Adult Medicaid Manual MA-2505 CITIZENSHIP/IDENTITY SSA DATA MATCH
II. Procedures to Verify Citizenship and Identity using SSA Data Match
A. Application
1. Each applicant or recipient claiming U.S. citizenship must provide or cooperate in obtaining acceptable proof of both citizenship and identity. Verify citizenship and identity for an individual stating he is a US citizen using the Citizenship/Identity (C/I) SSA Match, follow the procedures shown below.
2. Key the 8124 completing the US citizen field (CTZ field) for each applicant as follows:
a. “Y” (Yes) for those individuals who are claiming US citizenship. EIS will automatically update the citizen field (CTZ field) on the 8124 from a “Y” to a “S” when the match request is sent to SSA, or
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(II.A.2.)
b. “N” (No) for those individuals who are not claiming US citizenship. EIS will automatically update the citizen field (CTZ field) on the 8124 from a “Y” to an “N” for SCD, MRF, and RRF, or
c. “X” for caseheads not applying for benefits or individuals claiming US citizenship who do not have a social security number.
SSA cannot document citizenship and identity when a newborn not entitled to auto newborn coverage has not yet received their SSN, or when an individual does not have a SSN. See C. below for procedures to follow.
3. A file is sent daily to SSA via SVES batch process for a possible match and returned within 24 to 48 hours. A daily report appears in NCXPTR titled DHRWDB CITIZENSHIP APP RESPONSE. The report is displayed by county name and number, district number, payee name, application number and post date. Newest applications are displayed first. Those individuals with a “X” or “N” are not sent to SSA for a match request and do not appear on the DHRWDB CITIZENSHIP APP RESPONSE report. The IMC is responsible for working the report daily.
4. One of the following responses appears on the report:
a. “E”: Exceptions in the data (SSN, surname, given name, or date of birth not matching). Complete OLV/SOLQ and correct the data that is showing as an exception using the Citizen Exception (CE) function in EIS. Once the correction is complete, EIS removes the individual from the Citizen Exception Screen and resubmits the information to SSA for verification of citizenship.
If the caseworker needs to correct more than one item (for example, the last name and the date of birth, or the date of birth and the social security number), use the Name Change (NC) function to make the corrections instead of the Citizen Exception Screen. Once information is corrected on the Name Change Screen, you must return to the Citizen Exception Screen, display the individual and press PF5 to update the information. EIS removes the individual from the Exception Screen and resubmits the information to SSA for verification of citizenship.
The match for citizenship is not completed until the exception is resolved. The IMC is responsible for working exceptions daily.
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(II.A.4.a.)
There are also instances in which SSA cannot document citizenship and identity due to the spelling of the name. For example, if SSA has the individual’s name spelled with a hyphen, EIS does not allow names to be keyed using a hyphen or embedded spaces, therefore the exception cannot be resolved. See 5. below for procedures to follow .
b. “A”: SSN is verified, there is no indication of death, and the allegation of citizenship is consistent with SSA data. For those individuals with a code A, complete the DMA-5177, Documentation of Identity and Citizenship for US Citizens, in the CID subfolder with a C/I code 11. The date is the date verified by SSA. EIS automatically updates C/I code to 11 on the 8125 if the application is approved.
c. “B”: SSN is verified, there is no indication of death, and the allegation of citizenship is NOT consistent with SSA data.
(1) Send the individual the Request for Information form (DMA-5097) advising what items can be used to verify citizenship and identity.
(2) If all other eligibility factors are met, complete the 8125 approving the application and authorize with the appropriate certification period using C/I code 97. The date entered is the date the Request for Information (DMA-5097) is sent to the individual.
(3) Allow the individual 12 days and, if the requested information is not received, a second DMA-5097 is required.
