H. GLOSSARYAny expenses incurred by a blind individual that are reasonably attributable to earning income. The BWE provision permits the exclusion of these expenses from the earned income of a blind individual. (See “Impairment-Related Work Expenses (IRWE)” for the related exclusions for disabled individuals.)The phrase in the Social Security Act that defined disability for children prior to the Personal Responsibility and Work Opportunity Reconciliation Act of 1996 (Public Law 104-193). Under prior law, an individual under age 18 would have been considered disabled if he or she had an impairment of comparable severity to one that would disable an adult.The amount of resources after all exclusions. This amount is an important factor in an individual’s or couple’s SSI eligibility determination. A resource may be cash or other liquid assets or any real or personal property that an individual (or his or her spouse) owns and could convert to cash to be used for support and maintenance. Title XVI stipulates what items are to be excluded from resources.The standard used in computing the amount of Federal SSI benefits for individuals and couples. The FBRs increase annually to reflect increases in the cost of living. (See table IV.A2.)The provision that permits the exclusion from earnings of the costs of items and services needed in order for a disabled individual to work, paid for by the individual, and necessarily incurred by that individual because of a physical or mental impairment. We exclude these IRWEs from earnings when determining substantial gainful activity (SGA) or computing eligibility and ongoing SSI monthly payments. (See “Blind Work Expenses (BWE)” for the related exclusions for blind individuals.)Income received either infrequently or irregularly that we can exclude from the determination of an individual’s income. Infrequent income1 is income an individual has not received more than once in a calendar quarter from a single source.2 Irregular income is income that an individual could not reasonably expect to receive. In any given quarter, we exclude up to $30 of earned (infrequent or irregular) and $60 of unearned (infrequent or irregular) income.A determination SSA makes about an individual’s eligibility for benefits or about any other matter that gives that person a right to further administrative or judicial review.Income that is not cash, but is food or shelter or something an individual can use to obtain food or shelter.The process used to reimburse a State for basic assistance provided by the State to a claimant either while the claimant’s application for SSI was pending or during the period in which the claimant’s SSI benefits were suspended. SSA may reimburse a State from the claimant’s retroactive SSI payment if: (1) the State has an agreement with SSA to participate in IAR;
(2) the claimant has given SSA written authorization to reimburse the State from the retroactive payments; and (3) we find the claimant eligible for SSI benefits or for reinstatement of his or her benefits for the same period of suspense.A required condition for parent-to-child and spouse-to-spouse deeming. Deeming of income and resources occurs if an eligible child lives with his or her ineligible parent(s) or an eligible individual lives with his or her ineligible spouse.The measuring of income and resources against specified amounts as eligibility factors for certain assistance benefits. SSI is a means-tested benefit program.The program authorized under Title XIX of the Social Security Act, which provides medical assistance to certain low-income individuals and families and certain disabled and medically needy individuals. Medicaid is administered by the States with support from the Federal Government in the form of matching grants. The Federal Government provides guidelines to the States for formulating their programs. As a result of the flexibility of these guidelines, Medicaid programs vary widely among the States.A medical treatment facility such as a hospital, extended care facility, nursing home, or intermediate care facility, where Medicaid pays more than 50 percent of the cost of a person’s care.An institution or that part of an institution licensed or otherwise approved by a Federal, State, or local government to provide inpatient medical care and services.A nationwide, Federally-administered health insurance program authorized in 1965 under Title XVIII of the Social Security Act to cover the cost of hospitalization, medical care, and some related services for most people age 65 and over. In 1972, lawmakers extended coverage to people receiving Social Security Disability Insurance (SSDI) payments for two years and people with End-Stage Renal Disease. Effective July 2001, people with Amyotrophic Lateral Sclerosis became Medicare-eligible during their first 24 months of receiving SSDI payments. In 2010, people exposed to environmental health hazards within areas under a corresponding emergency declaration became Medicare-eligible. Traditional Medicare consists of two separate but coordinated programs — Hospital Insurance (HI, also known as Part A) and Supplementary Medical Insurance (SMI, also known as Part B). Part A helps pay for inpatient hospital care, inpatient skilled nursing care, and hospice care. Part B helps pay for doctors’ services and other medical expenses, and supplies not covered by Part A. In 2006, prescription drug coverage (also known as Part D) was added. Almost all persons who are aged 65 and over or disabled and who are entitled to Part A are eligible to enroll in Part B and Part D on a voluntary basis by paying monthly premiums.An individual who is not a United States citizen. Also referred to in welfare and immigration law as an alien. (See “Alien Lawfully Admitted for Permanent Residence,” “Asylee,” “Parolee” and “Refugee.”)The Old-Age, Survivors, and Disability Insurance programs established under Title II of the Social Security Act.One‑Third Reduction.The reduction of an individual’s SSI payment that occurs when an individual is living in the household of another. Instead of determining the actual dollar value of in-kind support and maintenance, we count one-third of the Federal benefit rate as additional income to an individual living in another person’s household for a full calendar month and receiving both food and shelter from the household.The payment of more than the amount due for any period, including any amounts of Federally-administered State supplementation payments.For SSI purposes, the natural mother or father of the child, or the person who legally adopted the child, or the stepparent who lives in the same household as the child.A noncitizen who appears to be inadmissible to the inspecting USCIS officer but is allowed to enter the United States because of emergency humanitarian conditions or the noncitizen’s entry is determined to be in the public interest. Parole does not constitute a formal admission to the United States and confers temporary admission status only, requiring parolees to leave when the conditions supporting their parole cease to exist.A requirement that States must meet in order to be eligible for Medicaid reimbursement. Any State making supplementary payments (see “State Supplementation”) after June 30, 1977, must continue making such payments and must pass along any cost-of-living increase to the Federal benefit rate. Two methods are available to ensure that cost-of-living increases are passed on to the recipients.
