)

         

      N56

      Impairment due to DAA (visual impairment)

         

      ‘*’

      Data transmitted in error.

      37. APPEAL REASON: This is the type of agency decision, in general, to which this particular occurrence of appeal data relates.

      AG

      Age

         

      CZ

      Citizenship

         

      DI

      Initial Disability

         

      DR

      Age 18 Disability Determination

REISSUED 05/01/11 – CHANGE NO. 04-11

III. B. 37. (CONT’D)

      IN

      Income

         

      LA

      Living Arrangement

         

      MA

      Marital Relationship

         

      MC

      Medical Disability

         

      OP

      Overpayment

         

      PA

      PASS

         

      RE

      Resources

         

      SG

      SGA

         

      WA

      Denied Waiver

         

      OT

      Other

      38. APPEAL CODE - DATE - FLAG: The status of an appeal, the month and year of the most recent appeal action, and the indicator of an appeal.

          APPEAL CODE

      A

      Appeals Council Review

         

      C

      Court Activity

         

      H

      Hearing

         

      R

      Reconsideration

         

      O

      Class Action

         

          APPEAL FLAG

      NOTE:

      Goldberg/Kelly appeal rights require that an individual be given advance notice prior to any reduction, suspension or termination of payments. After receipt of the notice, the individual may appeal this action within 60 days. If the appeal is filed within 10 days, the individual generally will receive payment at the prior rate until this appeal is resolved. Also, if the notice is not sent timely, the SSI system continues payment for the month following the month of the notice.

         

      BLANK

      No actual or potential Goldberg/Kelly involvement or Notice or Planned Action has been sent but no appeal has been filed or the potential appeals period has expired

         

      I

      In payment maintenance, but independent intervening event is applicable, Goldberg/Kelly applies

REISSUED 05/01/11 – CHANGE NO. 04-11

III. B. 38. (CONT’D)

      S

      In payment maintenance, but eligibility exceeds PPL (Protecteed Payment Level), Goldberg/Kelly applies.

         

      P

      Notice of Planned Action has been sent and appeal has been filed.

         

      T

      Notice of Planned Action has been sent, but could not be sent timely; thereafter, the higher payment has been maintained.

      39. APPEAL DECISION CD/DT: This field includes a 2 character code that indicates the actual appeal decision and the date the decision was rendered.

      AD

      Dismissed/Abandoned

         

      FA

      Favorable/SSA Appealed (court case only)

         

      FC

      Fully/Partially Favorable (Converted Records only)

         

      FF

      Fully Favorable

         

      FN

      Favorable/SSA did not appeal (Court Case only)

         

      OT

      Closed: Other

         

      PF

      Partially Favorable

         

      T1

      Dismissed: Claimant Deceased

         

      UA

      Unfavorable/Appealed by Recipient (Court Case only)

         

      UF

      Unfavorable

         

      UN

      Unfavorable/Not Appealed by Recipient (Court Case only)

         

      WC

      Dismissed: Withdrawn (Converted Records only)

         

      WD

      Dismissed: Withdrawn

         

      1D

      Dismissed: Cannot be Appealed

         

      2D

      Dismissed: Filed by Improper Requestor

         

      3D

      Dismissed: Filed prematurely

         

      4D

      Dismissed: Filed late without good cause

      40. RECORD IDENTIFICATION CODE: Identifies the type of SSI master record.

      C

      Couple (eligible individual with eligible spouse)

         

      F

      Child claim with father

         

      I

      Individual with or without ineligible spouse

         

      M

      Child claim with mother

         

      P

      Child claim with parents

REISSUED 05/01/11 – CHANGE NO. 04-11

III. B. 40. (CONT’D)

      X

      State-to-SSA record exception

      41. TRANSACTION CODE: The action and/or source of the SDX record.

      00

      No action has been taken since the last SDX record (appears on treasury files only), refers to no payment actions

         

      OP

      Identifies a pending record

         

      OW

      Identifies a T30 termination action

         

      OX

      Identifies a T30 recreation, potentially ineligible (appears only on SDX update files)

         

      OY

      Identifies a T30 reaccretion, potentially eligible (appears only on SDX update files)

         

      OZ

      Identifies a T30 new/replacement record (see How SDX SHOWS SNN CHANGES)

         

      NOTE:

      Currently, the SSI system cannot automatically compute the payment in certain instances. The District Office may initiate a "Force Payment" in this situation, which places the record into manual control. The T30 process allows SSA to terminate an existing record and establish a replacement record to "re-automated" the record.

         

      01

      New claim - currently eligible. If Payment Status Code is "E01", no SSI payment will be made.

         

      02

      New claim - currently ineligible

         

      03

      New to State - eligible for SSI and/or supplementation in new State

         

      04

      New to State - Ineligible in new State

         

      05

      Individual moved to another State

         

      06

      Change, other than a change of address, has occurred

         

      07

      Nonpayment or termination transaction to a record in pay status "C01", E01", "M01", "P01" or "SXX" or a change to an ineligible record that does not affect eligibility status

      08

      Intrastate change of address and/or payee name change

         

      09

      Intrastate change of address and change in amount paid

         

      10

      State identification number accreted

         

      16

      Combination of codes "06" and "10"

         

      17

      Combination of codes "07" and "10"

         

      20

      State identification number not accreted due to mismatch

         

      30

      State identification number changed

REISSUED 05/01/11 – CHANGE NO. 04-11

III. B. 41. (CONT’D)

      36

      Combination of codes "06" and "30"

         

      37

      Combination of codes "07" and "30"

         

      40

      State identification number not changed due to mismatch

         

      50

      State identification number deleted

         

      56

      Combination of codes "06" and "50"

         

      60

      State identification number not deleted due to mismatch

         

      70

      Requested SDX record provided in response to State query

         

      80

      No requested SDX data provided due to mismatch

         

      90

      No requested SDX data provided due to mismatch, the State requested a pending record and no record is in file

         

      A0

      State cross-reference WIN updated

         

      A6

      Combination of codes "A0" and "06"

         

      A7

      Combination of codes "A0" and "07"

         

      BJ

      Identifies a "503 Leads" file record

         

      BO

      IAR transaction processed

         

      CO

      IAR transaction rejected

         

      RF

      Identifies a reconciliation file record

      42. LAST TRANS TYPE-DATE:

        The most recent event and the date it was applied to the SSA’S records. Although more than one reportable event may have occurred simultaneously, the event reflected is based on an established priority.

