NC DEPARTMENT OF HEALTH AND HUMAN SERVICES EIS MANUAL

ELIGIBILITY INFORMATION SYSTEM EIS 1107

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STATE ONLINE QUERY/THIRD PARTY QUERY

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EIS 1107 – STATE ONLINE QUERY/THIRD PARTY QUERY


I. GENERAL INFORMATION

II. ACCESSING THE THIRD PARTY QUERY

III. REQUIRED INTERFACE INQUIRIES

IV. INITIATING A tpQY REQUEST

V. RETRIEVING THIRD PARTY QUERY REQUESTS

VI. NAVIGATION AND RETENTION

VII. INFORMATION ON THE TPQY RESPONSE RECORD

VIII. LOGOFF PROCEDURES


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EIS 1107 – STATE ONLINE QUERY/THIRD PARTY QUERY

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

Top Of Page

I. GENERAL INFORMATION

REVISED 05/01/11 – CHANGE 04-11

Top Of Page

II. ACCESSING THE THIRD PARTY QUERY

    A. To access the Third Party Query, the terminal screen must be on the Banner Screen. Refer to
    EIS 4900 Appendix A
    for an example of the Banner Screen.

      B. From the Banner Screen, key “SCC4CICS”. Press ENTER. The “WELCOME TO SCC4CICS 'EIS'” message appears at the top of the next screen. This is the RACF screen.

      C. From the RACF screen, key your RACF USER ID, the BILL-CDE, and your RACF PASSWORD. Press ENTER. A blank screen appears.

      D. Key “EIS3”. Press ENTER. The Primary Menu Screen appears.

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

II. (CONT’D)

      E. From the Primary Menu, key Selection “05”. The Interface Inquiry Menu appears.

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III. REQUIRED INTERFACE INQUIRIES

      A. From the Interface Inquiry Menu, key selection "04" and the applicant/recipient's social security number. If information is present, it will display in the following order:

        1. SDX
        2. BENDEX
        3. THIRD PARTY QUERY
        4. ESC

        NOTE: Only displayed if the employee is authorized to access data.

      B. Press PF1 to page forward within each inquiry. Press PF2 to page backward within each inquiry.

      C. Press the PF8 key to scroll to the next inquiry; i.e., if you are viewing SDX, press the PF8 key to view BENDEX. Press the PF7 key to view the previous inquiry; i.e., if you are viewing BENDEX, press the PF7 key to view SDX. Once viewing is complete, you may press the PF3 key to return to the Interface Inquiry Menu or you may enter the SSN for another individual. The next inquiry will begin with the SDX screen.

      D. If information is not present for a specific inquiry, the following message will appear, specific to the inquiry not found:

        "NOT FOUND FOR THIS SSN: BENDEX DATA"

REVISED 05/01/2011 - CHANGE NO. 04-11

III. (CONT’D)

    E. If information is not present for all inquiries, the following message will appear:

        "NOT FOUND FOR THIS SSN: SDX DATA BENDEX DATA

        TPQ DATA ESC DATA"

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IV. INITIATING A tpQY REQUEST

      Use the DSS-8200 as the input document in counties opting to have data entry perform the TPQY function.

      For those counties/state agencies who choose to have the individual employee perform the TPQY function, you may key into the input screen.

      To access the TPQY screen, from the Interface Inquiry Menu, key selection “05”. Press ENTER. The THIRD PARTY QUERY REQUEST ENTRY screen displays.

A. Complete the DSS-8200 or the input screen, by entering the following fields for both types of inquiries.

        1. County Number: Enter the two-digit county number for your county. Vocational Rehabilitation staff enter VR. State mental health facility staff enter MH. Division of Service to the Blind staff enter SB.
        2. Worker/District Number: Enter the three-digit worker or district number.
        REVISED 05/01/2011 - CHANGE NO. 04-11
IV. (CONT’D)
        3. Social Security Number: Enter the nine-digit social security number for the applicant/recipient.

          OR

        4. Claim Account Number: Enter the nine-digit account number from which the applicant/recipient receives benefits, followed by the BIC.

          NOTE: An entry in both Social Security Number and Claim Account Number is not allowed. If you have both, we recommend that you submit two TPQY requests, one using the Social Security Number and one using the Claim Account Number. These may both be submitted on the same day.

        5. BIC: Enter the one, two, or three-digit suffix.
        6. Last Name: Enter the applicant/recipient's last name.
        7. First Name: Enter the applicant/recipient’s first name.
        8. Middle Initial: Enter the applicant/recipient’s middle initial. This is an optional field for both inquiries.
        9. Date of Birth: Enter the applicant/recipient's date of birth as MMDDCCYY.
        10. Sex: This field is displayed only on the TPQY inquiry and is an optional field.
        11. Category of Assistance: Enter one of the following two digit indicators for category of assistance for SOLQ and TPQY requests.
          a. CI Crisis Intervention
          b. CS Child Support
          c. EA Emergency Assistance
          d. FM Food and Nutrition and Medicaid
          e. FS Food and Nutrition
          f. FW Food and Nutrition and Work First Family

                      Assistance

          g. LI LIEAP
          h. MA Medicaid
          i. MH State Mental Health Hospital
          j. SA Special Assistance
          k. SB Services for the Blind
          l. SW Social Worker
          m. VR Vocational Rehabilitation
          n. WF Work First Family Assistance

REVISED 05/01/2011 - CHANGE NO. 04-11

IV. (CONT’D)

        12. Individual/Case ID: Enter the Individual ID or the Case ID for the applicant/recipient. If the request is for a financially responsible spouse or parent who is not included in the case, follow the Case ID or the Individual ID with the abbreviation, “SP”, or “P”, respectively. If an Individual ID has not yet been assigned in the interview process, key in the word, “Interview”.

          NOTE: It is important that you key correct information in this field. If a case is selected for an audit, you must be able to justify the need for the request. This will link this request to a record or an intake interview.

        13. Alien Wage Request: This field is displayed only on the TPQY inquiry. Enter a “Y” if requesting 40 Quarters information. This field defaults to an “N”.

      B. When all information is entered, press ENTER.

      C. If a Third Party Request has been submitted earlier but a response has not been returned, the following message will display: “A REQUEST EXISTS FOR THIS SSN FROM COUNTY: XX WORKER: NNN”

      D. All Third Party Requests will be accumulated during the working day and transmitted to SSA in Baltimore at night. SSA responds to these requests in 24 to 48 hours.

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V. RETRIEVING THIRD PARTY QUERY REQUESTS

      You have three options to retrieve responses for Third Party Query requests.

      A. If you wish to determine if a response has been returned on a specific individual, key Selection "04" from the Interface Inquiry Menu and the individual's SSN. Press ENTER.