• Payment Levels Method — States may not lower their supplementary payment for any of the living arrangement categories below their adjusted March 1983 levels. The adjusted level is the State’s March 1983 payment level minus that portion of the July 1983 increase in the Federal benefit rate that was not attributable to the increase in the cost of living (i.e., $10.30 per individual and $15.40 per couple).
• Total Expenditures Method — State expenditures for supplementary payments in the current calendar year must at least equal expenditures in the preceding calendar year. If expenditures are less in the current year (shortfall), the State must increase expenditures in the next calendar year by an amount at least equal to the shortfall.The total amount of SSI payments accumulated because of a favorable administrative or judicial determination or decision, up to but not including the month the determination is made, and excluding any corresponding windfall offset amounts.The amount allowed for an institutionalized recipient’s personal needs (currently $30). If an SSI recipient is in a Medicaid facility, the law requires that the SSI benefit be used only for the recipient’s personal needs (i.e., that the institution cannot retain the benefit in repayment of the cost of the individual’s care).A plan that permits a disabled or blind SSI recipient to set aside income (earned or unearned) or resources for a work goal. The income and resources set aside under a PASS are used to pay for goods or services needed to reach that goal, such as education, vocational training, starting a business, or purchasing work-related equipment. We exclude income and resources set aside under a PASS from SSI income and resources. SSA must approve an individual’s PASS.A finding that SSI payments may be made before SSA makes a formal determination as to whether or not the individual is disabled or blind. The individual’s impairment must be apparent and meet specified criteria. In addition, the individual must meet all other requirements for eligibility. These payments may be made for no more than 6 months. The presumptive payments will not be considered overpayments if SSA later finds that the individual is not blind or disabled.The real and personal property used in a trade or business, nonbusiness income-producing property and property used to produce goods or services essential to the individual’s daily activities. We may exclude PESS from resources under certain conditions.The method of computing payment amounts in months in which the individual reacquires eligibility after a month or more of ineligibility. In such months, we will pay an individual’s SSI benefit according to the number of days in the month that he or she is eligible, beginning with the first day in the month on which he or she meets all eligibility requirements. In order to determine the benefit payable in a prorated month SSA counts the number of days an individual is eligible in the month. We then multiply the amount of the individual’s regular monthly payment by the number of days for which he or she is eligible for benefits. Finally, we divide that figure by the number of days in the month for which the benefit is being determined. The resulting amount is the amount due for the prorated month. The statute eliminated proration for months of initial eligibility for all claims filed August 22, 1996 and later.An institution operated by or controlled by the Federal Government, a State, or a political subdivision of a State, such as a city or county, for the primary purpose of providing educational or vocational training.A shelter for homeless individuals that provides food, a place to sleep, and some services.An institution operated by or controlled by the Federal Government, a State, or a political subdivision of a State such as a city or county.A facility that provides food and shelter and some other service such as social services, help with personal living activities, training in socialization and life skills, or occasional or incidental medical or remedial care. In order to be publicly operated it must be operated or controlled by the Federal Government, a State, or a political subdivision of a State such as a city or county. The facility must serve no more than 16 residents and must be located in a community setting.