      A1

      Eligible individual name change

         

      AD

      Address change or correction

         

      BA

      Dedicated Account Balance

         

      BC

      Direct deposit

         

      CC

      Folder involvement (8028 receipt by DO)

         

      CF

      Conserved funds

         

      CG

      Case characteristics

         

      CH

      Returned check

         

      CM

      Multicategories

         

      CO

      Overpayment decision

         

      CP

      Refund amount

REISSUED 05/01/11 – CHANGE NO. 04-11

III. B. 42. (CONT’D)

      D1

      Death notice from DO

         

      D3

      Death notice from MBR interface

         

      D4

      Death notice from Treasury Notification Process

         

      DA

      Diary code and date

         

      DD

      Direct deposit change

         

      DM

      Deemed Income or, if date is 08/31/74, a special diary selection

         

      DO

      Date of disability onset

         

      DT

      Drug/Alcohol

         

      DW

      Debt wipe out

         

      DY

      Selected for diary action

         

      EM

      Earned Income

         

      EN

      Earned Income

         

      EP

      Advance payment

         

      FL

      December 1973 Federal living arrangement

         

      FS

      Food Stamp

         

      FV

      Foreign language notice

         

      GA

      Grant amount

         

      GC

      Goldberg-Kelly notice date

         

      GF

      Adverse action

         

      GJ

      Protected payment level

         

      GM

      Minimum benefit level

         

      IC

      Initial Claims accretion

         

      IF

      MBR or Master Earning File interface reply

         

      IR

      IRS interface select

         

      JA

      Legal guardian agency

         

      JB

      Legal guardian consular code

         

      JC

      Legal guardian foreign country

         

      JD

      Legal guardian foreign postal zone

         

      JM

      Legal guardian mailing address

         

      JN

      Legal guardian name

REISSUED 05/01/11 – CHANGE NO. 04-11

III. B. 42. (CONT’D)

      JP

      Legal guardian telephone number

         

      JW

      Legal guardian foreign telephone number

         

      JZ

      Legal guardian Zip Code

         

      KE

      Authorized representaitve Out-of-Pocket expenses

         

      KM

      Authorized representative mailing address

         

      KN

      Authorized representative payee name

         

      KP

      Authorized representative telephone number

         

      KQ

      Authorized representative fee agreement involved claims

         

      KR

      Authorized representative fee approving office site

         

      KS

      Authorized representative fee status

         

      KT

      Authorized representative payee type

         

      KX

      Authorized representative telephone extension

         

      KZ

      Authorized representative Zip Code

         

      LA

      Federal living arrangement

         

      LT

      Last transaction

         

      M1/3

      Cross-reference number

         

      MA

      Title II payment

         

      MB

      MBR change, other than death activity

         

      MC

      IRS data

         

      MD

      Medical data

         

      MG

      Medical recovery

         

      MI

      Title II Critical Payment System

         

      MM

      Misused money

         

      MP

      Manual payment

         

      NC

      Non-receipt of check (Treasury)

         

      ND

      Date of overpayment notice

         

      NM

      Accounting done

         

      NP

      Notices

         

      NU

      NUMIDENT reply

         

      OL

      Online transaction (MMICS 4.4 process)

REISSUED 05/01/11 – CHANGE NO. 04-11

III. B. 42. (CONT’D)

      ON

      Automated One-Time Payment

         

      PC

      SF-1184 of deletion of a returned check

         

      PL

      Appeals request

         

      PN

      Payee's name

         

      PR

      Prior error input

         

      PS

      Payment status

         

      RA

      Residence address

         

      RB

      Rollback

         

      RC

      Returned check for other than death (Treasury)

         

      RD

      Resource disposal

         

      RE

      Resources

         

      RF

      1619(b) redetermination selection

         

      RG

      Redetermination diary update

         

      RI

      Limited issue redetermination selection

         

      RK

      Zebley redetermination needs development

         

      RP

      Representative payee

         

      RQ

      Non-selectable UC case

         

      RR

      Remittance register refund

         

      RS

      Data Operation Center redetermination second request

         

      RT

      Selected for redetermination

         

      RV

      Redetermination pending indicator deleted

         

      RW

      Redetermination established on start date record

         

      RX

      Redetermination transfer (high response record)

         

      RY

      Redetermination transfer

         

      RZ

      Redetermination

         

      R1-R5

      Remarks

         

      SB

      Suspend billing

         

      SC

      State/County of conversion

         

      SE

      Summary earnings record enforcement

         

      SI

      Title XIX status

REISSUED 05/01/11 – CHANGE NO. 04-11

III. B. 42. (CONT’D)

      SO

      Systems override

         

      SZ

      Special action code

         

      TL

      Telephone number

         

      TP

      Type of claim

         

      TR

      Transmission router

         

      TY

      Type of record change

         

      UC

      Un-negotiated check (credit)

         

      UD

      Un-negotiated check (debit)

         

      UF

      Limited Payability

         

      UG

      Limited Payability

         

      UH

      Limited Payability

         

      UL

      Limited Payability

         

      UM

      Unearned income

         

      VA

      VA interface

         

      VB

      RRB interface

         

      VC

      Federal civil service interface

         

      W

      Welfare number

         

      WA

      Waiver

         

      WI

      Windfall offset data

         

      XD

      Representative payee system direct deposit

         

      XI

      Mass address or EIN rep-payee change

         

      ZC

      ZIP code (residence address)

         

      ZP

      ZIP code (mailing address)

         

      Z4

      IRS interface reply

REISSUED 05/01/11 – CHANGE NO. 04-11

III. B. (CONT’D)

      43. 3RD PARTY INSUR IND - DATE: An indicator of third party liability for health care expenses, and the effective date of the recipient’s third party liability enrollment.

      A

      Applicant refuses to assign rights for third party insurance.

         

      F

      Disabled/Blind child living overseas, ineligible for Medicaid, and living with a parent who is a member of the military.

         

      N

      Third Party liability does not exist.

         

      R

      Applicant refuses to cooperate in providing third party liability data. Ineligible for Medicaid.

         

      Y

      Third Party liability does exist and applicant agrees to assign rights.

         

      BLANK

      Not applicable.

      44. FEDERAL ELIGIBILITY CODE: Identifies eligibility for SSI payment in the current month.

      E

      Eligible

         

      N

      Not eligible

         

      BLANK

      Not applicable

      45. CHANGE MONTH: The month in which one of the following items changed: Medicaid Eligibility Code, Payment Status Code, Federal Living Arrangement Code, State and County of Jurisdiction.
      46. JURIS STATE/COUNTY: The State and County of residence for the recipient unless another state and county have jurisdiction.
      47. PAYMENT STATUS: This consists of two data elements; the first position reflects the status of the SSI payment. The second and third positions reflect the reason for the status.

        First

        Position

      Code

      Value

         

      C

      Indicates the recipient is eligible for SSI/State Supplemental payments and payment is due.

         

      E

      Indicates eligibility for Federal and/or State benefits based on the eligibility computation, but no payment is due based on the payment computation.

         

      H

      Indicates a case in "hold" status, final disposition is pending.

         

      M

      Indicates a case is under manual control. Case is known as "forced payment" although payment may not be involved.

REISSUED 05/01/01 – CHANGE NO. 04-11

III. B. 47. (CONT’D)

      N

      Indicates the claimant/recipient is not eligible for SSI/State Supplement payments or that a previously eligible recipient is not currently eligible.

         

      S

      Administrative suspense. Indicates recipient may still be eligible for SSI/State Supplement payments, but payment is being withheld.

         

      T

      Indicates SSI/States Supplement eligibility is terminated. A record may be terminated and a new record established, in certain situations.

        Full

      Code

      Value

         

      C01

      Current Pay

         

      E01

      Eligible for Federal and/or State benefits based on the eligibility computation, but no payment is due based on the payment computation.

         

      E02

      Eligible for benefits but not payable in that month due to the new application date.

         

      H10

      Living Arrangement change is in progress.

         

      H20

      Marital Status change is in progress.

         

      H30

      Resource change is in progress.

         

      H40

      Student Status change is in progress.

         

      H50

      Head of Household change is in progress.

         

      H60

      Hold pending receipt of date of death.

         

      H70

      Hold pending posting of payment made outside the U.S.

         

      H80

      Early input.

         

      M01

      Force Payment - Recipient may be in payment or non-payment status. See SSI Gross Payable Amount or State Supplement Gross Payable Amount for eligibility amount. These two will equal zeros if the recipient is in non-payment status.