        1. If no response has been returned, the following message displays:

          "NOT FOUND FOR THIS SSN: TPQ DATA"

          Other inquiries not found are also listed in this message, i.e., "SDX DATA".

        2. If information is present, it displays in the following order:
          a. SDX
          b. BENDEX
          c. THIRD PARTY QUERY
          d. ESC

REVISED 05/01/2011 - CHANGE NO. 04-11

V. (CONT’D)

      B. To retrieve all responses in a county, key selection "05" from the Interface Inquiry Menu. Press ENTER. The Third Party Query Request screen displays. Key in your County Number. Press the PF1 key.

        1. A list of last names and SSN's for all responses in your county displays on the Third Party Query Response Summary Screen. The list is in SSN order (from left to right). If there is more than one page of responses, the message, “PF2: More Responses” appears.

HWA905-2 NC DEPT OF HEALTH AND HUMAN SERVICES TODAYS DATE:03/14/2011

THIRD PARTY QUERY RESPONSE SUMMARY

- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -

000000001 MCLEOUD 000000002 EARNHARDT

000000003 BARNES 000000004 DAWKINS

000000005 GOOCH 000000006 SPIVEY

000000007 DANIELS 000000008 MCDOUGAL

KEY AN "X" TO THE LEFT OF AN SSN AND PRESS ENTER TO SELECT IT FOR INQUIRY

PF1: REQUEST ENTRY SCREEN PF3: RETURN TO MENU

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

V. B. (CONT’D)

        2. Select the name and SSN you wish to view by keying an "X" to the left of the SSN. Press ENTER.

        NOTE: Once this individual has been selected, his name and SSN is removed from the Third Party Query Summary. If a second worker needs to access this individual's record, he must use the option in V. A. above.

      C. To retrieve all responses in a county for a particular worker, key selection "05" from the Interface Inquiry Menu. The Third Party Query Request screen displays. Key in your County Number and Worker or District Number (whichever was used for the request.) Press the PF1 key.

        1. A list of last names and SSN's for all responses in your county for the Worker/District Number keyed displays on the Third Party Response Summary screen. The list is in SSN order (from left to right.)
        2. Select the name and SSN you wish to view by keying an "X" to the left of the SSN. Press ENTER.

        NOTE: Once this individual has been selected, his name and SSN is removed from the Third Party Query Summary. If a second worker needs to access this individual's record, he must use the option in V. A. above.

Top Of Page

VI. NAVIGATION AND RETENTION

      A. Press PF1 to page forward within each inquiry. Press PF2 to page backward within each inquiry.

      B. Press the PF8 key to scroll to the next inquiry. Press the PF7 key to view the previous inquiry (not an option for SOLQ, since you did not view a previous inquiry).

      C. Once viewing is complete, you may press the PF3 key to return to the Interface Inquiry Menu or you may enter the SSN for another individual. This inquiry will begin with the SDX screen.

      D. A Third Party Query response will remain in inquiry for thirty days.

      E. If more current data is present on an individual in SDX or BENDEX when you are performing TPQY inquiry, the following message will display:

        "SDX OR BENDEX INFORMATION IS MORE CURRENT"

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

Top Of Page

VII. INFORMATION ON THE TPQY RESPONSE RECORD

      When TPQY information is returned from the SSA, the information will be formatted in the following order:

      A. General Information Screen

        The first screen contains the identifying information submitted in the request to SSA with some additional data elements. If no benefit information is found at SSA, this is the only screen. This screen indicates whether or not the SSN is verified.

              TPQY RESPONSE SCREEN

        In addition to the identifying information, the following fields display on the General Information Screen:

        1. Today's Date: Self-explanatory.
        2. Received Date: The date the record was received from SSA.
        3. State Agency Code: This is the three-digit state agency code used to identify each state.

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

VII. A. 3. (CONT'D)

      STATE

      CODE

      STATE

      CODE

             

      Alabama

      001

      Montana

      027

      Alaska

      002

      Nebraska

      028

      Arizona

      003

      Nevada

      029

      Arkansas

      004

      New Hampshire

      030

      California

      005

      New Jersey

      031

      Colorado

      006

      New Mexico

      032

      Connecticut

      007

      New York

      033

      Delaware

      008

      North Carolina

      034

      District of Columbia

      009

      North Dakota

      035

      Florida

      010

      Ohio

      036

      Georgia

      011

      Oklahoma

      037

      Guam

      065

      Oregon

      038

      Hawaii

      012

      Pennsylvania

      039

      Idaho

      013

      Puerto Rico

      040

      Illinois

      014

      Rhode Island

      041

      Indiana

      015

      American Samoa

      064

      Iowa

      016

      South Carolina

      042

      Kansas

      017

      South Dakota

      043

      Kentucky

      018

      Tennessee

      044

      Louisiana

      019

      Texas

      045

      Maine

      020

      Utah

      046

      Maryland

      021

      Vermont

      047

      Massachusetts

      022

      Virgin Islands

      048

      Michigan

      023

      Virginia

      049

      Minnesota

      024

      Washington

      050

      Mississippi

      025

      West Virginia

      051

      Missouri

      026

      Wisconsin

      052

        4. Alien QC’s: This field is applicable to the Medicaid, Special Assistance, and Food Stamp programs. It only appears on the TPQY response, not the SOLQ response.
        5. Record Code: This code indicates the type of information returned from SSA.
          a. Code 1: This indicates that the only information received from SSA is the identifying information. No Title II (RSDI) or Title XVI (SSI) information was found.
          b. Code 2: This indicates that the information received from SSA is Title II (RSDI) information only.
          c. Code 3: This indicates that the only information received from SSA is Title XVI (SSI) information.
          d. Code 4: This indicates that both Title II (RSDI) and Title XVI (SSI) information was found.
        6. Error Condition: This is a three-digit code indicating specific error conditions caused by invalid or missing data as follows:

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

VII. A. 6. (CONT'D)

          101

          Claim Account Number is invalid or missing.

          102

          Social Security Number is invalid or missing.

          103

          Both Claim Account Number and Social Security Number

          are invalid

          110

          Claim Account Number is unverified.

          120

          Social Security Number is unverified.

          201

          Surname is invalid or missing.

          202

          First name invalid or missing.

          300

          Date of birth invalid or missing.

          600

          Query is for a public figure whose record may not be routinely queried.

        7. SSN Verification Code: A one-digit indicator that shows whether the SSN number was verified. If the SSN is verified, the source of verification is given. If the SSN is not verified, a reason is given. Verification codes are as follows:

        V:

        SSN verified by Numident

        M:

        SSN verified by method other than Numident, because not found

        in Numident

        P:

        SSN verified by method other than Numident because the

        date of birth did not match Numident file. The correct

        date of birth is displayed in the Verified SSNs field.

