SI BOS02003.003 Massachusetts Interim Assistance Reimbursement Agreement

See SI 02003.000

A. Introduction

On February 10, 1975, the Massachusetts Department of Public Welfare, now the Department of Transitional Assistance (DTA), entered into an Interim Assistance Reimbursement (IAR) Agreement with the Social Security Administration (SSA). This agreement was updated and renewed with DTA, on September 25, 2010 and modified on November 20, 2010 to include the new electronic IAR (eIAR) process. The IAR Agreement covers both initial and posteligibility situations.

B. Policy

1. Initial and posteligibility periods covered

The IAR Agreement with DTA provides for reimbursement to DTA for Emergency Assistance to the Elderly, Disabled, and Children (EAEDC) benefits provided to SSI applicants/recipients for initial claims and posteligibility situations. For initial claims the reimbursement covers the EAEDC paid for the interim period while the SSI application is pending. For posteligibility situations, the reimbursement covers the EAEDC paid by DTA to an individual for the interim period while his or her SSI benefits are suspended or terminated if the individual is subsequently found to be eligible for SSI during those months. See SI 02003.001 for an explanation of the interim period.

2. Protective filing

The IAR authorization serves as a protective filing for an initial SSI claim. The date that DTA receives a signed IAR authorization establishes a 60-day protective filing period for SSI eligibility. If an individual does not file an SSI application within the 60-day protective filing period, the IAR authorization does not serve as protective filing for SSI purposes.

3. Life of the authorization

For initial SSI claims the IAR authorization is effective for one calendar year beginning with the date DTA notifies SSA that it has received a signed authorization. If the claimant is already eligible for SSI, or there is a claim pending at the time DTA receives the authorization, DTA must notify SSA of the authorization within thirty (30) calendar days of receiving it in order for it to be binding. If the claimant has not yet filed an SSI application at the time DTA receives the authorization, DTA must notify SSA of the authorization within thirty (30) days of matching the EAEDC eligibility record with a pending SSI claim on the SDX, in order for the authorization to be binding. If not notified timely, SSA will release a retroactive SSI payment to the individual, since the authorization is not binding on the applicant, and DTA will be responsible for pursuing recovery of IAR from the individual without assistance from SSA. If an individual applies for SSI within the one calendar year period covered by the IAR authorization or has already applied for SSI before SSA received notification of an authorization, the period for the life of the authorization will be extended beyond the one year period, until such time as:

  • SSA releases the initial retroactive payment; or

  • SSA makes a final determination (including a determination on appeal) and no timely request for review is filed; or

  • The State and the individual agree to terminate the authorization.

For initial posteligibility cases, the IAR authorization is effective for one calendar year beginning with the date DTA notifies SSA that it received a signed authorization. If DTA does not notify SSA within thirty (30) calendar days of matching the applicant's record on the EAEDC eligibility file with an SSI record on the SDX, the authorization is no longer binding on DTA or the SSI recipient. In such a situation, SSA will release the retroactive SSI payment to the individual and DTA will be responsible for pursuing recovery of IAR from the individual without assistance from SSA. If a timely request for administrative or judicial review is filed, the IAR authorization remains in effect until such time as:

  • SSA makes the first posteligibility payment of retroactive SSI benefits following the suspension or termination of the individual's benefits; or

  • SSA makes a final determination on the issue and no timely request for appeal is filed; or

  • The State and the individual agree to terminate the authorization.

C. Process

DTA uses one authorization form with a block to identify whether it is for an initial payment or posteligibility payment (Exhibit 1). A new authorization is required for each SSI application (initial), or period of suspension or termination (post-entitlement).

D. Procedure

When an EAEDC application is filed at a local DTA office, an IAR authorization is signed and dated by the applicant and a DTA representative. When the EAEDC claim is established on DTA's eligibility database, an automated record to update the SSR with GR coding is created. The EAEDC record is matched with the SDX to determine if there is a pending SSI claim, or suspended SSI record. If there is an SSI record, the GR code: 22160 is posted. If there is no SSI record, DTA continues to match the EAEDC record to the SDX until there is one and the GR code is reflected on the SSR. DTA's GR code update is reflected in the TRAN field on the SSR as an “SDX” transaction.

DTA will use the new electronic process to request IAR for most cases. Cases with an underpayment on more than one record require additional Field Office intervention. The System creates an I9 Diary to identify these cases (SI 02003.022). See Exhibit 2 for instructions on how to clear an I9 diary. The eIAR system and FO intervention process cannot process a small number of complex reimbursement cases. eIAR exception cases require manual processing (SI 02003.023).