         

      M02

      Force Due

         

      N01

      Non-pay - Recipient's countable income exceeds Title XVI payment amount and his/her State's payment standard. Also used for 1619(b) participants.

         

      N02

      Non-pay - Inmate of public institution

         

      N03

      Non-pay - Outside of the U.S.

         

      N04

      Non-pay - Non-excludable resources exceed Title XVI limitations.

         

      N05

      Non-pay – Recipient’s gross income from self-employment exceeds Title XVI limitation.

REISSUED 05/01/01 – CHANGE NO. 04-11

III. B. 47. (CONT’D)

      N06

      Non-pay - Failed to file for other benefits.

         

      N07

      Non-pay - Recipient's disability ceased. Not disabled.

         

      N08

      Non-pay - Recipient's blindness ceased. Not blind.

         

      N09

      Non-pay - Refused vocational rehabilitation without good cause.

         

      N10

      Non-pay – Recipient refused treatment for drug addiction.

         

      N11

      Non-pay - Recipient refused treatment for alcoholism.

         

      N12

      Non-pay – Recipient voluntarily withdrew from program.

         

      N13

      Non-pay - Not a citizen or an eligible alien.

         

      N14

      Non-pay - Aged claim denied for age.

         

      N17

      Non-pay - Failure to pursue claim by the claimant.

         

      N18

      Non-pay – Failure to cooperate.

         

      N19

      Non-pay - Recipient has voluntarily terminated participation in the SSI program.

         

      N20

      Non-pay - Recipient failed to furnish a required report or information.

         

      N22

      Non-pay – Inmate of a correctional institution.

         

      N23

      Non-pay – Not a legal resident in the U.S..

         

      N24

      Non-pay – Convicted of felony of fraudulently misrepresenting residence in two or more states. (Effective through 11/99).

      Administrative Sanctions penalty imposed because claimant has provided false or misleading statements to obtain benefits. (Effective 12/99 to opresent).

         

      N25

      Non-pay - Claimant is fleeing to avoid prosecution for, or custody or confinement after conviction for, a crime which is a felony (or in Jew Jersey, a high misdemeanor) under the laws of the place from which he/she flees, or is violating a condition of probation or parole imposed under Federal or State laws.

         

      N27

      Non-pay - Disability terminated due to Substantial Gainful Activity (SGA).

         

      N30

      Non-pay - Slight impairment - medical consideration alone, no visual impairment.

         

      N31

      Non-pay - Capacity for SGA - customary past work, no visual impairment.

         

      N32

      Non-pay - Capacity for SGA - other work, no visual impairment.

REISSUED 05/01/11 – CHANGE NO. 04-11

III. B. 47. (CONT’D)

      N33

      Non-pay - Engaging in SGA despite impairment, no visual impairment.

         

      N34

      Non-pay - Impairment is no longer severe at time of adjudication and did not last twelve months, no visual impairment.

         

      N35

      Non-pay - Impairment is severe at time of adjudication but not expected to last twelve months, no visual impairment.

         

      N36

      Non-pay - Insufficient, or no, medical data furnished, no visual impairment.

         

      N37

      Non-pay - Failure, or refusal, to submit to consultative examination, no visual impairment.

         

      N38

      Non-pay - Applicant does not want to continue development of the claim, no visual impairment.

         

      N39

      Non-pay - Applicant willfully fails to follow prescribed treatment, no visual impairment.

         

      N40

      Non-pay - Impairment(s) does not meet or equal listing (disabled child under age eighteen only), no visual impairment.

         

      N41

      Non-pay - Slight impairment - medical condition alone, visual impairment.

         

      N42

      Non-pay - Capacity for SGA - customary work visual impairment.

         

      N43

      Non-pay - Capacity for SGA - other work, visual impairment. (for age 18 and over)

      Or

      Non-pay – impairment(s) disabling for a period of less than 12 months (child under 18).

         

      N44

      Non-pay - Engaging in SGA despite impairment, visual impairment.

         

      N45

      Non-pay - Impairment no longer severe at time of adjudication and did not last twelve months, visual impairment.

         

      N46

      Non-pay - Impairment is severe at the time of adjudication but not expected to last twelve months, visual impairment.

         

      N47

      Non-pay - Insufficient, or no, medical evidence furnished, visual impairment.

         

      N48

      Non-pay - Failure, or refusal, to submit to consultative examination, visual impairment.

         

      N49

      Non-pay - Applicant does not want to continue development of the claim, visual impairment.

         

      N50

      Non-pay - Applicant willfully fails to follow prescribed treatment, visual impairment.

REISSUED 05/01/11 – CHANGE NO. 04-11

III. B. 47. (CONT’D)

      N51

      Non-pay - Impairment(s) does not meet or equal listing (disabled child under age eighteen only), visual impairment.

         

      N52

      Non-pay - Deleted from the State rolls before January 1973 payment.

         

      N53

      Non-pay Deleted from the State rolls.

         

      N54

      Non-pay - District Office unable to locate applicant.

         

      S01

      Suspended - Suspension of payments due to report of death by Treasury, potential automated death case.

         

      S04

      Suspended - System is awaiting disability determination (system generated).

         

      S05

      Suspended – System unable to determine prerequisite month for 1619(A) eligibility.

         

      S06

      Suspended - Recipient address unknown.

         

      S07

      Suspended - Returned check for other than death, address, payee change, or death of representative payee.

      S08

      Suspended - Representative payee development pending.

         

      S09

      Suspended – Recipient refuses to cooperate.

         

      S10

      Suspended – Adjudicative suspense (systems generated).

         

      S20

      Suspended - Potential rollback case or disability made prior to July 1973 (inactive). (rollback code 1 or 3)

         

      S21

      Suspended - The recipient is presumptively disabled or blind and has received three months payments.

         

      T01

      Terminated - Death of the recipient.

         

      T20

      Terminated - Received payment under two different account numbers.

         

      T22

      Terminated - Received payment under two different accounts, termination resulted from electronic screening.

         

      T30

      Terminated – Received payments, but must be reestablished to correct SSR.

         

      T31

      Terminated - System generated termination (payment previously made). Recipient met denial or non-pay terminated criteria. Payment received.

         

      T32

      Terminated - Systems generated termination of large records.

         

      T33

      Terminated - manual termination (previous payment made). WILL EVENTUALLY REPLACE T30.

         

      T50

      Terminated - Manual termination (no previous payment made).

REISSUED 05/01/01 – CHANGE NO. 04-11

III. B. 47. (CONT’D)

      T51

      Terminated - System generated termination (no previous payment made). Recipient met denial or non-pay terminated criteria.

      48. FED LIVING ARGMT: The type of Federal living arrangement (for the current month) of the recipient for Title XVI purposes.

      A

      Own household

         

      B

      Another's household

         

      C

      Parent's household (for child cases only)

         

      D

      Title XIX institution

         

      “” (blank)

      Individual is in a non-Title XIX institution, living arrangement change in progress or outside the U.S.

         

      *

      Initial claims surface edit

      49. MEDICAID ELIG CD: An indicator of the recipient’s Medicaid eligibility status.

      A

      Applicant refused to assign rights to third party insurance

         

      B

      Deeming waived: child under a State home care plan

         

      C

      Applicant is covered under provisions of section 1619(b) of Title XVI of the Act (MEDTEST indicator is A, B or F and Payment Status Code is equal to ‘E01’, or ‘N01’ – eligible.