        R:

        SSN verified by method other than Numident because the

        name did not match Numident file.

        F:

        SSN is verified, although surname may not match

        Numident file

        Z:

        If a claim account number request was submitted, this

        indicates that SSA did not perform a formal verification,

        but was able to locate the claim account number.

        1:

        SSN is not in SSA's files

        3:

        Name and sex matches SSA's files, birthdate does not match

        5:

        Name does not match SSA's files; sex and birthdate not

        checked

        *

        The input SSN was not verified; however, the correct SSN

        is provided in the Verified SSN field

        &

        Multiple SSNs are provided in Verified SSNs field

        NOTE: The primary method of SSN verification is the Numident File. SSA has separate databases for RSDI recipients (the MBR) and SSI recipients (SSR). If SSN cannot be verified by Numident, these databases are used as the secondary sources for SSN verification (see M, P, and R above.)

REVISED 05/01/2011 - CHANGE NO. 04-11

VII. A. (CONT'D)

        8. Verified SSNs: If the input SSN is incorrect, but the number was transposed or had a slight error, SSA may provide the correct SSN. The exception is if the incorrect SSN entered actually matched an SSN belonging to another individual. In that case, the SSN Verification Code "5" is displayed (see VI. A. 7. above). If the individual has multiple verified SSNs, the additional SSNs are displayed. If the date of birth keyed on the request is more than one year greater or less than the date on the Numident file, SSA will return a corrected date of birth in this field. SSA only looks at month and day when making this determination. If the month and day of birth are within one year of the date on the Numident file, SSA does not provide a corrected date of birth.
        9. Welfare ID Number: The Individual ID or Case ID keyed in the request.
        10. Worker/District Number: The worker/district number entered on the request.

      B. RSDI Information

        1. If the individual has RSDI information, the second screen will display RSDI information.

REVISED 05/01/2011 - CHANGE NO. 04-11

VII. B. 1. (CONT’D)

                TPQY SCREEN

          In addition to the name and social security number, the following fields will display on this screen:

          a. Title II CAN: The account number under which a Title II claim exist.
          b. State/County Code: The first two positions represent the state code. The remaining positions is the code for the county that is responsible for any mandatory or optional supplementation payment. This field represents the state and county residence for recipients unless another state and county have jurisdiction.

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

VII. B. 1. (CONT'D)

COUNTY CODE

COUNTY NAME

COUNTY CODE

COUNTY NAME

000

Alamance

500

Johnston

010

Alexander

510

Jones

020

Alleghany

520

Lee

030

Anson

530

Lenoir

040

Ashe

540

Lincoln

050

Avery

550

McDowell

060

Beaufort

560

Macon

070

Bertie

570

Madison

080

Bladen

580

Martin

090

Brunswick

590

Mecklenburg

100

Buncombe

600

Mitchell

110

Burke

610

Montgomery

120

Cabarrus

620

Moore

130

Caldwell

630

Nash

140

Camden

640

New Hanover

150

Carteret

650

Northampton

160

Caswell

660

Onslow

170

Catawba

670

Orange

180

Chatham

680

Pamlico

190

Cherokee

690

Pasquotank

200

Chowan

700

Pender

210

Clay

710

Perquimans

220

Cleveland

720

Person

230

Columbus

730

Pitt

240

Craven

740

Polk

250

Cumberland

750

Randolph

251

Currituck

760

Richmond

270

Dare

770

Robeson

280

Davidson

780

Rockingham

290

Davie

790

Rowan

300

Duplin

800

Rutherford

310

Durham

810

Sampson

320

Edgecombe

820

Scotland

330

Forsyth

830

Stanly

340

Franklin

840

Stokes

350

Gaston

850

Surry

360

Gates

860

Swain

370

Graham

870

Transylvania

380

Granville

880

Tyrrell

390

Greene

890

Union

400

Guilford

900

Vance

410

Halifax

910

Wake

420

Harnett

920

Warren

430

Haywood

930

Washington

440

Henderson

940

Watauga

450

Hertford

950

Wayne

460

Hoke

960

Wilkes

470

Hyde

970

Wilson

480

Iredell

980

Yadkin

490

Jackson

981

Yancey

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

VII. B. 1. (CONT’D)

          c. Zip Code: The zip code of the residence address.
          d. Address: The residence address of the recipient.
          e. First Name: The first name of the recipient.
          f. Initial: The middle initial of the recipient.
          g. Last Name: The last name of the recipient.
          h. Date of Birth: The date of birth of the recipient.
          i. Sex: The sex of the recipient.

          M

          Male

          P

          Female

          U

          Unknown

          j. LAF (Leger Account File) Code: This reflects the Master Beneficiary Record payment status for this beneficiary.

          A

          Withdrawal for adjustment

          AA

          Adjusted to split PICs in Advance File Status

          AC

          PIA correction (no recomputation)

          AD

          Adjusted for dual entitlement

          AF

          Transferred to another program service center or OIO. This code is no longer valid since implementation of national MBR. Adjusted to cancel worker’s compensation offset

          AJ

          Worker’s compensation offset/public disability benefits cancellation

          AM

          Withdrawn from HIB-only status

          AP

          Withdrawn for change of PIC or post-entitlement action adjusted simultaneous entitlement

          AR

          Withdrawal of a beneficiary from LAF S or T to place in current payment status

          AS

          Adjusted for simultaneous entitlement

          AW

          Withdrawn to impose worker’s compensation offset/public disability benefits

          A(-)

          Withdrawn from current payment status to be placed in suspense or deferred status

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

VII. B. 1. (CONT’D)

          A0

          Withdrawn to adjust reduction factor

          A2

          Withdrawn for 1965 or 1968 recomputation

          A4

          Withdrawn for disability offset recomputation

          A6

          Withdrawn to recalculate PIA to include disability freeze

          A7

          Withdrawn for recomputation under Section 217 (non-contributory military credits before 1957)

          A8

          Record transferred from OIO to another program service center. This code is no longer valid since implementation of national MBR.