(4) Although the individual is authorized, citizenship and identity have not been verified, and the information must be requested from the individual. The individual is allowed 90 days from the date the first Request for Information form (DMA-5097) is sent to provide acceptable documentation of citizenship and identity. The individual appears on the Case Management Report under special message “RESOLVE CITIZENSHIP ISSUE DUE” until the individual is terminated, or the CI code is changed to another code.
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(II.A.4.c.(4))
d. “C”: SSN is verified, there is indication of death, and the allegation of citizenship is consistent with SSA data.
(1) If the IMC can verify the individual is not deceased and all eligibility factors are met, authorize the application and manually enter a C/I code 12 in the C/I field on the 8125 with the date of the SSA match as citizenship/identity is verified. Refer the individual to SSA to resolve indication of death.
(2) If the individual is deceased and all information matches, process as open-shut, if otherwise eligible, and key C/I code 12 in the C/I field on the 8125 with the date verification received from SSA.
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(II.A.4.)
e. “D”: SSN is verified, there is indication of death, and the allegation of citizenship is NOT consistent with SSA data.
(1) If the IMC verifies that the individual is not deceased, follow procedures outlined in II.A.4.c.above. Refer the individual to SSA to resolve indication of death.
(2) If the IMC verifies the individual is deceased and all other eligibility factors are met, follow procedures in MA-2506/3332 to obtain documentation of citizenship and identity. Complete the DMA-5177, Documentation of Identity and Citizenship for US Citizens, in the CID subfolder when documentation is received.
5. Instances when SSA cannot document citizenship and identity due to the spelling of the name includes those individual’s whose name is spelled using a hyphen or embedded spaces. These exceptions can not be resolved via the EIS CE or NC function.
a. Send the individual the DMA-5097 advising what items can be used to verify citizenship and identity.
b. If all other eligibility factors are met, complete the 8125 approving the application and authorize with the appropriate certification period using C/I code 97. The date entered is the date the Request for Information (DMA-5097) is sent to the individual.
c. Allow the individual 12 days and, if the requested information is not received, a second DMA-5097 is required.
NOTE: The 90 days remain the same. Do not give an additional 90 days from the date the second DMA-5097 is sent.
Complete the DMA-5177, Documentation of Identity and Citizenship for US Citizens, in the CID subfolder with a C/I code 97. The date is the date the first Request for Information (DMA-5097) is sent.
d. Although the individual is authorized, citizenship and identity have not been verified, and the information must be requested from the individual. The individual is allowed 90 days from the date the first Request for Information form (DMA-5097) is sent to provide acceptable documentation of citizenship and identity. The individual appears on the Case Management Report under special message “RESOLVE CITIZENSHIP ISSUE DUE” until the individual is terminated, or the C/I code is changed to another code.
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(II.A.5.d.)
B. Auto Newborn
An Auto Newborn is a child born in the United States to a mother who was covered by Medicaid for the delivery. The C/I SSA data match is not required for automatic newborns as they have already met citizenship/identity requirements. See MA-2506, US Citizen Requirements and MA-3230, Eligibility of Individuals Under Age 21. Key an “X” in the US citizen field (CTZ) on the 8124. When processing the application, manually enter a C/I code 10 in the CI field on the 8125. The match request is not submitted to SSA, and does not appear on the NCXPTR DHRWDB CITIZENSHIP APP RESPONSE daily report. Complete the DMA-5176, US Citizenship Documentation Birth Certificate Request, in the CID subfolder with C/I code 10.
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(II.)
C. Newborn Not Entitled to Auto Newborn Coverage or Applicant Who Does Not Have a SSN
1. Key an “X” in the US citizen field (CTZ) on the 8124 if a newborn is not entitled to automatic newborn coverage and does not have a SSN, or any other individual who does not have a SSN. The match request is not submitted to SSA, and does not appear on the NCXPTR DHRWDB CITIZENSHIP APP RESPONSE daily report.
2. Send the individual the DMA-5097 advising what items can be used to verify citizenship and identity.
3. If all other eligibility factors are met, complete the 8125 approving the application and authorize with the appropriate certification period using C/I code 97. The date entered is the date the Request for Information (DMA-5097) is sent to the individual.