         

      D

      Disabled adult child

         

      G

      Payment is being continued due to an appeal – eligible

         

      P

      Drug addiction and/or alcoholism

         

      Q

      Medicaid qualifying trusts may exist

         

      R

      Case is referred for State Determination of Medicaid eligibility due to:

       

      * Initial denial

       

      * Initially eligible for SSI, but there is no money being paid (Payment Status Code is ‘E01’, ‘E02’ or ‘M01’) ineligibility for SSI

       

      * Payment is suspended (Payment Status Code is equal to ‘Sxx’)

      S

      No determination of Medicaid eligibility because:

       

      Essential person record, and/or State is not a 1634 State)

         

      W

      Widow(er) (1634 States)

         

      Y

      SSI payment is being made - eligible

REISSUED 05/01/11 – CHANGE NO. 04-11

III. B. (CONT’D)

          SCREEN THREE

      50. PAYMENTS FOR CURRENT AND PRIOR THREE MONTHS
        a. COUNTY: The State and County of residence for the recipient unless another state and county have jurisdiction.
        b. SSI GROSS AMOUNT: The amount the recipient is entitled to receive before any adjustments for overpayments.
        c. SSI MO ASSIST AMT: The cumulative SSI payment(s) actually paid to the recipient under Title XVI.

          This is the amount of the previous month's check, plus any underpayments which have been issued since the monthly run.

        d. COUNTABLE EARNED: The current month's amount of earned income, after all exclusions are applied; used in determining eligibility and if the Budget Month Flag is equal to zero, compiling the payment. The portion of a work study program that is not allocated for school, book, lab fees, and transportation is included as Earned Income.
        e. COUNTABLE UNEARNED: The current month's amount of unearned income after all exclusions are applied; used in determining eligibility and, if the Budget Month Flag is zero, computing the benefit; including income deemed to the eligible individual if applicable.

REISSUED 05/01/11 – CHANGE NO. 04-11

III. B. (CONT’D)

      51. CONDITIONAL PYMT: An indicator of whether or not a payment is, or was, subject to disposition of excess resources. When a payment is no longer conditional, the code "C" will remain in this data element.

      C

      Conditional

         

      N

      Not conditional

         

      BLANK

      Not applicable

      52. DEEMED INC: The current month's amount of income deemed to the eligible individual used in determining eligibility and, if the Budget Month Indicator is zero, computing the SSI payment.
    53. CODE: Deemed income source codes:

      Spouse to Spouse deeming after March 1983:

      C

      Computation based on couple’s income

         

      D

      Computation based on individual’s income

         

      I

      Computation based on individual’s income

         

      V

      Income present for month and override system deeming

      Parent to Child deeming after March 1982:

      I

      Computation based on eligible child’s income only

         

      P

      Parental deeming under current (1997) regulations

         

      V

      Income present for month and override system deeming

      For sponsor to alien deeming 10/80:

      V

      Sponsor deeming applicable

      54. ADVANCE PAYMENT: The amount of emergency payment to the recipient. This amount is subtracted from the first payment. This data is not removed from the record.
      55. OVER/UNDER PAY IND: Indicates whether or not overpayments and/or underpayments exist, and if the balance is reflected in the SSI Monthly Assistance amount.

      O

      Overpayment exists

         

      U

      Underpayments exists

         

      B

      Both overpayment and underpayment exist

      56. OVER PAY BALANCE: The remainder after subtracting the overpayment amount collected from the overpayment amount outstanding.

REISSUED 05/01/11 – CHANGE NO. 04-11

III. B. (CONT’D)

      57. OVER PAY WAIVER: The amount of overpayment which has been waived from recovery efforts.
      58. CUR RECOVERY AMT: The amount of advanced payment or overpayment recovered from the payment month's check.
      59. BLIND EXPENSE: The amount of work expenses of a blind recipient for the month in the Earned Income Period which may be excluded from the earned income amount.
      60. EARNED INCOME
        a. PERIOD: The month and year to which the earnings are to be charged. Earned income is shown on a monthly basis.
        b. WAGE EST: The gross amount of wages which the recipient expects to earn in the month reflected in the Earned Income Period.
        c. RETRO AMT: The amount of earned income used in computing the payment if the Budget Month Flag is not zero or blank. This will always be zeros if the Budget Month Flag is zero or blank.
        d. SELF EMPLOY: The estimated net amount of self-employment income for the period shown in the Earned Income Period.
      61. BUDGET MONTH IND: The budget month used for computation purposes.

      O

      Payment is based on factors in the computation month.

         

      1

      Payment is based on factors one month before the computation month.

         

      2

      Payment is based on factors two months before the computation month.

REISSUED 05/01/11 – CHANGE NO. 04-11

III. B. (CONT’D)

              SCREEN FOUR

      62. UNEARNED INCOME INFORMATION
        a. TYPE: Indicates the kind of unearned income the recipient is, or was, receiving. The last three occurrences of RSDI appear. The most recent payments will be displayed first, followed by the earlier payments in reverse chronological order. All other types of unearned income reflect the most recent occurrence.

        A

        Social Security (T2)
           

        B

        Black Lung

           

        C

        VA (not based on need) Veterans Administration Compensation

           

        D

        RRB

           

        E

        VA (based on need) Veterans Administration Pension

           

        F

        Assistance based on need and not excluded from unearned income

        G

        Title II income used to offset SSI

           

        H

        Income in-kind (support and maintenance)

           

        I

        Ineligible child allocation (spouse-to-spouse or parent-to-child deemed income)

           

        J

        Value of one-third reduction

           

        K

        Blind countable income

REISSUED 05/01/11 – CHANGE NO. 04-11

III. B. 62. (CONT’D)

        L

        Military unearned pension

           

        M

        Federal Civil Service pension

           

        N

        Support payments received from absent parent

           

        O

        Income based on need from private sources

           

        P

        Employment-related pension (State or local government retirement, private pension)

           

        Q

        Worker's Compensation

           

        RC

        Category – Conversion Value

           

        RH

        Category – Royalties and Honoraria

           

        RI

        Category – Interest and Dividends

           

        RL

        Category – Rental/Lease Income

           

        SA

        Category – Assistance Payments (Emergency Assistance Payments (not IBON or ABON), Certain Foster Care Payments, Certain Adoption Assistance, Assistance involving Community Service Block Grants, and Certain Austrian Social Insurance Payments (Not based on wage credits))

           

        SC

        Category – Conversion Value

           

        SD

        Category – Death Related Incomes (Cash Inheritance, In-Kind Inheritance, Unspent Death Benefits, and Insurance Proceeds)

           

        SG

        Category – Monetary Award (Gifts, Grants, Scholarships, and Fellowships not used for Educational Benefits, Prizes, Gambling Winnings, and Awards)

           

        SM

        Multiple Entries

           

        SN

        Category – Payments to Native American Indians (Alaska Native Claims Distribution (Those over $2000/month), Payments derived from Individual interests in Indian Trust or Restricted Lands (In excess of $2000/month), and Indian Tribal Funds distributed to Individuals)

           

        SO

        Category – Other

           

        SS

        Category – Court Ordered or Voluntary Support Payments (Alimony/Spousal support and Child support not subject to the one-third reduction)

           

        ST

        Category – COLA Coordination Computation (One-time Title II payment to be excluded from COLA coordination computation (January and February only)

           

        SU

        Category – Unemployment Benefits

REVISED 05/01/11 – CHANGE NO. 04-11

III. B. 62. (CONT’D)

        SW

        Category – Work Related Unearned Income

           
         

        1. Jury Duty

         