          A9

          Withdrawn for adjustment action not separately defined

          B

          Abatement status

          C

          Current payment status (except Railroad payment)

          D

          Deferred payment status

          DP

          Deferred because of Public Assistance

          DW

          Deferred because of worker’s compensation/public disability benefit offset

          D1

          Deferred because of Foreign Work Test

          D2

          Deferred because of annual retirement test

          D3

          Deferred as an auxiliary because the primary beneficiary is LAF-D2

          D4

          Deferred for no child-in-care

           

          Deferred as an auxiliary because the primary beneficiary is in LAF-D1

          D6

          Deferred to recover overpayments not separately defined

          D9

          Deferred for reasons not separately defined

          E

          Current payment certified to the RRB

          F

          Advanced Filing for Current Payment through RRB

          J

          Advanc File Current Pay Case

          K

          Advanced Filing for Deferred Payment

          L

          Advanced Filing for Conditional Payment

          N

          Disallowed claim

          ND

          Denied claim

          P

          Delayed claim (adjudication pending)

          PB

          Delayed claim - beneficiary’s claim not finally adjudicated

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

VII. B. 1. (CONT’D)

          PF,

          PH, PJ, PK, PL, PM, PP

          Used with delayed claims to indicate the beneficiary is to be placed in conditional payment status (LAF S) upon final adjudication. The second position character (subscript) has the same meaning as the subscript for the S LAFs.

          PT

          Claim has been terminated from delayed claims status

          PW

          Used with delayed claims to indicate the beneficiary is to be placed in conditional payment status (LAF S) upon final adjudication. The second position character (subscript) has the same meaning as the subscript for the S LAFs.

          P0-P9

          Used with delayed claims to indicate the beneficiary is to be placed in conditional payment status (LAF S) upon final adjudication. The second position character (subscript) has the same meaning as the subscript for the S LAFs.

          R

          Kill Credit

          Sx

          Conditional/Suspended statuses

          SB

          Benefits due but not paid (ess than S1.00)

          SD

          Technical Dual Entitlement – beneficiary is entitled on another claim or disability family maximum provision has reduced the MBA to zero

          SF

          Prouty beneficiary fails to meet residency requirement

          SH

          Prouty beneficiary receiving government pension

          SJ

          Alien suspension

          K

          Deportation

          SL

          Beneficiary is in a barred payment country

          SM

          Refused old age insurance benefits to get Medicare-only coverage (prior to 1/81)

          SP

          Prouty beneficiary receiving public assistance

          SS

          Post-secondary student summer suspension

          SW

          Worker’s compensation/public disability benefit offset

          S0

          Pending determination of continuing disability

          S1

          Beneficiary worked outside the U.S.

          S2

          Beneficiary worked inside the U.S.

          S3

          Primary beneficiary worked in the U.S.

          S4

          Failure to have child-in-care

          S5

          Primary beneficiary worked outside the U.S.

          S6

          Development of a better (correct) address for mail or direct deposit, as appropriate

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

VII. B. 1. (CONT’D)

          S7

          Prisoner suspension, suspension due to extended trial work period (EPE SGA); or suspension for refusing vocational rehabilitation (VR) services

          S8

          Payee is being determined

          S9

          Miscellaneous suspension

          Tx

          Terminated status

          TA

          Advanced filing claim terminated before maturity

          TB

          Mother’s/Father’s benefits terminated because beneficiary is entitled to disabled widow(er)s benefits

          TC

          Disabled widow attained age 62 and is not entitled as an aged widow

          TJ

          Advance filed claim terminated after maturity

          TL

          Termination of student (post secondary)

          TP

          Terminated for change of payment identification code (PIC) on post entitlement actions

          TX

          DIB attained age 65 (also used for auxiliary beneficiaries)

          T(&)

          Claim was withdrawn

          T(-)

          Disability benefits terminated because of conversion to retirement benefits upon attainment of age 65

          T0

          Benefits payable by some other agency

          T1

          Death of beneficiary

          T2

          Auxiliary terminated due to death of primary beneficiary (converted to survivor’s benefits)

          T3

          Beneficiary divorced, married, or remarried

          T4

          Child beneficiary terminated because of attainment of age 18 or 19 and is not disabled; mother/father terminated based on last child’s attainment of age 16

          T5

          Entitled to other benefits

          T6

          Child beneficiary is no longer attending school on full-time basis and is between ages 18 or 19, or a disabled child is no longer under a disability. Termination of a mother/father because of death or marriage of the last remaining child entitled to receive benefits

          T7

          Child terminated because of adoption, mother/father terminated because last entitled child adopted

          T8

          Primary DIB no longer disabled; mother/father terminated because child no longer disabled

          T9

          Terminated for reasons not separately defined

          U

          Active Uninsured Status

          W

          Withdrawal before entitlement

          Xx

          Adjusted/Suspended/Terminated/Un-insured statuses

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

VII. B. 1. (CONT’D)

          XD

          Withdrawal for adjustment

          XF

          Entitlement transferred to another program service center or OIO

          XK

          Beneficiary deported

          XR

          Withdrawn from SMIB

          X(+)

          SMI withdrawn; beneficiary entitled only to SMI

          X0

          Claim transferred to RRB

          Xl

          Death of beneficiary

          X5

          Beneficiary entitled to other benefits

          X7

          Health insurance benefits (HIB)/SMIB terminated

          X8

          Payee being developed

          X9

          Entitlement has been interrupted for reasons not separately defined

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

VII. B. 1. (CONT’D)

          k. Proof of Age Indicator:

          A

          Alleged

          B

          Birth/Baptismal Certificate

          C

          Convincing Evidence

          F

          Formerly established by SSA

          Q

          Established by method other than B or C above

          l. Initial Entitlement Date: This is the initial date of entitlement to Title II benefits.
          m. Current Entitlement Date: This indicates the month and year the beneficiary became entitled to benefits for the current period of entitlement.
          n. Suspension Term Date: The date an event causing a suspension or termination occurred.
          o. Net Monthly Benefit: The benefit payable after deduction of the beneficiary obligation.
          p. Direct Deposit: The type of account to which the payment is being deposited.

          C

          Checking account

          S

          Savings account

          N

          No direct deposit

          q. Deferred Pay Date: Reflects the month and year the first or next payment can be made. This is typically a one-time retroactive adjustment.
          r. Schedule Pay: Information on the scheduled payment.
            (1) Ind: This indicates how schedule pay was made.

            P

            Prior Month Accrual Amount paid by daily update

               

            R

            Current month accrual paid by month merge

               

            B

            Prior month accrual only

            (2) Date: Reflects current operating month when the prior month accrual is made.
            (3) Current: The total amount to be paid by a current month accrual.

REVISED 05/01/2011 - CHANGE NO. 04-11

VII. B. 1. r. (CONT'D)

            (4) Comb Ck Ind: This indicates that the schedule payment or the scheduled prior payment was included in the regular monthly check.
            (5) Prior: The total amount paid by scheduled check.
          s. Railroad Information: This data relates to Railroad Retirement Benefits for the recipient, if applicable.
            (1) Indicator: Indicates status of claim

            A

            Active claim

            T

            Terminated claim

            (2) Persons Own SSN: The recipient's social security number.
            (3) Date of Death: The recipient's date of death.
            (4) Dis Onset Date: First date of onset of disability.
        2. If the individual has RSDI information, the third screen will display as follows:

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

VII. B. 2. (CONT’D)

                TPQY SCREEN

In addition to the name and social security number, the following fields will display on this screen:

          a. Supplemental Medical Insurance: This information pertains to Medicare B.
            (1) Indicator: A "Y" (yes) or "N" (no) will indicate if beneficiary has Medicare B.
            (2) Option Code: This indicates status of Medicare B.