FAX manually prepared SSA-L8125s and SSA-L8125-F6s to:

617 889-7845.

Issue A-OTP's and mail correspondence to:

SSI/EAEDC Refund Unit
PO Box 120391
Boston, MA 02112-0391

E. Exhibits

EXHIBIT 1

AUTHORIZATION FOR REIMBURSEMENT OF INTERIM ASSISTANCE

    

INITIAL CLAIM OR POSTELIGIBILITY CASE

   

Name ____________________________

Social Security Number ________________________________

Address________________________________________________________________

City/State/Zip Code

   

The term “state” means the Massachusetts Department of Transitional Assistance.

    

What actions am I authorizing when I sign this authorization and I check the “Initial Claim Only” block?

  

[ ] Initial Claims Only

You are authorizing the Commissioner of the Social Security Administration (SSA) to reimburse the state for some or all of the money the state gives you. This money helps you while SSA decides if you are eligible to receive SSI benefits. If you become eligible, SSA pays the State from the retroactive SSI benefits due you. The reimbursement covers the time from the first month you are eligible to receive SSI benefits through the first month your monthly SSI benefit begins.

If the state cannot stop the last payment made to you, SSA can reimburse the state for this additional payment amount.

   

What actions am I authorizing when I sign this authorization and I check the “Posteligibility Case Only” block?

   

[ ] Posteligibilty Case Only

   

You are authorizing the Commissioner of the Social Security Administration (SSA) to reimburse the state for some or all of the money the state gives you. This money helps you while SSA decides if your SSI benefits can be reinstated after being terminated or suspended. If your SSI benefits resume, SSA pays the state from the retroactive SSI benefits due you. The reimbursement covers the time from the day of the month the reinstatement is effective through the first month your monthly SSI benefit resumes.

If the state cannot stop the last payment made to you, SSA can reimburse the state for this additional payment amount.

   

How can the state use this form when blocks for initial claims and posteligibility cases are part of the form?

  

The state can use this form for one case situation at a time, either an initial claim or a posteligibility case. If both blocks are checked the form is not valid. You and the state must sign and date a new form with only one block checked.

   

What kind of state payment qualifies for reimbursement by SSA?

SSA can reimburse a state for a payment that is paid only from state or local funds. The state cannot be reimbursed for payments made wholly or partially from Federal funds.

   

How does SSA determine how much of my SSI money to pay the state?

  

SSA decides the amount of payment based on two considerations. First, SSA looks at the amount of money claimed by the state, and second, SSA looks at the amount of your retroactive SSI money available to pay the state. SSA can reimburse the state for a payment made in a month only when you receive a state payment and an SSI payment for the same month. SSA will not pay the state more money than you have for the SSI retroactive period.

   

How long is this authorization effective for the state and me if I checked the “Initial Claims Only” block?

    

This authorization is in effect for you and the state for twelve (12) months. The 12 months begin with the date the state notifies SSA through an electronic system that the state has received the authorization and ends 12 months later. You and a state representative must sign and date the authorization for the authorization to be valid.

   

Exceptions apply to this rule. The state must send SSA the authorization within a certain time frame. For a state using an electronic system, SSA must receive the authorization information within 30 calendar days of the state matching your SSI record with your state record. If the information is late, SSA will not accept the information sent by the state. SSA will not pay any of your retroactive SSI benefits to the state. SSA will send you any SSI money that may be due you, based on SSA’s regular payment rules.

   

Can the authorization stay effective longer than the 12-month period? Can the authorization end before or after the 12-month period ends?

   

The authorization can stay effective longer than the 12-month period, if you

  • apply for SSI benefits before the state has the authorization form, or

  • apply within the 12-month period the authorization is effective, or

  • file a valid appeal of SSA’s determination on your initial claim.

  

The period of the authorization can end before the 12-month period ends, or end after the 12-month period ends when any of these actions take place:

  • SSA makes the first SSI payment on your initial claim; or

  • SSA makes a final determination on your claim; or

  • the state and you agree to terminate this authorization.

The authorization period will end with the day of the month any of these actions take place.

   

How long is this authorization effective for the state and me if I check the “Posteligibility Case Only” block?

  

This authorization is in effect for you and the state for twelve (12) months. The 12 months begin with the date the state notifies SSA through an electronic system that the state has received the authorization and end 12 months later. You and a state representative must sign and date the authorization for the authorization to be valid.