        2. Stipends

         

        3. Tips

         

        4. Indian fishing rights income

         

        5. In-Kind Remuneration for Work

         

        6. Money paid to Residents of a Public Institution where no ER/EE relationship exicts

           
         

        (JTPA Payments, Job Corps Dependents Allowance, Sick Pay that is Unearned Income, Sick Pay that is Unearned Income, Trade Readjustment ACT Payments, Uniformed Services Special Pay and Allowances, State Disability Insurance Benefits, and VA Educational Benefit)

           

        SX

        Category – Unstated Income

           

        T

        Alaska longevity bonus

           

        V

        Net deemed income (see Deemed Income Amount and Deemed Income Amount (Retrospective))

           

        W

        Title II offset

           

        X

        Mandatory income level amount (conversion cases only)

           

        Y

        Special needs reduction (applies to a Federal countable minimum income level)

           

        Z

        State countable income (State of Vermont only)

           

        Blank

        Not applicable.

        b. START: The date when the unearned income started if the payment is monthly or when received if a one-time payment. This is the month in which they receive the check.
        c. STOP: The effective date of termination of unearned income. In a situation where the unearned income changes, this will be the last date the previous rate, or one-time payment, was received. If the year is "89", this indicates a payment adjustment is in process.
        d. AMOUNT: The monthly amount of unearned income for the recipient.

REISSUED 05/01/11 – CHANGE NO. 04-11

III. B. 62. (CONT’D)

        e. FREQUENCY: Indicates whether or not unearned income is being received, or was received.

        C

        Continuous monthly payment, or uninsured (Title II claim number suffix "T" or "M"), or Title II benefits in non-pay status

           

        N

        One-time payment

           

        R

        Used in conjunction with type "A" income to indicate recent RSDI filing, or with type "D" income to indicate potential eligibility to a Railroad Benefit

           

        T

        Termination of a continuous monthly payment

           

        U

        Uninsured (T2 claim types T&M) If type D, this indicates RRB ID assigned, currently T2 only. (Future RRB entitlement possible)

           

        BLANK

        Initialized value

        f. CLAIM ID: The Claim Number or Claim Identification Number under which each type of unearned income is received. For Income-in-Kind, this data element may contain an identifying legend entered by the District Office; e.g., RENTFREE, FREERENT, ETC.
        g. VERIFICATION: This indicates whether or not the unearned income allegations of the recipient have been verified.

        0

        Number and income amount have not been verified

           

        1

        Number has been verified, amount has not been verified

           

        2

        Number and income amount have been verified

           

        3

        Number and income amount have not been verified. Title II IMPACC/A payment made

           

        4

        Number has been verified, amount has not been verified. Title II IMPACC/A payment made

           

        5

        If Unearned Income Type Code is equal to "A", number and income amount have been verified for IMPACC/A payment (Code was previously "2"). If Unearned Income Type Code is equal to "X", the Federal Countable minimum income level has been transmitted to the new record following a "T30"/"T50" action.

           

        6

        If Unearned Income Type Code is equal to "A", IMPACC/A payment has been made (no previous code).

         

        If Unearned Income Type Code is equal to "X", systems generated one-time Title II payment was received in the first quarter of 1974.

REISSUED 05/01/11 – CHANGE NO. 04-11

III. B. 62. (CONT’D)

        8

        Dually entitled to Title II benefits.

           

        I

        Identification number and amount verified Title II being paid in installments because of DA & A provision

           

        BLANK

        Not applicable

      63. REP PAYEE/AGENCY: This is the full name of the person who has been selected as the representative payee for the individual.
      64. ADDRESS: Address of the representative payee.

              SCREEN FIVE

      65. ELIG SPOUSE SSN: The SSN of the eligible spouse, parent, or eligible individual.
      66. ESSENTIAL PERSON: Indicates whether an essential person exists in the case and the relationship of the essential person to the eligible individual.

      0

      Initialized value

         

      1

      Essential person is an ineligible spouse

         

      2

      Essential person is a living-with father

         

      3

      Essential person is a living-with mother

         

      4

      A non-relative is in the SSN of Eligible Spouse or Parent

      5

      A non-relative is in the SSN of Other Parent

REVISED 05/01/11 – CHANGE NO. 04-11

III. B. 66. (CONT’D)

      A

      An ineligible spouse and at least one other person are both essential persons

         

      B

      A living-with father and at least one other person are both essential persons

         

      C

      A living-with mother and at least one other person are both essential persons

         

      D

      There are at least two essential persons, one of whom is in SSN of Eligible Spouse or Parent

         

      E

      There are at least two essential persons, one of whom is in SSN of Other Parent

         

      F

      A living-with parent is the essential person (applicable in pipeline cases only)

      67. ESSENTIAL SSN: The SSN of the essential person in the record of an eligible individual, or the SSN of the eligible individual in the record of an essential person.
      68. INELIGIBLE SPOUSE
        a. IND: Indicates whose information is present on the record.

        E

        Eligible spouse or eligible individual in the spouse's record

           

        I

        Ineligible spouse

           

        P

        Parent

        b. NAME: The name of the ineligible spouse or parent.
        c. SSN: The SSN of the ineligible spouse or parent.
        d. CAN: This is the claim or identification number of the ineligible spouse or parent.
        e. UNEARN INCOME: The monthly amount of unearned income for the ineligible spouse or parent.
        f. UNEARN INC TYP: The kind of unearned income the ineligible spouse or parent is, or was receiving. The last three occurrences of RSDI will appear. The most recent payments will be displayed first, followed by the earlier payments in reverse chronological order. All other types of unearned income reflect the most recent occurrence.

        A

        Social Security

           

        C

        VA (not based on need) Veterans Administration Compensation

REVISED 05/01/11 – CHANGE NO. 04-11

III. B. 68. (CONT’D)

        D

        RRB

           

        E

        VA (based on need)

           

        F

        VA Fixed Payment

           

        G

        Title XVI offset

           

        L

        Military Retired Pay

           

        M

        Federal Civil Service pension

           

        W

        Title II offset

           

        ?

        Unknown Data

        g. UNEARN INC FREQ: Indicates whether or not unearned income is being received, or was received.

        C

        Continuous monthly payment, or uninsured (Title II claim number suffix "T" or "M"), or Title II benefits in non-pay status

           

        N

        One-time payment

REISSUED 05/01/11 – CHANGE NO. 04-11

III. B. 68. (CONT’D)

        R

        Used in conjunction with type "A" income to indicate recent RSDI filing, or with type "D" income to indicate potential eligibility to a Railroad Benefit

           

        T

        Termination of a continuous monthly payment

           

        U

        Used only in conjunction with a type "D" entry to indicate Railroad Benefit has jurisdiction of the Title II payment and that recipient's entitlement to a Railroad Benefit has not been determined.

           

        BLANK

        Not applicable

        h. EARN INC WAGE: The gross amount of wages for the month which the ineligible spouse or parent expects to earn in the month reflected in the Earned Income Period.
        i. SELF EMPLOY INC: The estimated net amount of self-employment income for the ineligible spouse or parent for the period shown in the Earned Income Period.

              SCREEN SIX

      69. RESOURCES
        a. HOUSE: Indicates whether or not the recipient owns a house.

        *

        Initial claims exception

           

        A

        Possession of a home - principal place of residence

REISSUED 05/01/11 – CHANGE NO. 04-11

III. B. 69. (CONT’D)

        J

        Recipient owns house to be disposed of

           

        S

        Equity in a non-excludable property is expected to increase in value

           

        T

        Home and equity in non-excludable property

           

        Z

        None

           

        BLANK

        Not determined

        b. VEHICLE: Indicates whether or not recipient owns a vehicle. If so, the code indicates whether or not the individual must dispose of the vehicle.