            C

            No (cessation)

            D

            No (denied)

            F

            No (terminated, invalid enrollment)

            G

            Yes (good cause)

            N

            No (no response)

            P

            Railroad

            R

            No (refused)

            S

            No (no longer renal disease provision)

            T

            No (terminated for nonpayment)

            W

            No (withdrawal)

            Y

            Yes

            (3) Start Date: This is the current date of entitlement to Medicare B.

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

VII. B. 2. a. (CONT’D)

            (4) Stop Date: This is the date entitlement to Medicare B ended.
            (5) Premium: This is the current Medicare B premium amount collectible. The amount is deducted from benefits if premium payer is the recipient.
          b. SMIB Buy-In:
            (1) Indicator: A "Y" (yes) or "N" (no) will indicate if Medicare B buy-in data is present.
            (2) Code: This is a three-digit code indicating the payer of the Medicare B premium.
            (3) Start Date: The date for which a third party first paid the Medicare B premium.
            (4) Stop Date: The date the third party last paid the Medicare B premium.
          c. Dual Entitlement No: The other claim account number (CAN) under which the beneficiary is entitled to Title II benefits.
          d. Health Insurance: This information pertains to Medicare A.
            (1) Indicator: A "Y" (yes) or "N" (no) will indicate if the beneficiary has Medicare A.
            (2) Option Code: This code indicates the status of Medicare A.

            C

            None - Cessation

            D

            None - Denied

            E

            Yes - Automatic

            F

            None - Invalid enrollment

            G

            Yes - Good cause

            H

            None - Not eligible or did not enroll

            P

            Railroad

            R

            None - Refused

            S

            None -No longer under renal disease provision

            T

            None- Terminated for nonpayment of premiums

            W

            None- Withdrawal

            X

            None - Title II termination

            Y

            Supplemental insurance (Part B) premium is payable

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

VII. B. 2. d. (CONT'D)

            (3) Start Date: This is the current date of entitlement to Medicare A.
            (4) Stop Date: This is the date entitlement to Medicare A ended.
            (5) Premium: This is the current Medicare A premium amount if payable.
          e. HIB Buy-In:
            (1) Indicator: A "Y" (yes) or "N" (no) will indicate if Medicare A buy-in data is present.
            (2) Code: Third party code for health insurance.
            (3) Start Date: First month of coverage for which a third party paid the HI premium.
            (4) Stop Date: Last month of coverage for which a third party paid the HI premium.
          f. Welfare Agency Code: The three-digit State exchange welfare code.
          g. Assistance Code: The state exchange categorical assistance code.

          A

          Aged

          B

          Blind

          C

          AFDC

          D

          Disabled

          F

          Food Stamps

          H

          Health Maintenance

          I

          Income Maintenance

          J

          Work First and Food Stamps

          K

          Food Stamps and Medicaid

          N

          Title XIX Medicaid Eligibility

          P

          Child Support Enforcement

          S

          Statement of consent

          U

          Unemployment Compensation

          h. Black Lung: This information pertains to Black Lung benefit information, if applicable.
            (1) Entitlement Code: Present entitlement status of the Black Lung benefit:

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

VII. B. 2. h. (CONT’D)

            E

            Entitled

            N

            Nonpayment status

            P

            Entitlement pending

            T

            Terminated (other than death)

            D

            Deceased

            (2) Entitlement Amount: Black Lung monthly payment amount. Amounts paid to a miner or widow include all benefits due the family in the same household.
        3. If the individual has RSDI information, the fourth screen will display as follows:

                TPQY SCREEN

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

VII. B. 3. (CONT’D)

          In addition to the name and social security number, the following fields will display on this screen:

          a. Cross-Reference Account Numbers:
            (1) Code:

            A

            MAFDUP selection precluded (possible duplicate Social Security Number (SSN) has already been investigated)

            C

            Civil Service number

            D

            Dual wage record number

            E

            Simultaneous entitlement number

            F

            Multiple SSN from claims automated processing system (CAPS)

            G

            Multiple SSN from automatic reappraisal military service an multiple account numbers (ARMSMULT)

            H

            Multiple SSN from program service center (PSC) or central office correction

            L

            Black Lung benefits number

            M

            Multiple SSN

            O

            Potential or actual entitlement number

            S

            Spouse's SSN

            U

            SSN upon which renal entitlement is based

            V

            Second validated beneficiary's own SSN/beneficiary's own account number (BOSSN/BOAN)

            W

            State welfare case number

            (2) Entitlement No.: The social security number on which actual or potential entitlement exists.
            (3) BIC: The Beneficiary Identification Code (suffix) for which an actual or potentials entitlement exists.
          b. Monthly Benefit Credited: This lists the last four changes in benefit amounts.

            Date: The date of the change in benefits.

            Amount: The amount of the changed benefit.

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

VII. B. 3. b. (CONT’D)

            Type: Indicates whether or not benefits are being received.

            C

            Continuous monthly payment, or uninsured (Title II claim number suffix T and M)

               

            N

            One-time payment

               

            T

            Termination of continuous monthly payment

               

            R

            Used in conjunction with type A income to indicate recent RSDI filing or with type D income to indicate potential eligibility to an RRB benefit.

               

            U

            Used only in conjunction with a type D entry to indicate RRB has jurisdiction of the Title II (type A) payment and that recipient's entitlement to an RRB annuity has not been determined.

      C. Supplemental Security Information

        1. If the individual has SSI information only, the second screen will display SSI information. If the individual has RSDI and SSI, the following screen will display as the fifth screen:

                TPQY SCREEN

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

VII. C. 1. (CONT’D)

          In addition to the name and social security number, the following fields display on this screen:

          a. Person's own SSN: The social security number of the recipient.
          b. SSN Correction Ind: A one-digit code indicating the status of a pseudo SSN (900 series) or invalid SSN assigned to the recipient.

            CODES:

          A

          A pseudo or invalid SSN appears in the SSN field.

          A valid SSN appears in the last 9 positions of

          the Multiple SSN field and is initially transmitted to

          the State.