• A person whose deportation is withheld under section 243(h) of the INA as in effect prior to April 1, 1997, or whose removal has been withheld under section 241(b)(3) of the INA;
•
• A Cuban or Haitian entrant as defined by Federal statute, including section 501(e) of the Refugee Education Assistance Act of 1980;
—
— Aliens who became permanent residents under the provisions of the Immigration Reform and Control Act (IRCA) of 1986;
— Has been battered or subjected to extreme cruelty in the United States by a spouse, parent, or certain other family members the alien, parent or child lived with;Credit for a requisite amount of earnings assigned to a calendar quarter for the purpose of determining the SSI eligibility of a lawfully admitted permanent resident.The crediting of coverage needed for insured status under the Social Security program. In 2013, a worker receives one quarter of coverage (up to four a year) for each $1,160 of annual earnings reported from employment or self-employment. The amount of earnings required for a quarter of coverage is subject to annual automatic increases in proportion to increases in average wages.A person who is receiving SSI payments based on an evaluation of his or her countable income and resources, age, and disability status.The first step in the administrative review process if an individual is dissatisfied with SSA’s initial determination, unless it is one of ten States that has eliminated reconsideration. See “Appeal Rights Process.”A periodic review of eligibility for SSI recipients to ensure that requirements for eligibility continue to be met and that payment levels are in the proper amount. During redeterminations we review income, resources, living arrangements and other factors. In the redetermination process we do not review the determination of disability.A noncitizen outside of his or her country of nationality who is unable or unwilling to return to his or her country of nationality or to seek the protection of that country because of persecution (or a well-founded fear of persecution) based on the noncitizen’s race, religion, nationality, membership in a particular social group or political opinion. Unlike asylees, refugees apply for and receive this status prior to entry into the United States.A type of assistance provided to persons displaced by projects that acquire real property. Examples of types of reimbursement, allowances, and help provided are:
•
• A person who receives SSI payments on behalf of an SSI recipient. SSA will pay benefits to a representative payee on behalf of an individual 18 years old or older when it appears that such method of payment will be in the interest of the individual. A representative payee will be appointed if the individual is legally incompetent or mentally or physically incapable of managing or directing the management of his or her benefits. Also, in general, if the individual is under the age of 18, a representative payee will be appointed. The law and regulations generally require that a beneficiary under age 15 have a representative payee.An individual who can receive substantially all of his or her food and shelter while living in a public institution is considered a resident of the public institution. Generally, an individual who is a resident of a public institution throughout a month is ineligible for SSI.A person who has established an actual dwelling place within the geographical limits of the United States with the intent to continue to live in the United States. (See “United States.”)The cash or other liquid assets or any real or personal property of an individual (or his or her spouse) that he or she could use or could convert to cash to be used for his or her support and maintenance.The calculation method used in the SSI program to determine an individual’s eligibility for each month. RMA has two parts: (1) an eligibility determination; and (2) a payment computation. If the individual is ineligible based on the current month’s factors (including the current month’s countable income), no payment is due and we make no payment. If the individual is eligible based on the current month’s factors, we compute the payment. The benefit for a month is generally based on the individual’s countable income in the second month prior to the current month. However, at the start of a period of eligibility or re-eligibility, we determine the amount of benefits for both the first and second months using the income received in the first month.The special SSI cash benefits provided to disabled individuals who lose eligibility for SSI benefits under the regular rules because they have earnings at the level ordinarily considered substantial gainful activity.The special SSI recipient status for Medicaid purposes provided to working disabled or blind individuals when their earnings make them ineligible for regular or special cash payments.Provisions of the law governing most operations of the Social Security programs. The original Social Security Act is Public Law 74-271, enacted August 14, 1935. With subsequent amendments, the Social Security Act consists of 21 titles, of which three have been repealed. In particular five titles of the Act authorized the following programs:The population comprised of: (i) residents of the 50 States and the District of Columbia (adjusted for net census undercount); (ii) civilian residents of Puerto Rico, the Virgin Islands, Guam, American Samoa and the Northern Mariana Islands; (iii) Federal civilian employees and persons in the Armed Forces abroad and their dependents; (iv) crew members of merchant vessels; and (v) all other U.S. citizens abroad.The payments made by a State or one of its political subdivisions to aged, blind, or disabled individuals.
• Administration — The governmental unit responsible for administering State supplementation payments may be either a State or local agency or SSA. Under State administration, the State must absorb both program benefits and administrative costs. Under Federal administration, the State is responsible for the program benefits and, for 2013, pays a $11.12 administrative fee for each benefit paid.