        B

        Owns a vehicle - either over or under the limit

           

        G

        Unverified resource

           

        K

        Individual is required to dispose of the vehicle

           

        Z

        None

           

        BLANK

        Not determined

        c. INSURANCE: Indicates whether or not the recipient has life insurance. If so, the code indicates whether or not the individual must dispose of the life insurance.

        C

        Life insurance - face value is over $1,500.00

           

        L

        Individual is required to dispose of the life insurance

           

        H

        Unverified resource

           

        Z

        None

           

        BLANK

        Not determined

        d. PROPERTY: Indicates whether or not the recipient owns income producing property. If so, the code indicates whether or not the individual must dispose of the property.

        D

        Income producing property to be disposed of.

           

        M

        Recipient owns income producing property to be disposed of.

           

        Z

        None

           

        BLANK

        Not determined

REISSUED 05/01/11 – CHANGE NO. 04-11

III. B.69. (CONT’D)

        e. OTHER: Indicates whether or not the recipient owns other resources. If so, the code indicates whether or not the individual must dispose of the other resources.

        E

        Owns other resources over the limits. Must be accompanied by a denial code or a disposition code is accompanied by a disposition code, the entry appears as an ‘N’ on the SSR.

           

        N

        Individual is required to dispose of the other resources.

           

        Z

        None

           

        BLANK

        Not determined

      70. MN DIARY: This indicates a transfer of assets has taken place.

        MN

        Transfer of resources at less than fair value

      71. MN DATE: This indicates the date the MN Diary action should be taken.
      72. PASS (Plan for Achieving Self-Support): This is the monthly amount of earned income for blind and disabled recipients which may be excluded under an approved plan for achieving self-support.
      73. 1619A: Indicates if recipient is eligible for special payments under 1619(a) provisions.

      D

      The presence of one of these codes indicates monthly

      E

      Gross earned income to be the Substantial Gainful

      F

      Activity level with SSI payment continuation under

      G

      1619(a).

      74. 1619B: Indicates if recipient is considered an SSI recipient for Medicaid purposed under 1619(b) provisions.

      A

      Individual meets the SSI income test; however, no date has been entered by SSA for Medicaid use and insufficiency of earning test. (This individual may be eligible for 1619(b) status but a determination by SSA has not been made.)

         

      B

      Individual meets the SSI income test and also meets the Medicaid use and insufficiency of earnings test. (This individual has been determined eligible for 1619(b) status by SSA.)

         

      F

      Individual meets the SSI income test. The Medicaid use and insufficiency of earnings tests decision pending with SSI. (This individual may be eligible for 1619(b) status but a determination by SSA has not been completed.)

         

      BLANK

      Not eligible

REISSUED 05/01/11 – CHANGE NO. 04-11

III. B. (CONT’D)

      75. SSN VERIFY CD: Indicates the possibilities in the List of Multiple SSNs.

      A

      Affirmed by SSA District Office

         

      I

      Incorrect SSN, change has been processed

         

      N

      SSN has not been verified

         

      P

      "Pseudo" SSN

         

      T

      Cross-reference number terminated and will not be re-accreted

         

      X

      Cross-reference SSN

         

      Y

      SSN has been verified

      76. MULTIPLE SSN: The additional SSNs used by the recipient. Up to five SSNs may be listed.
      77. MEDICARE ENTITLEMENT CD: Reflects the individual's current Medicare entitlement status, as follows:

      A

      The individual is covered for Hospital Insurance (Medicare A), but not for Supplementary Medical Insurance (Medicare B)

         

      B

      The individual is covered for (Supplementary Medical Insurance) Medicare B, but not (Hospital Insurance) Medicare A

         

      C

      The individual is covered for both Medicare A (Hospital Insurance) and (Supplementary Medical Insurance) Medicare B

         

      D

      To be added 10/05 at earliest

         

      N

      The individual is not covered for either Medicare A or B

         

      “” (Blank)

      Space-initialized default

        NOTE: SSA is not currently sending reliable data in this field.

      78. QUAL MEDICARE BENEFICIARY: Not currently in use.
      79. CONVERTED RALIROAD #: This is the Railroad Retirement Board (RRB) number converted from the SSA version.

REISSUED 05/01/11 – CHANGE NO. 04-11

III. B. (CONT’D)

      80. FOOD STAMPS APP - DATE - STAT: Indicates whether or not SSA personnel took an application for Food Stamps; the month and year of the initial Food Stamp data input; and whether or not the recipient receives Food Stamps or has filed an application for Food Stamps in the past sixty days on which no decision has been made.

                APP

      A

      SSA taking food stamp application in a waiver state and shelter cost is at or above state standard.

         

      B

      SSA taking food stamp application in a waiver state and shelter cost is below state standard.

         

      N

      SSA did not take a Food Stamp application.

         

      Y

      SSA took Foood Stamp application.

         

      Z

      Invalid character(s) transmitted.

         

      “” BLANK

      No input

                STAT

      Y

      Yes, either is receiving or applied.

         

      N

      No, is not receiving and has not applied.

         

      Z

      Invalid character(s) transmitted

         

      BLANK

      No input

      81. ALIEN IND - RESIDENCY DATE: Indicates if the eligible/ineligible individual is in a special alien status and the month and year of residence in the U.S. An entry of "01/74" means the residency began in January 1974 or earlier. For all other dates, it is the actual year and month that residency began.

      1

      No status alleged

         

      2

      Valid status alleged, but not proven – N13 being processed

         

      3

      American Immigrant

         

      4

      North American Indian

      A

      Proven born in U.S., U.S. citizen

         

      B

      Alleged born in U.S., U.S. citizen

         

      C

      U.S. citizen born outside of the U.S.; this includes naturalized citizens

         

      D

      Alleged U.S. citizen - Pre-January 01, 1972

REISSUED 05/01/11 – CHANGE NO. 04-11

III. B. 81. (CONT’D)

      E

      No citizenship or alien status development undertaken; case denied for reason(s) other than citizenship/alien status

         

      F

      Refugee status - Section 207 or 203(A)(7) of the I.N.A.

         

      G

      Parole status - Section 212(d) of the I.N.A.

         

      J

      Deferred action status alien

         

      K

      Alien lawfully admitted to the U.S. for permanent residence

         

      L

      Asylum status - Section 208 of the I.N.A.

         

      N

      Identity and citizenship of the individual verified by the Numident interface (code was previously A or B)

         

      P

      Pre-January 01, 1972 alien (presumed lawfully admitted for permanent residence)

         

      Q

      Alleged born in the U.S. - allegation corroborated by a U.S. place of birth shown on the on-line Numident

         

      R

      Lawful temporary resident - status granted as a result of the Immigration Reform and Control Act of 1986

         

      S

      Lawful permanent residence - status granted as a result of the Immigration Reform and Control Act of 1986.

