Special Assistance SA-3120 EIS Instructions for SA

IV. Case Special Review Codes Required for cases with Total Countable Monthly income (TCMI) less than the FBR

A. Effective November 22, 2010 cases are required to use an SA Case Special Review Code when entering income into the EIS form 8125 screen if the income is an amount less than the FBR for SSI.

Case Special Review Codes allowing for less than FBR TCMI are for use as a case management tool for the IMC and are only to be used for a specified situation and for the specified timeframe designated. See B. below.

B. The following Case Special Review Codes are required in order to allow an EIS SA budget with a TCMI less than the FBR. The codes and corresponding case situations are

1.

Case Special Review Code ‘E’: ‘SSI 1/3 Reduced: Allows TCMI at less than FBR for SA applicants who have recently moved into an SA eligible facility from a private living arrangement where he/she was receiving SSI at the one-third reduced income rate based on SDX Living Arrangement Code “J”.

Use of EIS Case Special Review Code ‘E’ is time limited for SA Basic and SCU cases and provides for budgeting of the SA payment for not more than a two month period following the a/r’s month of admission to an SA eligible facility. It is not time limited for SA/IH cases.

2. Case Special Review Code ‘I’: ‘SSI In Kind Support/Maint: Allows TCMI at less than FBR for SA applicants who have recently moved into an SA eligible facility from private living arrangement where he/she was receiving SSI income based on in-kind support and maintenance (ISM) SDX Living Arrangement Code “H

Use of EIS Case Special Review Code ‘I’ is time limited for SA Basic and SCU cases, and provides for budgeting of the SA payment for not more than a two month period following the a/r’s month of admission to an SA eligible facility. It is not time limited for SA/IH cases.

3. Case Special Review Code ‘LI’: ‘Life Insurance (with) Cash Accruing Face Value Greater Than $1500’: Required for cases with TCMI less than the FBR who were denied SSI due to cash accruing life insurance whose total FV is more than $1500, and who were receiving SA prior to December 1, 2009.

Use of the “LI” code, once assigned to a case is allowed ongoing until the SA case is correctly terminated. It is not time limited.

NOTE: The case must also have the Case Level Special Use Code ‘LI’. See SA-3200, Resources.

4. Case Special Review Code ‘RS’: ‘SSI/SS Recoupment’: Allows TCMI at less than FBR for SA and SA/IH only for the months of continuing SSA overpayment recoupment. In the the case of an SSA recoupment, the recoupment amount must be waived or adjusted to the lowest possible monthly amount. In many cases this can be $10.00. The time limit on the use of this code varies for each SA recipient depending on the projected end date for recoupment.



5. Use Case Special Review Code ‘VA’: ‘VA only OR VA/other income only”. If any combination of VA and other income is less than $674 after the allowable exclusion up to $20 is applied, require a/r to apply for SSI. See SA 3210 XIIIC.13.c. for information on when the (up to) $20 general exclusion is applied to VA income. When discovered, use time frame and follow procedures in SA 3210 III.

6. An additional Case Special Review Code, “N” is valid for SA In-Home cases only; “H” ambulation code. See SA/In-Home policy section SA-5200.

Note: The Eligibility System Case Management report, produced monthly on the last working day of the month, reflects SA cases flagged with the Case Special Review Codes listed above. It is imperative that the SA caseworkers/supervisors review the Case Management Report each month and immediately follow up as appropriate for each case reflected on the report. See EIS-3551-Case Management Report.