Special Assistance SA-3210 INCOME

V. CASE SPECIAL REVIEW CODES REQUIRED FOR CASES WITH TCMI LESS THAN THE FBR.

A. Effective November 22, 2010 SA cases are required to use a SA Case Special Review Code if the TCMI in the EIS DSS-8125 screen is less than the FBR for SSI. This applies to all applications processed on or after November 22, 2010, and when any change is made in EIS for an existing case. The purpose of this edit is to either allow certain exceptions to cases having income below the FBR (Special Review Codes ‘LI’, ‘RS’ and ‘N’) or to allow a window of time for the a/r to obtain the FBR (Special Review Codes ‘E’, ‘I’ and ‘VA’). It is specifically to be used as a case management tool by the worker, the supervisor, and the State.

1. Cases with SSI only income will require a Case Special Review Code if the TCMI is less than $678. This amount is based on the FBR of $698 minus the SA $20 general income exclusion.

If TCMI for a case is less than $678 and no Case Special Review Code is entered, an error message will be displayed:

“TOT COUNTABLE MONTHLY INCOME LESS THAN SSI FBR. SPECIAL REVIEW CODE REQUIRED”.

2. Cases with income from any source without SSI or in addition to SSI, will require a Case Special Review Code if the TCMI is less than $698. This amount is the total minus the SA $20 general income exclusion.

3. If TCMI for a case receiving income from sources other than or in addition to SSI is less than $698 and no Case Special Review Code is entered, an error message will be displayed:

“TOT COUNTABLE MONTHLY INCOME LESS THAN SSI/OTHER FBR. SPECIAL REVIEW CODE REQUIRED”.

4. The commonly occurring situations for which these codes are appropriate are found in VI below.

5. Case Special Review Codes are only to be used for a specified situation and for the specified timeframe designated. See VI. below.

B. Case Special Review Codes are as follows:

1. Case Special Review Code ‘E’: ‘SSI 1/3 Reduced Ending’

2. Case Special Review Code ‘I’: ‘SSI In Kind Support/Maint Ending

3. Case Special Review Code ‘LI’: ‘Life Insurance (with) Cash Accruing Face Value Greater Than $1500

4. Case Special Review Code ‘RS’: ‘SSI/SS Recoupment’

5. Case Special Review Code ‘VA’: ‘VA only OR VA/other income only”. The edit was created for ongoing cases erroneously approved for SA without an SSI referral.

6. Case Special Review Code, “N” ‘SSI Couple Deeming’. This code is valid for SA In-Home cases only; “H” ambulation code. See SA/In-Home policy section SA-5200.

C. Information on specific use of these Case Special Review Codes is found below in VI

Note: The Eligibility Information 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.