         

      T

      Alien granted voluntary departure

         

      U

      Unknown

         

      W

      Alien granted stay of deportation

         

      X

      Cuban/Haitian entrant

         

      Y

      Legalized agricultural worker pursuant to the Immigration Reform and Control Act of 1986

         

      Z

      Alien on whose behalf an immediate relative petition has been approved

      82. COUNTRY OF ORIGIN: The country of origin for recipient.
      83. ALIEN SPONSOR STATUS CODE: The status of the alien’s sponsorship. Codes A, C, D, E, F, G, H, J, and L apply to aliens for whom the sponsor(s) signed the old affidavit of support. Regular deeming rules (spouse-to-spouse or parent-to-child) supersede sponsor-to-alien deeming if the sponsor is also a regular deemer on the alien’s record.

        Alien Sponsor Status Codes M, N, O, P, Q, R, S, and V apply to aliens for whom the sponsor(s) signed the new affidavit of support. Sponsor-to-alien deeming rules apply regardless of the sponsor’s status as a regular deemer on the alien’s record.

        Alien Sponsor Status Codes B, T, and U can apply to both groups of aliens listed above.

REISSUED 05/01/11 – CHANGE NO. 04-11

III. B. 83. (CONT’D)

      A

      No sponsor or the three year deeming period has ended.

         

      B

      Sponsor legally exempt from deeming (institution, church, etc.)

         

      C

      Sponsor liable for support. Sponsor has no other status, so deeming from sponsor only.

         

      D

      Sponsor liable for support. Sponsor also has status as a regular deemer, so regular deeming (spouse-to-spouse or parent-to-child) applies.

         

      E

      Sponsor liable for support. SSA’S record has a regular deemer plus the sponsor, so deeming occurs from both the regular deemer (spouse/parent) and the sponsor.

         

      F

      Sponsor liable for support. Sponsor has a spouse. Sponsor has no other status, so deeming from sponsor only.

         

      G

      Sponsor liable for support. Sponsor also has status as a regular deemer, so regular deeming (spouse-to-spouse or parent-to-child) applies. Sponsors are specifically identified as parents of the alien, and both parents (sponsor and sponsor’s spouse) are liable for deeming.

         

      H

      Sponsor liable for support. SSA’s record has a regular deemer plus the sponsor, so deeming occurs from both the regular deemer (spouse/parent) and the sponsor. Sponsor has a spouse, i.e., deeming has been considered from at least three potential sources: the sponsor, the sponsor’s spouse, and the regular deemer on the SSA record (alien’s ineligible spouse or parent).

         

      J

      Multiple legal sponsors exist. One or more of the sponsors may have status as a regular deemer on SSA’S record, or one or more of the sponsors may also have a spouse whose income is deemable.

         

      L

      Sponsor is liable for support; however, recipient’s disability onset date is later than his/her date of U.S. entry; therefore, exemption applies. No sponsor-to-alien deeming.

         

      M

      Sponsor liable for support. Sponsor does not have other status on the alien’s SSA record, so deeming occurs only from the sponsor. A new affidavit of support is in effect.

         

      N

      Sponsor liable for support. Sponsor also has status as a regular deemer on the alien’s SSA record; however, sponsor-to-alien deeming rules apply since a new affidavit of support is in effect.

         

      O

      Sponsor liable for support. SSA’S record contains a regular deemer plus the sponsor (sponsor is not the regular deemer) and deeming occurs from both the sponsor and the regular deemer (spouse/parent). New affidavit of support is in effect.

REISSUED 05/01/11 – CHANGE NO. 04-11

III. B. 83. (CONT’D)

      P

      Sponsor liable for support. Sponsor does not have other status on the alien’s SSA record, so deeming occurs only from the sponsor. A new affidavit of support is in effect. The sponsor has a spouse.

         

      Q

      Sponsor liable for support. Sponsor also has status as a regular deemer on the alien’s SSA record; however, sponsor-to-alien deeming rules apply since a new affidavit of support is in effect. The sponsor has a spouse, and the sponsors are specifically identified as parents of the alien, and both parents (sponsor and sponsor spouse) are liable for deeming.

         

      R

      Sponsor liable for support. SSA’S record contains a regular deemer plus the sponsor (sponsor is not the regular deemer) and deeming occurs from both the sponsor and the regular deemer (spouse/parent). New affidavit of support is in effect. The sponsor has a spouse. Therefore, deeming is considered from three potential sources: the sponsor, the sponsor’s spouse, and the regular deemer (alien’s ineligible spouse or parents).

         

      S

      Multiple legal sponsors exist. One or more may have other status as a regular deemer on SSA’S record or one or more of the sponsors may have a spouse whose income is also deemable. A new affidavit of support is in effect.

         

      T

      Sponsor no longer liable; for example, sponsor is deceased.

         

      U

      Unknown; system generated prior to the advent of sponsor-to-alien deeming. Cannot be input by Field Office.

         

      V

      New affidavit is in effect and deeming terminated because alien has acquired 40 work credits.

      84. ALIEN ELIGIBILITY CODE: The eligibility codes listed below identify those aliens who remain eligible for SSI based on the new requirements in the Welfare Reform Act of August 1996. All asylees (alien indicator of “L”) are eligible for five years from the date they were granted asylee status by the Immigration and Naturalization Service.

      1

      Alien admitted to the U.S. as a refugee under section 207 of the Immigration and Nationality Act (INA); can receive SSI for 7 years beginning with the date of entry into the U.S.

         

      2

      Alien whose deportation has been withheld under section 243(h) or 241(b)(3) of the INA; can receive SSI for 7 years beginning with the date the deportation was withheld.

REVISED 05/01/11 – CHANGE NO. 04-11

III. B. 84. (CONT’D)

      3

      Alien lawfully admitted for permanent residence who has been credited with 40 work credits. These credits can be earned from the alien’s own work or from work done by a parent or spouse of the alien. For initial claims filed after August 22, 1996, these aliens cannot receive SSI for the first five years they are in the U.S.

      4

      Alien on active duty military/veteran

      5

      Spouse/widow(er) of active duty military/veteran

      6

      Child of active duty military/veteran

      7

      Grandfathered alien indicator

      8

      Aged alien who is legally residing in the US on 8/22/96 and require a disability determination

      9

      Grandfathered Nonqualified aliens coded H, P, R, T, W or J who were receiving SSI on August 22, 1996

      A

      Pending citizenship continuous eligibility. Alien entitled to benefit extension through 09/30/11.

      B

      Pending citizenship reinstatement of eligibility. Time-limited Alien entitled to benefit extension. Benefits paid 10/01/08 through 09/30/11.

      C

      Good faith continuous eligibility. Additional two years of benefits payable.

      D

      Good faith reinstatement of eligibility. Additional two years of benefits payable beginning 10/01/08.

      E

      Age 18 continuous eligibility. Additional two years of benefits payable beginning 10/01/08.

      F

      Age 18 reinstatement of eligibility. Additional two years of benefits payable beginning 10/01/08.

      G

      Age 70 and birthdate after 09/301938 and prior to 10/01/1941 continuous eligibility. Additional two years of benefits payable beginning 10/01/08.

      H

      Age 70 and birthdate after 09/30/1938 and prior to 10/01/1941 reinstatement of eligibility. Additional two years of benefits payable.

REISSUED 05/01/11 – CHANGE NO. 04-11

III. B. CONT’D

      85. FOREIGN LANGUAGE CODE: This code identifies the foreign language preferred over English, with which the person is most comfortable.

