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)

A. Introduction

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:

STEP

ACTION

1

  • Review an SSID and the Post Entitlement Operational Data Store (PE ODS) listing to determine whether a face-to-face or telephone interview is appropriate.

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.

2

Tear off the perforated tab at the top of the form to separate pages 1 and 2.

3

On page 1, fill in the following information:

  • Recipient's name and mailing address or use a preprinted label.

  • Office address.

  • Recipient's social security number.

  • Date you complete the appointment notice.

  • Date and time of the scheduled interview.

4

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.

5

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.

6

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.)

7

Check off the appropriate item(s) recipients should:

  • Have on hand for telephone interviews; or

  • Bring with them for face-to-face interviews.

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.

8

Enter the FO phone number and the person to ask for if recipients have any questions.

9

Enter the FO manager's name and title.

10

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.

11

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.


To Link to this section - Use this URL:
http://policy.ssa.gov/poms.nsf/lnx/0502305019
SI 02305.019 - SSA-L3074-U2, Supplemental Security Income Notice of Appointment, and SSA-L3075-U2, Supplemental Security Income Notice of Appointment 1619(b) - 02/25/2013
Batch run: 02/25/2013
Rev:02/25/2013