             

          B

          The valid SSN appears in the SSN field. The

          pseudo or invalid SSN appears in one of the five

          slots of the multiple SSN field.

          c. SSI Application Date: The date the claimant files the application for SSI or the date the individual is deemed to have filed the application.
          d. Denial Code: The reason an applicant was denied initially for SSI. These reasons are defined in VI. C. 1. m. (Payment Status Codes) below.
          e. Date of Birth: The date of birth of the recipient.

        f. Date of Death: The date of death of the recipient.

          g. Disability Onset Date: First date of onset of disability. Prior to a determination of eligibility for Title XVI, this is the alleged date of disability.
          h. Last Name: The recipient's last name.
          i. First Name: The recipient's first name.
          j. Initial: The recipient's middle initial.
          k. Race: A one-digit code indicating the race of the individual. The Race Code will be overlayed with a one-digit ZEBLEY INDICATOR CODE in the current RACE CODE field, when applicable.
            (1) RACE CODES:

            W

            White

            B

            Black

            O

            Other

            U

            Unknown

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

VII. C. 1. k.(CONT’D)

            (2) ZEBLEY INDICATOR CODES:

              Z Zebley case is pending determination of eligibility.

              F Zebley case approved and all Zebley related payments have been made.

              D Zebley payments have been denied.

          l. Sex: A one-digit code indicating the sex of the individual.

            CODES:

          M

          Male

          F

          Female

          U

          Unknown

          m. Current Pay Status: This is what the payment status will be if there are no other changes to the record. This also provides the reason for the status. The first position of the payment status code indicates the status of SSI/SS payment/eligibility. The second and third positions indicate the reason for the status.
      (1) FIRST POSITION CODES:

      C

      Client is eligible for SSI/SS payment

      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

      Case is under manual control; case is known

      as "force payment" although a payment may

      not be involved

      N

      Client is not eligible for SSI/SS payment or that a previously

      eligible recipient is no longer eligible

      S

      Client may still be eligible for SSI/SS but

      payment is being withheld

      T

      SSI/Social Security (SS) eligibility is terminated

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

VII. C. 1. m. (2) (CONT’D)

      (2) SPECIFIC CODES:

      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

      First month of eligibility for claims filed on or after 8/22/96. Claimant is eligible for a payment in that month but is NOT due a payment.

      H10

      Living arrangement change in progress

      H20

      Marital status change in progress

      H30

      Resource change in progress

      H40

      Student status change in progress

      H50

      Head of household change in progress

      H60

      Hold pending receipt of date of death

      H70

      Hold pending receipt of date of death

      H80

      Early input

      H90

      Systems limitation involved. DO must manually compute and input payment amounts

      M01

      Force Payment – Recipient may be in payment or non-payment status

      M02

      Force Payment – Recipient may be in payment or non-payment status

      N01

      NON-PAY - individual's countable income exceeds title XVI federal benefit rate

      N02

      NON-PAY - Recipient is inmate of public institution

      N03

      NON-PAY - Recipient is outside U.S.

      N04

      NON-PAY – Recipient’s nonexcludable resources exceed Title XVI limitations

      N05

      NON-PAY – Unable to determine if eligibility exists

      N06

      NON-PAY – Recipient failed to file for other benefits

      N07

      NON-PAY - Cessation of recipient’s disability

      N08

      NON-PAY - Cessation of recipient’s blindness

      N09

      NON-PAY – Recipient refused vocational rehabilitation without good cause

      N10

      NON-PAY – Recipient refused treatment for drug addiction

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

    VII. C. 1. m. (2) (CONT'D)

      N11

      NON-PAY – Recipient refused treatment for alcoholism

      N12

      NON-PAY – Recipient voluntarily withdrew from program

      N13

      NON-PAY - Not a citizen or eligible alien

      N14

      NON-PAY - Aged claim denied for age

      N15

      NON-PAY – Blind claim denied. Applicant not blind.

      N16

      NON-PAY – Disability claim denied. Applicant not disabled.

      N17

      NON-PAY - Failure to pursue claim by applicant

      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

      N22

      NON-PAY - Inmate of a penal institution

      N23

      NON-PAY – Not a U.S. resident

      N24

      NON-PAY – Convicted of felony of fraudulently misrepresenting residence in two or more States (Effective Through 11/99) Non-pay - Administrative Sanctions penalty imposed because claimant has provided false or misleading statements to obtain benefits. (Effective 12/99 until present)

      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 or is violating a condition of probation or parole imposed under Federal or State law.

      N27

      NQNPAY - Disability terminated due to substantial gainful activity

      N30

      NONPAY - Slight impairment - medical consideration alone, no visual impairment

      N31

      NONPAY - Capacity for substantial gainful activity - customary past work, no visual impairment

      N32

      NONPAY - Capacity for substantial gainful activity - other work, not visual impairment

      N33

      NONPAY - Engaging in substantial gainful activity despite impairment, no visual impairment

      N34

      NONPAY – Before 3/9/91: Impairment no longer severe at the time of adjudication and did not last 12 months, no visual impairment Effective 3/9/91: Child under age 18, impairment(s) disabling for a period of less than 12 months

      N35

      NONPAY - Impairment is severe at time of adjudication but not expected to last 12 months, no visual impairment

      N36

      NQNPAY - Insufficient or no medical data furnished

      N37

      NONPAY - Failure or refusal to submit to consultative examination

      N38

      NONPAY - Applicant does not want to continue development of claim

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

    VII. C. 1. m. (2) (CONT'D)

      N39

      NONPAY - Applicant willfully fails to follow prescribed treatment

      N40

      NONPAY - Impairment(s) does not meet or equal listing (disabled child under age 18 only), no visual

      impairment

      N41

      NONPAY - Slight impairment-medical condition alone,visual

      impairment

      N42

      NONPAY - Capacity for substantial gainful activity -customary work, visual impairment

      N43

      NONPAY - Capacity for substantial gainful activity other work, visual impairment

      N44

      NONPAY – Before 3/9/91: Engaging in SGA despite impairment,

      Effective 3/9/91: Child under 18. Impairment not severe

      N45

      NONPAY - Impairment no longer severe at time of adjudication and did not last 12 months, visual impairment, or denial of child’s claim

      N46

      NONPAY - Impairment is severe at the time of adjudication but not expected to last 12 months, visual impairment

      N47

      NONPAY - Insufficient, or no, medical evidence furnished, visual impairment

      N48

      NONPAY - Failure, or refusal, to submit to consultative examination, visual impairment

      N49

      NONPAY - Applicant does not want to continue development of the claim, visual impairment

      N50

      NONPAY - Applicant willfully fails to follow prescribed treatment, visual impairment

      N51

      NONPAY – Before 3/9/91: Impairment does not meet or equal listing (disabled child under age 18 only), visual impairment Effective 3/9/91: Child under 18. Individual Functional Assessment (IFA) shows impairments(s) not of comparable severity, visual impairment

