Title XVI Supplemental Security Income

Previous Topic: Title II Old-Age, Survivors, and Disability Insurance

Next Topic: Medicaid

In 1972, Congress passed Title XVI of the Social Security Act. This federalized state programs for people who were aged, blind or disabled, and poor.

  • To be eligible for SSI benefits, an individual must be disabled, blind, or at least 65 years old and have "limited" income and resources.
  • SSI benefits are not based on prior work or a family member's prior work.
  • SSI is financed by general funds of the U.S. Treasury. Social Security taxes withheld under the Federal Insurance Contributions Act (FICA) do not fund the SSI program.
  • SSI benefits are paid on the first of the month for the entire month.
  • In addition, to be eligible for SSI benefits, an individual must:
    • be a resident of the United States, and
    • not be absent from the country for more than 30 days; and
    • be either a U.S. citizen or national, or in one of certain categories of eligible non-citizens

Definition of Disability - Child

  • A child may be eligible for SSI disability benefits beginning as early as the date of birth; there is no minimum age requirement.
  • To be eligible for SSI benefits, a child must be either blind or disabled.
  • An individual under age 18 is "disabled" if he or she has a medically determinable physical or mental impairment, which:
    • results in marked and severe functional limitations; and
    • can be expected to result in death; or
    • has lasted or can be expected to last for a continuous period of not less than 12 months.

Overview: Payments

  • The SSI payment for any individual may vary by a number of  factors, including:
    • the maximum amount payable in the state;
    • the person's living arrangement;
    • the person's category of eligibility;
    • other income the person may have;
    • whether the income of another counts toward the person's eligibility.

Living Arrangements

  • Benefit amounts may vary depending on where a person lives:
    • In his/her own home; or
    • In someone else's household; or
    • In a group care or board and care facility; or
    • In a medical treatment facility; or
    • In a public institution.

20 CFR 416.211, .401-.435, POMS SI 00835.100 - .170, SI 01400.000 et. seq.

Income Eligibility

  • Income is defined as “anything you receive in cash or in kind that you can use to meet your needs for food and shelter.”
    • Income can be earned or unearned.
    • Income can be in-kind in the form of shelter or food received free or at reduced cost.
    • Income can be deemed from a spouse, parent, or sponsor (of an alien).
  • Income is counted in the month it's received for SSI income eligibility purposes.

20 CFR 416.1100 - .1147

Unearned Income Examples

  • Annuities, pensions and other periodic payments (such as SSDI and Unemployment)
  • Alimony, child support
  • Dividends, interest
  • Gifts, prizes
  • Rental income
  • Inheritances
  • In kind support, maintenance

20 CFR 416.1121

Unearned Income Exclusions

  • $20 general income exclusion.
  • Certain types of unearned income carry their own exclusions, e.g.:
    • Gross rental income is reduced by expenses associated with that income.
    • Deemed income is reduced by deductions contained within the deeming formulas.
    • 1/3 child support for minors is excluded.
  •  Examples of unearned income exclusions:
    • Medical care and services
    • Assistance provided in cash, or in kind, under a state, federal, local providing medical care or services (including VR.
    • Income used to replace a resource (e.g. insurance proceeds)
    • Income tax refunds
    • Proceeds of a loan
    • Bills paid for the recipient - if paid directly to the vendor (for non-shelter/food items)
    • Replacement of income that was lost, stolen or destroyed
    • Housing assistance such as public housing or a Section 8 voucher
    • Food Stamps

20 CFR 416.1123, .1124

In-kind Income

  • Food or shelter-related items provided for free or at reduced cost to an SSI recipient count as in-kind income.
  • Shelter-related items are rent or mortgage, property taxes, heating fuel, gas, electricity, water, sewer, and garbage removal.

POMS SI 00835.465.

The One-Third Reduction (VTR)

  • The applicable FBR is reduced by one-third when an individual/couple lives throughout a month in another person's household and receives both food and shelter from others living in the household.

20 CFR 416.1131

  • The VTR applies in full or not at all.
  • When the VTR applies, no additional In Kind Support and Maintenance (ISM) is chargeable.

POMS SI 00835.200

The Presumed Maximum Value Rule: Countable In-Kind Income

  • Applies when the VTR does not apply, i.e., when recipient receives free or reduced cost food or shelter related items. 20 CFR 416.1140
  • Countable in-kind income is the lesser of:
    • The actual value of the in-kind items; or
    • 1/3 of the SSI Federal Benefit Rate plus $20. Amounts to $253.66 in 2012.

20 CFR 416.1130 - .1147

Deeming

The process of considering another person's income and/or resources to be available for meeting an SSI claimant's (or recipient's) basic need for food and shelter

  • Parent-to-Child Deeming
  • Spouse-to-Spouse Deeming
  • Sponsor-to-Alien Deeming
  • Limited to legal support obligations:
    • Parent to minor child (when living together).
    • Spouse to spouse (must live together).
    • Sponsor to sponsored immigrant (regardless of whether living together).

20 CFR 416.1160 - .1166a

Earned Income Eligibility

  • Income from work, including:
    • wages
    • self-employment net income
    • in-kind payment (e.g., free rent for work)
    • royalties and honoraria
    • treated much more favorably than unearned income

20 CFR 416.1110 - .1111

Basic Earned Income Deduction - Basic Formula

  • Gross Earned Income
    • Less $65 earned income exclusion
    • Less unused portion $20 general exclusion
    • Divided by 2
    • Equals SSI Countable earned income

20 CFR 416.1112

Resources

  • SSI limits the amount of countable resources that an SSI recipient can own.
  • Must both own and have legal access to resource or it's not countable.
  • An individual recipient can hold only $2000 in countable resources.
  • A married couple can hold only $3000 in countable resources.
  • A resource is cash or any other liquid asset, real estate, or personal property of the individual (or spouse) that could be converted to cash and used to meet basic needs.
  • Income remaining as of the 1st of the month after the month received becomes a resource.

20 CFR 416.1201 - .1266

SSI Excluded Resources

  • Some examples of resources that are not counted as a matter of policy:
    • The home that the individual lives in.
    • Household goods and personal effects.
    • One automobile of any value.
    • Life insurance (face value up to $1500).
    • Burial funds (up to $1500); burial spaces.
    • Retroactive SSI and SSDI benefit payments (excluded for 9 months from receipt).
    • Resources in an SSA approved Plan for Achieving Self-Support (PASS).
    • Income producing property essential to self-support .
    • Earned Income Tax Credit received after 3/2/04 (excluded for 9 months).

20 CFR 416.1210

SSI Transfer of Assets Penalty

  • Any resource that is transferred for less than fair market value will result in a “transfer of assets penalty” causing ineligibility for a maximum of 36 months.
  • Spending resources to buy goods or services for yourself, at fair market value, does not cause a transfer penalty.
  • Individuals must keep good records when spending down to show when excess funds were spent and on what.

POMS SI 01150.000 et seq

Suspense vs. Termination

  • SSI ineligibility for a nondisability reason (e.g., income or resources) does not immediately result in eligibility termination; it results in suspense of benefits instead.
  • Suspense for 12 consecutive months results in termination.

20 CFR 416.1335

  • The difference is that a termination requires a reapplication to regain eligibility.