Magazine article The Exceptional Parent

SSI and Medicaid Recipients Have a Responsibility to Report Changes That Can Affect Benefits

Magazine article The Exceptional Parent

SSI and Medicaid Recipients Have a Responsibility to Report Changes That Can Affect Benefits

Article excerpt

Overview. Supplemental Security Income (SSI) and Medicaid are both "need-based" federal programs intended to benefit certain categories of individuals who are legal residents of the United States--primarily those 65 or older, those who are blind or those with disabilities--who have minimal income and financial resources. However, an individual's responsibility does not end once all of the eligibility requirements for benefits have been established. An individual receiving benefits (or his or her representative payee) continues to have a duty to report changes in circumstances to the Social Security Administration and his or her State Medicaid agency. These changes may subsequently affect continued eligibility for benefits. This article will explain: 1) who is responsible for reporting changes; 2) what changes must be reported; 3) when to report; 4) how to report; 5) the content of the report; and 6) potential consequences of untimely reporting.

SSI REPORTING REQUIREMENTS

1. Who is Responsible for Reporting? Social Security recipients or their representative payees (a relative, friend or other interested party of a person receiving Social Security benefits who is appointed by the Social Security Administration to handle the beneficiary's Social Security matters) must report changes in their financial circumstances.

2. What Changes Must be Reported? A recipient of Social Security is required to report the following information to the Social Security Administration:

* Moves or changes of address.

* Changes in living arrangements (persons moving in or out of recipient's household).

* Changes in recipient's income or resources.

* Recipient's eligibility for other benefits.

* Changes in the recipient's marital status (marriage, separation, divorce, resumption of cohabitation after separation or divorce, or annulment)

* Refusal to accept or comply with treatment for medically determined drug addiction or alcoholism.

* Improvements in medical condition (if recipient is eligible for SSI because of blindness or disability).

* Admission to or discharge from a medical institution.

* Changes in school attendance (if under age 22).

* Temporary absence from the U.S. (more than 30 consecutive days). Note: A Social Security recipient is also required to report if he or she is "fleeing to avoid prosecution for a crime" or "fleeing to avoid custody or confinement after conviction for a crime." 20 C.F.R. [section] 416.708(o). One can't help wondering just how often the Social Security Administration receives such reports, or just how scrupulous criminal recipients are in adhering to this particular requirement of the law!

This list covers most reporting requirements. For an exhaustive listing, see 20 C.F.R. [section] 416.708.

In addition, an SSI recipient (or the individual acting on behalf of the recipient) must also report changes involving certain other individuals. One reason for this requirement is the SSI concept known as "deeming," whereby the income and resources of certain other individuals are treated as available to the recipient. (For example, the income and resources of an ineligible spouse--that is, a spouse not receiving SSI--who is living with the recipient are "deemed" to be the income and resources of the recipient. Similarly, the income and resources of an ineligible parent are treated as belonging to an unmarried child under age 22 who lives with the parent.)

The matters that must be reported concerning other individuals are as follows:

* Changes in the income or resources of the recipient's spouse, parent, child or "essential person" (a non-relative living in the recipient's home).

* The death of recipient's spouse who was receiving SSI (or, if not receiving SSI, the death of recipient's spouse if they were living together).

* The death of recipient's parent who was living with the recipient. …

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