      01

      English

      02

      Spanish

      03

      American Sign Language

      04

      Alaska Native

      05

      Albanian Creole-Haitian

      06

      American Indian-Apache

      07

      American Indian-Choctaw

      08

      American Indian-Crow

      09

      American Indian-Dakota

      10

      American Indian-Lakota

      11

      American Indian-Nakota

      12

      American Indian-Navajo

      13

      American Indian-Zuni

      14

      American Indian-Other

      15

      Amharic

      16

      Arabic

      17

      Armenian

      18

      Assyrian

      19

      Bengail

      20

      Bosnian

      21

      Bulgarian

      22

      Burmese

      23

      Cambodian

      24

      Chamorro

      25

      Chinese-Cantonese

      26

      Chinese-Formosan

      27

      Chinese-Mandarin

      28

      Chinese-Mien

      29

      Chinese-Shanghainese

      30

      Chinese-Taiwanese

      31

      Chinese-Toishanese

      32

      Chinese-Other

      33

      Creole-Criollo

      34

      Creole-French

      35

      Creole-Haitian

      36

      Creole-Other

      37

      Croatian

      38

      Czech

      39

      Dutch

      40

      Farsi

      41

      Finnish

      42

      French

      43

      German

      44

      Greek

      45

      Gujarathi

      46

      Hebrew

      47

      Hindi

      48

      Hmong

      49

      Hungarian

      50

      Ilocano

      51

      Indonesian

      52

      Italian

      53

      Japanese

      54

      Khmer

REISSUED 05/01/11 – CHANGE NO. 04-11

III. B. 85 CONT’D

      55

      Korean

      56

      Kurdish

      57

      Lao (Laotian)

      58

      Lithuanian

      59

      Macedonian

      60

      Malayalam

      61

      Mongolian

      62

      Norwegian

      63

      Oromo

      64

      Pashto

      65

      Pennsylvania Dutch

      66

      Persian

      67

      Pidgin-Hawaiian

      68

      Polish

      69

      Portuguese

      70

      Punjabi

      71

      Romanian

      72

      Russian

      73

      Samoan

      74

      Serbo-Croatian

      75

      Slovak

      76

      Somali

      77

      Swahili

      78

      Swedish

      79

      Syriac

      80

      Tagalog

      81

      Thai

      82

      Tongan

      83

      Turkish

      84

      Twi (Fanti)

      85

      Ukrainian

      86

      Urdu

      87

      Vietnamese

      88

      Yiddish

      89

      Yugoslavian

      90

      Other

REVISED 05/01/11 – CHANGE NO. 04-11

III. B. (CONT’D)

      86. ZEBLEY IND: The status of the Zebley claim.

      Z

      The individual has been identified by the SSA Field Office as a potential Zebley case.

         

      D

      The case has been denied for any Zebley payments.

         

      F

      The final Zebley payment has been made to the individual.

      87. ROLLBACK: Indicates if the recipient received State payments prior to July 1, 1973, or is subject to Title XVI disability criteria.

      1

      Potential rollback

         

      2

      State payments were made prior to July 1, 1973

         

      3

      No disability payments were made prior to July 1, 1973 (State Disability Determination Section determination is needed)

         

      4

      The recipient meets Title XVI criteria

         

      5

      The recipient is not disabled (Title XVI criteria), reviewed and denied by the State Disability Determination Section

         

      6

      Final disability allowance determination has not been input

         

      7

      Final disability denial determination has not been input

      88. DIR DEPOSIT: The type of account to which the SSI check is directly deposited.

      C

      Checking

         

      E

      Electronic benefits transfer

         

      S

      Savings

         

      BLANK

      None

IV. LOGOFF PROCEDURES FOR SCC4CICS

    A. Key “99” in Next Selection.

    B. Press ENTER. The message “EIS SESSION TERMINATED” appears.

    C. Key “LOGOFF” over this message.

    D. Press ENTER. The Banner screen appears.

REISSUED 05/01/11 – CHANGE NO. 04-11

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V. SDX INFORMATION SHEETS

    A. In addition to the on-line inquiry, case specific SDX Information Sheets are produced for individuals in SA, and HSF cases, and for individuals in MAA, MAB, and MAD cases if the individual has a long term care living arrangement code and is SSI. An individual SDX Information Sheet is produced from the daily updates when an active recipient:

      1. has been newly approved for SSI
      2. has certain specified changed information on his SSI record.

    B. The SDX Information Sheets have program specific information displayed as indicated on the following pages.

    C. The following changed information will generate an SDX Information Sheet for Medicaid or Special Assistance recipients:

      1. Payee Name and Address
      2. Date of Birth
      3. Living Arrangement
      4. Marital Status
      5. Title II Claim Number
      6. SSI Gross Amount
      7. SSI Assistance Amount
      8. Pay Status
      9. Death Date
      10. Denial Code
      11. PASS
      12. Resource Code-House
      13. Resource Code-Income Producing Property
      14. Resource Code-Life Insurance
      15. Resource Code-Vehicle
      16. Resource Code-Other
      17. Countable Earned Income
      18. Countable Unearned Income
      19. Unearned Income Information
        a. Type
        b. Start
        c. Stop
        d. Amount
        e. Frequency
        f. Claim/ID Number
      20. Transaction Record is '05' (Individual Moved Out of State)

    D. The changed data element will be preceded by an asterisk (*).

    E. Refer to III. above for data element definitions and codes.

    F. The SDX Information Sheets are produced from the quarterly recon; however, they are not printed for changes in SSI Assistance Amount.

REVISED 05/01/11 – CHANGE NO. 04-11

V. (CONT’D)

UNEARNED INCOME INFORMATION

TYPE

START

STOP

AMOUNT

FREQUENCY

CLAIM/ID NO

VALIDATION

V

09/1985

09/1985

464.17

N

 

0

I

01/1994

 

669.00

C

 

0

REVISED 05/01/11 - CHANGE NO. 04-11

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VI. ADDITIONAL INFORMATION

    The SDX On-Line Inquiry, SDX Information Sheets, and OLV System must be used as much as possible. However, there may be situations which require additional information.

    A. Use Form DMA-5049 (Referral to Local Social Security Office) for recipients who:

      1. Have potential for SSI benefits but have not applied; or
      2. Have a change in case status and the Social Security Office needs to be notified.

    B. Use the State On-Line Query or the Third Party Query to verify:

      1. Cases not appearing on the SDX; and/or
      2. Questionable information on the SDX.

    C. Call Candes Smith, IEVS Coordinator, to assist in resolving discrepancies that cannot be resolved by B. above.

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VII. SDX HISTORY

    The SDX History screen allows up to 20 past SSI records to be viewed through the online SDX.

    A. Accessing SDX History

      While viewing an SDX record, press PF9 on any page. The following screen displays.

    B. INFORMATION ON THE SDX HISTORY

      Each field that appears on the SDX History is listed below with the corresponding codes and definitions.

      1. RECIPIENT: Recipient Name

REVISED 05/01/11 - CHANGE NO. 04-11

VII. B. (CONT’D)

      2. SSN: Recipient Social Security Number
      3. PROCESSED: The date the record was processed by the Social Security Administration.
      4. CUR REC IND: This indicates which record is the most current on file for a given date.
      5. TRANS CODE: The action and/or source of the SDX record.

    C. VIEWING HISTORICAL RECORDS (Cannot be viewed in OLV System)

      1. Key an “X” to the left of the “Processed” date of the record you wish to view. Press Enter.

        The SDX Screen displays the previous SSI record data along with the message “>THIS IS NOT THE CURRENT SDX REC<” in the lower right hand corner.

      2. To view another SDX record for the same person, press PF9 and follow instructions in VII.C.1., above.
      3. To view an SDX record for a new person, key the social security number in the “KEYS” field and press Enter.
      4. To return to the main menu, press PF3.

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