      N52

      NONPAY - Deleted from the State rolls before 1/73 payment

      N53

      NONPAY - Deleted from the State rolls after 1/73 payment

      N54

      NONPAY – DO 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 – Substantial gainful activity decision pending

      S06

      SUSPENDED – Recipient’s address unknown

      S07

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

      S08

      SUSPENDED - Representative payee development pending

      SO9

      SUSPENDED – Temporary Institutionalization Suspense (systems-generated)

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

    VII. C. 1. m. (2) (CONT'D)

      S10

      SUSPENDED – Recipient has a bank account and refuses to receive payments via direct deposit

      S20

      SUSPENDED - Potential rollback case or disability decision made prior to 7/73

      S21

      SUSPENDED - The recipient is presumptively disabled or blind and has received six months payments (systems-generated)

      S90

      SUSPENDED – PR1 change in process because SSR was established under the incorrect SSN (this condition is extremely rare)

      S91

      SUSPENDED – PR1 change in process because SSR was established under the incorrect SSN (this condition is extremely rare)

      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 – Manual termination (payment previously made). Change in record composition requires termination of existing record

      T31

      TERMINATED - System generated termination (payment previously made or refund on record)

      T32

      TERMINATED – Automated systems termination of a paid record that has exceeded certain size limitation

      T33

      TERMINATED - Manual termination (through MSSICS)

      T50

      TERMINATED – Manual termination (no previous payment made)

      T51

      TERMINATED – System generated termination (no previous payment made)

      *

      Data transmitted in error

          n. Direct Deposit Ind: This is an indicator that benefits are deposited directly to an account as follows:

          C

          Checking

             

          E

          Electronic Benefits Transfer

             

          S

          Savings

             

          Blank

          None

          o. Address: The mailing address of the recipient.
          p. Zip Code: The zip code of the mailing address.
          q. Address: The address where the recipient lives if the address is different from the mailing address. Otherwise, the field will be blank.
          r. Zip Code: The zip code of the residence address.

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

VII. C. 2.

        2. If the individual has SSI information only, the third screen displays payment and income information for SSI. If the individual has RSDI and SSI, this displays as the sixth screen.

                TPQY SCREEN

          In addition to the name and social security number, the following fields display on this screen:

          a. Current payment:
            (1) Federal: The cumulative Federal SSI payment(s) actually paid to the recipient under Title XVI. This is the amount of the regular monthly check issued to the recipient.
            (2) State: The cumulative State Supplementation payment(s) actually paid to the recipient.

            NOTE: North Carolina does not have a State Supplementation payment.

          b. Payment History:
            (1) Federal: Historical payment history data.
            (2) State: Historical payment history data.

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

VII. C. 2. b. (CONT’D)

            NOTE: If an individual is determined to be disabled due to a

              drug or alcohol addiction (DAA), and they are eligible

              for a lump sum payment, their lump sum is prorated over a period of time. In this situation, the Payment History reflects the regular monthly payment associated with the first day of the month and the prorated lump sum payment associated with the second day of the month.

          c. Net Countable Earned Income: The current month’s amount of earned income after all exclusions are applied. This is used in determining eligibility and, if the Budget Month Flag is zero, computing the payment.
          d. Net Countable Unearned Income: The current month’s amount of unearned income after all exclusions are applied. This is used in determining eligibility and, if the Budget Month Flag is zero, computing the benefit. It includes income deemed to the eligible individual.
          e. Resources:
            (1) House: A one-digit code indicating that the individual does or does not own a home.

            A

            Possession of a home-principal place of residence

            S

            Equity in nonexcludable property is expected to increase in value

            T

            Home and equity in nonexcludable property

            Z

            None

            (2) Vehicle: A one-digit code indicating that the individual does or does not own a vehicle and if the individual must dispose of the vehicle for SSI eligibility.

            B

            Vehicle - either over or under limit

            K

            Individual required to dispose of vehicle

            Z

            None

            Blank

            Not determined

            (3) Life Ins.: A one-digit code indicating if the individual has life insurance and if the individual must dispose of life insurance for SSI eligibility.

            C

            Life insurance - face value over $1500

            L

            Individual required to dispose of life insurance

            Z

            None

            Blank

            Not determined

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

VII. C. 2. e. (CONT'D)

            (4) Income Prop.: A one-digit code indicating if the individual owns income producing property and if the individual must dispose of the property for SSI eligibility.

            D

            Income producing property under or over limit

            N

            Individual required to dispose of income producing property

            Z

            None

            Blank

            Not determined

            (5) Other: A one-digit code indicating if the individual owns other resources and if the individual must dispose of other resources for SSI eligibility.

            E

            Other resources-over limit

            N

            Individual required to dispose of other resources

            Z

            None

            Blank

            Not determined

          f. Telephone Number: The recipient's telephone number, including area code.
          g. Wage Amount: The gross amount of wages for the month, which the recipient expects to earn in a specified month.
          h. Self-Employment: The estimated net amount of self-employment income for a specified month.
          i. Blind Work Expenses: The amount of work expenses of a blind recipient for a specified month, which may be excluded from earned income.
          j. Self-Support Amount: The monthly amount of earned income for blind or disabled recipients which may be excluded under an approved plan of self-support.
          k. Reimbursements Code: This indicates the timing of SSA reimbursement of State interim assistance payment(s) or the reason for not effecting reimbursement. The reimbursement status code may change.

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

VII. C. 2. k. (CONT’D)

          0

          Essential person record; applicant did not authorize reimbursement; there is no Federal/State agreement for reimbursement; or SDX record is for the month following the month of recipient's move from the state of reimbursement.

             

          1

          Total amount shown in the SSI Monthly Assistance Amount and the State Supplement Amount fields is being sent or was sent to State/county.

             

          2

          All or part of the amount shown in the SSI Monthly Assistance Amount and the State Supplement Amount fields in current record is being or was sent to the State/County.

             

          3

          Reimbursement not being effected; applicant ineligible or retroactive payment not due.

             

          4

          Reimbursable assistance case pending or denied.

             

          5

          Reimbursement check returned.

          l. Reimbursements: State/County: Reflects the State/County code corresponding to the agency with which the SSI/SS applicant signed an agreement for reimbursement of interim assistance payments. This field is zeroes in the following situations: The SDX record is for an essential person, an applicant who may not have authorized reimbursement to the State, or where there is no Federal/ State agreement for reimbursement.
          m. Representative Payee Ind: This indicates whether or not representative payee data is present.
        3. If the individual has SSI information only, the fourth screen displays additional information for SSI. If the individual has RSDI and SSI, this displays as the seventh screen:

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

VII. C. 3. (CONT'D)

                TPQY SCREEN

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

VII. C. 3. (CONT'D)

          In addition to the name and social security number, the following fields will display on this screen:

          a. Over/Under Pay Ind: This indicates if an overpayment or underpayment exists. The SSI Monthly Assistance Amount reflects overpayment and/or underpayment.