4. Allow the individual 12 days and, if the requested information is not received, a second DMA-5097 is required.
Complete the DMA-5177, Documentation of Identity and Citizenship for US Citizens, in the CID subfolder with a C/I code 97. The date is the date the first Request for Information (DMA-5097) is sent.
5. Although the individual is authorized, citizenship and identity have not been verified, and the information must be requested from the individual. The individual is allowed 90 days from the date the first Request for Information form (DMA-5097) is sent to provide acceptable documentation of citizenship and identity. The individual appears on the Case Management Report under special message “RESOLVE CITIZENSHIP ISSUE DUE” until the individual is terminated, or the C/I code is changed to another code.
NOTE: It is important to key the date the first DMA-5097 is sent when entering C/I code 97 on the 8125. EIS automatically calculates the 90 days from the date entered for the Case Management report.
6. The caseworker must verify citizenship within 90 days. If unable to verify, send a timely notice, DSS-8110, on the 91st day or the next workday following the 90th day to terminate the individual or case.
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(III.C.)
7. The individual is allowed only one (lifetime) 90 day period while trying to resolve an inconsistency with SSA data to verify citizenship/identity. If he reapplies, citizenship documentation must be provided before approval of benefits. See MA-2506, US Citizenship Requirements.
8. If documentation from any level is provided within the 90 days, key an 8125 and update the C/I field with the appropriate C/I code and the date the documentation is received. Complete the DMA-5177, Documentation of Identity and Citizenship for US Citizens, in the CID subfolder with appropriate C/I and the date the documentation is received.
9. If the individual cannot obtain the necessary documents, requests help, or has special needs demonstrating a need for assistance and lacks someone who can act on his behalf, the county must assist the individual in acquiring the documents, including the cost involved. See MA-2303, Verification Requirements for Applications.
D. Reapplication
1. Key the 8124 completing the US citizen field (CTZ) for each applicant as follows:
a. “Y” (Yes) for those individuals who are claiming US citizenship, or
b. “N” (No) for those individuals who are not claiming US citizenship, or
c. “X” for caseheads not applying for benefits or individuals with no SSN.
2. EIS auto searches the C/I codes linked to the individual ID number.
a. EIS overlays the “Y” in the US citizen field with a “V” for citizenship verified for existing C/I codes 10 and 25.
b. EIS overlays the “Y” in the US citizen field with an “A” or “C” for citizenship verified for existing C/I codes 11 and 12.
c. EIS overlays the “Y” in the US citizen field with an “S” when sent to SSA for a match request for existing C/I codes 35, 45, 98, 99, or blank.
A file is sent daily to SSA via SVES batch process for a possible match and is returned within 24 to 48 hours with a response of A, B, C, D, or E on the NCXPTR DHRWDB CITIZENSHIP APP RESPONSE report. Follow the procedures outlined in II.A.4 above.
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(III.D.)
d. EIS overlays the “Y” in the US citizen field with a “B or D” for those individuals with an existing C/I code 97.
(1) The individual is allowed only one 90 day period while trying to resolve an inconsistent match with SSA data. An existing C/I code 97 verifies the individual has received their one 90 day period. Citizenship documentation must be provided before approval of benefits. Follow procedures in MA- 2506, US Citizenship Requirements.
(2) If documentation from any level is provided within 45/90 days, process the application. See MA-2304, Processing the Application.
e. EIS overlays the “Y” in the US citizen field with an “N” for SCD, MRF, and RRF individuals.
E. Redetermination
SSA Citizenship/Identity match request are completed through EIS for NCHC and Medicaid applicants. Ongoing recipients are not submitted to SSA for a C/I match request at redetermination. Follow procedures to verify citizenship and identity outlined in MA-2506, US Citizenship Requirements, or MA-2320, Redetermination of Eligibility.
