TN 41 (09-02)
SI 02305.019 SSA-L3074-U2, Supplemental Security Income Notice of Appointment, and SSA-L3075-U2, Supplemental Security Income Notice of Appointment 1619(b)
The Supplemental Security Income Notice of Appointment is used to schedule posteligibility personal contact interviews with SSI recipients/rep payees.
The two notices for scheduling post-eligibility personal contact interview appointments' are:
SSAL-3074-U2 used to schedule appointments with recipients who are other than 1619(b) eligible or their rep payees or third party representatives;
SSAL-3075-U2 used to schedule appointments with recipients who are 1619(b) eligible or their rep payees or third party representatives.
Both notices are available in a preprinted format and on the Field Office Notice Software (FONS)/Distributed Online Correspondence System (DOCS) personal compute package.
The preprinted and FONS/DOCS forms are available in both English and Spanish.
B. Procedure when to use
Schedule RZ and/or limited issue personal contact interviews using the SSA-L3074-U2.
EXCEPTION: Use SSA-L3075-U2 to schedule interviews with 1619(b) eligibles.
Conduct a telephone interview whenever possible, especially if recipients and /or their rep payees/third party representatives work. Earnings posted to the record may indicate that these individuals are working and a face-to-face interview may be inconvenient.
C. Procedure completing the fill-in spaces on the form
Complete the fill-in spaces on the SSAL-3074-U2 and the SSA-L3075-U2, as follows:
EXAMPLE: ZH09 coding in the CG field of the SSID indicates that the recipient is deaf and uses sign language; a telephone interview is not appropriate.
Whether rep payee suitability needs to be developed, a disability redetermination is required, or the individual is a non-citizen with a 7-year eligibility limit ;
If the recipient needs to bring evidence with him to a face-to-face interview or submit evidence subsequent to a telephone interview.
NOTE: The presence of a diary may be an indicator of required evidence.
Tear off the perforated tab at the top of the form to separate pages 1 and 2.
On page 1, fill in the following information:
Recipient's name and mailing address or use a preprinted label.
Recipient's social security number.
Date you complete the appointment notice.
Date and time of the scheduled interview.
Check the appropriate blocks on page 1 of the form and fill in:
The number the recipient should call and the name of the person the recipient should ask for if scheduling a call-in interview; or
The number you will be calling if you will make the phone call to conduct a phone interview; or
The address of the field office and the person the recipient should ask for if scheduling a face-to-face interview.
Continue on page 1 and fill in the month/day/year the recipient needs to contact you to avoid suspension; i.e., 30 days from the date of the notice.
On page 2, fill in the reference date. Use the proposed appointment date to determine the reference date. (See SI 02305.034C. for instructions on determining the reference date.)
Check off the appropriate item(s) recipients should:
Include the name of the recipient or deemor for whom you need the item(s).
NOTE: For the third item, enter the earliest date (month/year) for which you need to verify earnings.
In alien cases, use the other fill-in to suggest that if the recipients' alien status has changed since the last time they had contact with SSA, they should bring in evidence showing their new status.
EXAMPLE: If you are not considered a U.S. citizen for SSI purposes and your immigration status has changed since the last time we contacted you, please have available the necessary papers that show your current alien status.
Enter the FO phone number and the person to ask for if recipients have any questions.
Enter the FO manager's name and title.
Enclose a copy of the SSA-3073 (or SSA-3073-SP for recipients who receive Spanish forms), Important Messages from Your Social Security Office. (See SI 02305.813 for an exhibit.) Because California is a cash-out state, enclose the SSA-3073-NFS or SSA-3073-SPNFS, since these versions of the form do not include a food stamp message.
NOTE: SSA is required to inform recipients about computer matching, food stamps, and Medicaid transfer of resources rules during the RZ process. Enclosing the SSA-3073 with the appointment notice fulfills this requirement.
Retain a dated copy of the notice to document the beginning of the 30-day closeout period.
D. Procedure face-to-face interview is required
1. Rep payee suitability
Conduct a face-to-face interview with the recipient and the rep payee when the Representative Payee (REPY) segment of the pre-RZ SSID has a Type of Payee (T) code of OTH and a Custody (CU) code of SEL (see SI 02305.123) unless the face-to-face interview requirement would clearly be unproductive. See SI 02305.123B. for an example of an exception to the face-to-face interview requirement.
2. Disability redetermination
Conduct a face-to-face interview with the recipient and the rep payee when a disability redetermination is required at age 18 per DI 11070.001.
3. Recipient is a qualified alien with a 7–year limit
Conduct a face-to-face interview with recipients when they are qualified aliens with a 7-year limit per SI 00502.130 and they are about to lose SSI eligibility because the 7-year period is about to expire.