          O

          Overpayment

          U

          Underpayment

          R

          Both overpayment and underpayment exists

          b. Current Pay Status: Refer to VII C. l. m. above.
          c. Head of Household: A field indicating whether or not the recipient is the head of the household for Title XVI purposes at the time the record is established. In addition, it is also used to indicate that one member of a couple was determined eligible for SSI while a disability determination was pending for the other member.

          Y

          Head of household

             

          N

          Not head of household

             

          S

          Member of the couple that is (or was) paid as an individual while disability was being determined for the other member of the couple.

             

          R

          Member of the couple for which the disability determination is or was pending.

          d. Marital Status: Indicates the marital status of the recipient at the time the record was established.

          1

          Married and living with (ceremonial marriage, common law marriage, or de facto marriage)

             

          3

          Single, widowed, or divorced

             

          4

          Married, but separated

          e. Student Indicator: Indicates whether a recipient under age 22 is a student.

          Y

          Student

             

          N

          Not a student

             

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

VII. C. 3. (CONT'D)

          f. Conditional Payment: A code indicating whether or not a payment is or was subject to disposition of excess resources. When a payment is no longer conditional, the code "C" remains.

          C

          Conditional

             

          N

          Not conditional

             

          Blank

          Not applicable

          g. Disability Code: A one-digit code indicating the status of SSI disability and blind cases.

          P

          Presumptive Finding

          F

          Final determination - allowance

          S

          State determination (conversion cases only) - allowance

          R

          Referred to state agency - final determination (denied, or pending determination)

          T

          Presumptive finding (state conversion case)

          X

          No disability determination made - claim denied on basis of nondisability issues

          h. Food Stamp Int Date: The month and year of the initial Food Stamp data input.
          i. Food Stamp App Sec: Indicates whether or not SSA personnel took an application for Food Stamps.

          Y

          Yes

          N

          No

          Blank

          No input

          j. Food Stamp Status: Indicates whether the recipient currently receives Food Stamps or had filed an application for food stamps in the past 60 days on which no decision has been made.

          Y

          Yes

          N

          No

          Blank

          No input

          k. Multiple SSNs: This field shows additional Social Security numbers used by the individual.

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

VII. C. 3. k. (CONT'D)

          l. Unearned Income Information
            (1) Type - A one-digit code indicating the kind of unearned income that the individual is or was receiving. Each code is listed below.

            A

            Social Security

            B

            Black Lung

            C

            Veterans Administration Compensation

            D

            Railroad Retirement

            E

            Veterans-Administration Pension

            F

            Assistance based on need and not excluded from unearned income (Work First Family Assistance)

            H

            Income in-kind

            I

            Ineligible child allocation

            J

            Value of 1/3 reduction

            K

            Blind countable income

            L

            Military Pension (includes survivor payments)

            M

            Federal Civil Service Pension

            N

            Child Support payments received from absent parent

            P

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

            Q

            Workmen's Compensation

            R

            Rents, interest, dividends, royalties

            S

            Other - A variety of types of income, including case contributions

            T

            Alaska longevity bonuses

            V

            Net deemed income- Income from a financially responsible spouse/parent

            X

            Minimum income level amount

            Y

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

            Z

            State countable income (Vermont only)

            1

            This code indicates that the IMC must determine the source of income from the client and take any necessary action in the case. If type H income is indicated, further verification is needed to determine the value of the contribution.

            (2) Start - The date indicating when the unearned income began if the payment is monthly or if a one-time payment (MMCCYY).

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

VII. C. 3. l. (CONT'D)

            (3) Stop - The termination date of unearned income (MMCCYY). In a situation where the unearned income amount changes, this is the last date the previous rate or one-time payment was received.

            NOTE: THE YEAR CAN BE "98" OR "99" ON CONTINUING TITLE II INCOME TO INDICATE PAYMENT ADJUSTMENT IN PROCESS.

            (4) Amount - The monthly amount of unearned income for the period indicated on the left.
            (5) Frequency - A one-digit code indicating whether or not unearned income is being received or was received. The codes are listed below.

            C

            Continuous monthly payment, or uninsured (Title II claim number suffix T and M)

            N

            One-time payment

            T

            Termination of continuous monthly payment

            R

            Used in conjunction with type A income to indicate recent RSDI filing or with type D income to indicate potential eligibility to an Railroad Retirement Board (RRB) benefit

            U

            Used only in conjunction with a type D entry to indicate RRB has jurisdiction of the Title II (type A) payment and that recipient's entitlement to an RRB annuity has not been determined

            (6) Claim/ID No. - The individual's claim number followed by a one-digit code indicating the claim or identification number under which each type of unearned income is being received. This field contains the following coding for "H" (income-in-kind) type income:

            A

            Living in own household

            B

            Living in noninstitutional care situation

            C

            Living in private nonprofit residential care institution covered by Church Amendment

            D

            Living in other private nonmedical institution (domiciliary care, personal care, retirement homes, etc.)

            E

            Living in private medical institution but Medicaid payees less than 50% of the cost

            F

            Living in public institution for education or vocational training

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

VII. C. 3. l. (CONT'D)

            (7) Program Service Center Code - A one-digit code following claim/ID No. which indicates the service center from which payment is made.

            1

            New York

            2

            Philadelphia

            3

            Birmingham

            4

            Chicago

            5

            San Francisco

            6

            Kansas

            7

            Office of Disability Operations, Baltimore

            8

            Division of Internal Operations, Baltimore

            B

            Type B (Black Lung income under Department of Labor jurisdiction

            D

            Individual is a VA dependent; Type C or E amount represents dependent's portion of a combined VA check payment

            F

            Type C or E VA fixed payment or Type D (RRB Benefit) not subject to general legislative increases

            G

            Type E VA parent's dependency and indemnity compensation

            V

            Individual is a veteran or surviving spouse of veteran. Type C or E amount represents Veteran/Surviving spouse portion of a combined VA check payment

            X

            Same as "V" above except not subject to general legislative increases

            (8) Verification - A one-digit code indicating whether or not the unearned income, as stated by the individual, has been verified.

            O

            Number and income amount not verified

            1

            Number verified, amount not verified

            2

            Number and income amount verified

            8

            Dually entitled to Title II benefits

Top Of Page

VIII. LOGOFF PROCEDURES

      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.

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