• Mandatory Supplementation — The supplementary payments made only to beneficiaries converted to the SSI program from former State assistance programs at the inception of the SSI program. The law requires mandatory minimum State supplementation payments to maintain the December 1972 payment levels that these beneficiaries received under the former State assistance programs. The law also requires States to provide the supplementation to maintain their Federal matching funds for Medicaid.
• Optional Supplementation — The payments made by States to help persons meet needs not fully covered by Federal SSI benefits. The State determines whether it will make a payment, to whom, and in what amount. These supplements, paid on a regular basis, are intended to cover such items as food, shelter, clothing, utilities, and other daily necessities. Some States provide optional supplementary payments to all persons eligible for SSI benefits, while others may limit them to certain SSI recipients such as the blind or residents of domiciliary-care facilities, or they may extend payments to persons ineligible for SSI because of SSI income.An individual who is regularly attending a school, college or university, or a course of vocational or technical training designed to prepare him or her for gainful employment.An earned income exclusion for a student under age 22 with certain limitations established by regulations. For 2013, we exclude up to $1,730 earned income in a month, but no more than $6,960 per year.The level of work activity used to establish disability. A finding of disability requires that a person be unable to engage in SGA. For 2013, a person who is not statutorily blind and is earning more than $1,040 a month (net of impairment-related work expenses) is ordinarily considered to be engaging in SGA.The U.S. Department of Agriculture (USDA), under cooperative Federal-State agreements, issues Supplemental Nutrition Assistance Program (SNAP) benefits in the form of paper food coupons (commonly known as food stamps) and through electronic benefit transfer, to provide nutrition for low-income families. Recipients can use food stamps only to buy food at stores authorized by USDA to accept them. Prior to October 1, 2008, the Supplemental Nutrition Assistance Program was known as the Federal Food Stamp Program.The computerized database maintained by SSA and containing identifying information, income, resources and other eligibility factors, for all SSI recipients. The SSR includes the history of SSI payments made to an individual.An ineligibility status that causes the nonpayment of benefits for a period of anywhere from 1 to 12 months for any of a number of reasons such as income or resources over allowable levels, absence from the United States, residence in a public institution, etc. Benefits can resume without reapplication, when all requirements for entitlement are again met. Suspense that lasts more than 12 months (24 months for individuals who were made ineligible because of their spouses or parent being called to active military duty) results in a termination of the SSI record. (Once a record is terminated, reapplication is necessary.)An individual’s physical move from his or her permanent place of residence that does not constitute a change in living arrangement. In general, a temporary absence is an absence from a permanent residence that is not intended to, and does not, exceed a full calendar month.The State grant program of assistance for needy families established by the Personal Responsibility and Work Opportunity Reconciliation Act of 1996 (Public Law 104-193). TANF replaced the Aid to Families with Dependent Children program.For an individual, cessation of benefits, which can occur for a number of reasons, including death, medical improvement, or a period of suspension lasting longer than 12 months.As used in Section IV, the net reduction (after accounting for new entrants) in the number of SSI recipients in current-payment status during a period.The Ticket to Work and Work Incentives Improvement Act of 1999 established a voluntary Ticket to Work and Self-Sufficiency program (Ticket to Work program) under which a blind or disabled beneficiary may obtain vocational rehabilitation (VR), employment and other support services from a qualified private or public provider referred to as an “employment network,” or from a State VR agency.A legal arrangement involving property and ownership interests. Generally, we consider property held in a trust to be a resource for SSI purposes if the assets of the trust could be used for the benefit of the individual or spouse.The income that is not earned income. Unearned income may be in cash or in-kind. Some examples of unearned income are:
• For purposes of the SSI program, the United States consists of the 50 States, the District of Columbia, and the Northern Mariana Islands.The process of restoring individuals with disabilities to full capabilities. VR services are designed to provide an individual with the training or other services that are needed to return to work, to begin working, or to enter a new line of work.A provision to prevent a person from receiving monthly SSI and OASDI benefits in excess of the total amount that would have been paid if the OASDI benefits had been paid when they were due rather than retroactively.Provisions in the SSI program that are intended to act as incentives for disabled or blind individuals to work. Examples of work incentives under the SSI program are:
We modified the definition of infrequent income in final rules published on August 9, 2006 (71 FR 45375). Previously, we defined infrequent income as income not received more than once a quarter from a single source.
Also, infrequent income is income that an individual has not received in two consecutive months, regardless of whether these payments occur in different calendar quarters.
SSA Home | Privacy Policy | Website Policies & Other Important Information | Site Map | Actuarial Publications | June 21, 2013 |