SSI Application Process

At Intake, redetermination, or any time the immigrant or disability status of a CAPI applicant or recipient changes, he or she must be referred to the SSA) to apply for SSI/SSP.

A Conditional CAPI recipient, must apply for SSI/SSP within 30 calendar days of signing the Request for Conditional CAPI after Naturalization Pending SSI/SSP Eligibility Determination form (SOC 830). Refer to Conditional CAPI for Naturalized U.S. Citizens.

SCD 169

As a condition of eligibility for CAPI, a “Referral To/From Social Security” (SCD 169) must be completed for the applicant or recipient to take to SSA to apply for SSI/SSP (unless the applicant or recipient can provide proof of application).

The completed SCD 169 (or other proof of SSI/SSP application) must be returned to the EW before CAPI eligibility can be established.

SSP 14

Eligibility staff must obtain a new “Authorization for Reimbursement of Interim Assistance Initial Payment or Initial Post eligibility Payment” (SSP 14) form whenever a client is referred to SSA or it is determined that the client has applied (or re-applied) for SSI/SSP. The EW must ensure a copy of the SSP 14 is in Imaging.

Approval

If SSI/SSP is approved, there is no eligibility for CAPI benefits. If CAPI payments have been issued, aid must be discontinued, and the computation of CAPI Interim Assistance must be done within 10 working days in order that the IAR process may be completed.

If the 10-day deadline is not met, the entire retroactive SSI/SSP payment must be sent to the recipient. [Refer to Interim Assistance Overview]. If the 10 day requirement causes a situation which will result in Overlapping CAPI and SSI payments, the recipient should be warned that they are receiving an overpayment which will be collected back.

If the assistance payment has already been prepared, and cannot stop delivery of the next assistance payment when the initial payment is received from SS, the amount of the next payment is also reimbursable as interim assistance per DSS manual - EAS 46-377.5.52.

Note: There will be situations in which both GA and CAPI Interim Assistance has been paid and both must be reimbursed from the SSI/SSP retroactive payment. Timely processing of IAR is essential.

Denial

Due to Immigrant Status

Denial of SSI/SSP based solely upon immigrant status is required before CAPI can be approved.

Reminder: CAPI must be denied when the applicant is under 65 years of age and a SSI disability determination is pending with Social Security Administration since the applicant will either be found eligible for SSI/SSP or denied due to not being disabled; which are reasons other than immigration status.

Appeal Levels

After the initial SSI/SSP application is denied, the CAPI applicant/recipient must file an appeal. There is a 60-day limit after each denial to file hearing requests for the following levels of the appeal process:

Reconsideration;
Administrative Law Judge;
Appeals Council in Washington, D.C.; and
Federal District Court.

Failure to File Appeal

CAPI benefits will be denied or discontinued if the applicant / recipient fails or refuses to file either:

A timely appeal with the Social Security Administration; or
A timely waiver (based on good cause) of the time limit.

The recipient shall remain ineligible until cooperation is achieved with all aspects of the SSI application process, including medical examinations.

Note: CAPI may not be discontinued for the above reason unless it can be proven that the recipient was aware of the responsibility to file an appeal.

The only time the client would not file an appeal is when he or she:

Receives notification of a denial too late to file an appeal within the time limit, or
Determines there is no good cause for a waiver, or
Determines the appeal to be inappropriate.