REVISED INSTRUCTIONS FOR PAYMENT OF PAST DUE SSI BENEFITS

SI 02101.020 Large Past-Due Supplemental Security Income (SSI) Payments by Installments – Individual Alive (EFFECTIVE 06/22/2016)

A. Introduction

Effective for past-due SSI payments issued on May 22, 2006 or later, section 7502 of the Deficit Reduction Act of 2005, (P.L. 109-171), enacted February 8, 2006, changes the installment formula for SSI past-due payments. This section describes when we must issue the past-due payments by installments.

B. Policy - installment payments

Amounts (including any federally administered State supplement) subject to the installment payment requirement include:

• payments due but unpaid that accrued prior to the month payment was effectuated;
• payments due but unpaid that accrued during a period of suspension for which the recipient was subsequently determined to have been eligible; and
• any adjustment to the record that results in an accrual of unreleased payments.

1. Installment Payment requirements

The installment payment requirement applies when a recipient (or eligible couple) is eligible for past-due SSI in an amount that equals or exceeds:

• three times the current maximum individual FBR (after reimbursement for interim assistance (IA) or direct payment of representative fees), plus
• the recipient’s (or eligible couple's) current federally administered State supplement.

In applying this formula, we subtract any overpayments or penalties that we withhold from the past-due SSI payments. For instructions on determining the amount of past-due SSI payments, see SI 02101.020C.6 and SI 02010.020D.8 in this section. For the exception to priority of payment order when there is a prior overpayment and payable representative fees, see SI 02101.002.

2. Exception to installment payment requirements

At the time of the past-due payment eligibility determination or during the installment process, installment payments are not required for a recipient:

• who has a medical condition which is expected to result in death within 12 months; or
• who is no longer eligible for SSI and is determined likely to remain ineligible for the next 12 months.

If the conditions above apply to an SSI recipient, we should pay the past-due amount in full.

3. Amount and timing of installment payments

We must pay installment payments in no more than three payments. We pay each installment payment in six-month intervals. If the second installment is not released timely, we must wait six months after the second installment to release the third (and final) installment. Each of the first and second installment payments cannot exceed three times the FBR (plus any federally administered State supplement), unless the exception for increasing the installment amount applies (see SI 02101.020B.4. in this section). The first and second installment payments should each be for the maximum FBR amount even if the balance due equals or exceeds this amount. The third (and final) installment payment includes the remainder of the past-due amount.

4. Exceptions to the limitation on the amount of the first and second installment payments

If the recipient provides documentation of any of the following debts or expenses, increase the amount of each of the first and second installment payments by the total amount of the documented debts and expenses.

a. Debts

Increase the amount of the first or second or both installment payments if the recipient provides documentation of outstanding debts relating to:

• food, clothing, and shelter; or
• medically necessary services, supplies or equipment, or medicine.

NOTE: Shelter may include any of the following:

• rent,
• property insurance,
• utilities (Gas, electric, heating fuel, water, sewer, garbage)
• mortgage payments, and
• property tax

NOTE: We determine medically necessary services, supplies or equipment on a case-by-case basis. Examples of non-traditional medical expenses can include, but are not limited to, the purchase of a:

• Car when necessary to get to doctor appointments or medical treatment, especially if the recipient lives in a rural area with no public transportation;
• Mobile phone to enable the recipient to contact medical offices; or
• Computer to enable the recipient to use SSA’s online services.

b. Expenses

Increase the amount of the first, second or both installment payments if the recipient provides documentation of current or expected expenses relating to:

• medically necessary services, supplies or equipment; or
• the purchase of a home.

NOTE: We determine medically necessary services, supplies or equipment on a case-by-case basis. Examples of non-traditional medical expenses can include, but are not limited to, the purchase of a:

• Car when necessary to get to doctor appointments or medical treatment, especially if the recipient lives in a rural area with no public transportation;
• Mobile phone to enable the recipient to contact medical offices; or
• Computer to enable the recipient to use SSA’s online services.

c. Amount of increase allowed and when we will pay

If the recipient provides the debt or expense documentation, we may increase the installment payment amount by the total debt or expense amount. The recipient may request, and be paid, an installment increase at any time.EXAMPLE: A recipient is due $10,000.00 in past-due SSI. We release the first installment to the recipient on 02/16, in the amount of $2199.00. His letter tells him he can receive more of the back payments right away if he has certain debts or expenses. He goes into the field office in 05/16 with his bills and requests an additional $2000.00. If his debts or expenses meet the criteria for an increase, we can pay the $2000.00 immediately via A-OTP. We consider the additional money an increase of the first installment. This leaves a balance of $5801.00.In 08/16, he is due the second installment, so we release $2199.00, leaving a balance of $3602.00 as the third and final installment.

d. Increase only allowed for non-reimbursable expenses

The increase only applies with respect to debts or expenses that are not reimbursable by any public assistance program, Title XVIII, a State plan approved under Title XIX, or by any private party liable for payment by an insurance policy, prepaid plan, or other arrangement.NOTE: Attorneys and non-attorney representatives who do not receive direct fee payment by SSA do not qualify as an exception for an increased first or second installment payment.