Exceptions apply to this rule. The state must send SSA the authorization within a certain time frame. For a state using an electronic system, SSA must receive the authorization information within 30 calendar days of the state matching your SSI record with your state record. If the information is late, SSA will not accept the information sent by the state. SSA will not pay any of your retroactive SSI benefits to the state. SSA will send you any SSI money that may be due you, based on SSA’s regular payment rules.

   

Can the authorization stay effective longer than the 12-month period? Can the authorization end before or after the 12-month period ends?

   

The authorization can stay in effect longer than the 12-month period if you file a valid appeal. You must file your appeal within the time frame SSA requires.

The period of the authorization can end before the 12-month period ends, or can end after the 12-month period ends when any of these actions take place:

  • SSA makes the first SSI payment on your posteligibility case after a period of suspension or termination; or

  • SSA makes a final determination on your appeal; or

  • the state and you agree to terminate this authorization.

The authorization period will end with the day of the month any of these actions take place.

  

Can SSA use this authorization form to protect my filing date for SSI benefits?

  

SSA can use this form to protect your filing date if you checked the “Initial Claims Only” block. When you sign this form, you are saying that you have the intention of filing for SSI benefits if you have not already applied for benefits.

You have sixty (60) days from the date the state receives this form to file for SSI benefits. Your eligibility to receive SSI benefits can be as early as the date you sign this authorization if you file within the 60-day time period. If you file for SSI benefits after the 60-day time period, this form will not protect your filing date. Your filing date will be later than the date you sign this form.

   

How do I appeal a state’s decision if I do not agree with the decision?

  

You can disagree with a decision the state made during the reimbursement process. You will receive a state notice telling you how to appeal the decision. You cannot appeal to SSA if you disagree with any state decision.

Within 10 working days after the state receives the reimbursement money from SSA, the state must send you a notice. The notice will tell you three things: (1) the amount of the payments the state paid you; (2) that SSA will send you a letter explaining how SSA will pay the remaining SSI money (if any) due you, and (3) about your right to a hearing with the state, including how to request the hearing.

  

What Happens if SSA mistakenly sends the payment to me?

  

I understand that if I am found eligible to receive SSI payments, and by mistake the payment is sent to me, when it should have been sent to DTA, then DTA can demand that I pay to it the amount of money that SSA determines is due DTA. If I do not pay this amount, I understand DTA can seek to collect this amount from me through a court action or other legal remedy. The Commissioner of the SSA will not be a party to, or responsible for, participating in DTA’s efforts to recover any IAR due it, under these circumstances.

_____________________________                        Date__________________
Signature of Individual Receiving Interim Assistance

   

___________________________    Date______________ GR Code______
Signature of State Representative

   

EXHIBIT 2

  

SSA Field Office Intervention Needed

When the SSI System receives the electronic reimbursement request from the State Agency, and cannot automatically compute the reimbursement amount, the system sets an I9 diary on the SSR.

The I9 diary indicates FO Intervention is required. I9 diaries are listed in ChiNet. The I9 diary may be posted to the SSR in 3 to 25 business days from the start of the eIAR process.

How do I resolve the I9 diary?

  1. Review the SSR to determine any months that require a manual SSI payment computation.

  2. Select Special Payments Menu (UPSP) in Direct SSR Update (UMEN).

  3. Establish an A-OTP.

  4. On UPOT, select option 3=Interim Assistance Reimbursement. Do NOT input a payment date range on UPOT. The system takes care of this for you.

    The System pre-fills the One Time Payment screens (UPOA) with State Agency’s information and (UPOP) with information from the SSR.

  5. Review the UPOP screen for accuracy. Input any corrections to the SSI Federal and State amounts due and paid for the months in the IAR period. Complete the “Prorate Day” column where proration is required.

    The System determines the amount of reimbursement, alerts the CR that a 2-PIN approval is required and displays the Simulated SSR.

  6. Confirm that the Simulated SSR is accurate, obtain the 2-PIN approval, and send data to the SSR.

    The System pays the State Agency and resolves the rest of the underpayment according to the priority of payment rules.

Reference: SI 02003.022


To Link to this section - Use this URL:
http://policy.ssa.gov/poms.nsf/lnx/0502003003BOS
SI BOS02003.003 - Massachusetts Interim Assistance Reimbursement Agreement - 11/09/2011
Batch run: 11/09/2011
Rev:11/09/2011