Pickle Amendment - Lynch v. Rank

The 1976 Pickle Amendment to the Social Security Act introduced the Title II Social Security Retirement, Survivors and Disability Insurance (RSDI) income disregard. This amendment requires that zero share-of-cost Medi-Cal benefits be provided to any aged, blind or disabled (ABD) person or couple who meet ALL of the following requirements:

  • Currently receiving RSDI benefits,
  • Received RSDI and SSI and/or SSP benefits simultaneously in any month after April 1977, 
    • Note: When a person applies for RSDI and SSI/SSP simultaneously, sometimes SSI/SSP is granted first. RSDI will then be granted several months later, retroactive to the date of application. In these instances, the person may be required to reimburse the SSI/SSP program for any benefits received. However, he/she is still considered to have been eligible for and entitled to receive both RSDI and SSI/SSP in the same month. If SSI/SSP benefits are awarded retroactively, Pickle eligibility may be determined from the first date of actual entitlement to SSI/SSP.
  • Was discontinued from SSI and/or SSP after April 1977
  • Received an RSDI cost of living adjustment (COLA) since being discontinued from SSI and/or SSP, and
  • Would be entitled to receive SSI and/or SSP benefits if the RSDI COLAs received after SSI and/or SSP ineligibility are disregarded. If an individual loses his/her SSI/SSP eligibility as a result of an RSDI COLA, the specific RSDI COLA that caused the SSI/SSP discontinuance must be:
    • Counted as a “COLA received since SSI/SSP was discontinued,” and
    • Included in the RSDI COLA disregard computation.

When to Screen

All Aged, Blind, or Disabled (ABD) individuals who are currently receiving RSDI income must be screened for Pickle at the following times:

  • Application
  • Redetermination
  • Change-in-Circumstance Renewal
  • (This includes the start of Medicare eligibility and when a change is reported)
  • When an individual is recently discontinued from Supplemental Security Income (SSI) /State Supplementary Payment (SSP) and/or an individual recently received Title II income for the first time
  • When an individual who was previously on Pickle is recently determined to have a share of cost (SOC)
  • In the month after a Social Security Title II COLA
  • Discontinued SSI/ SSP beneficiaries who require a redetermination under Craigv.Bonta.
  • Following a break-in-aid
  • Inter-County Transfer (ICT)
  • Whenever a client requests a Pickle determination.
    • Individuals in Long Term Care (LTC) should not be screened for Pickle unless they leave LTC.

      • Note: Individuals who refuse to complete the Pickle review may remain eligible for Non-MAGI MC. However, they must be offered Pickle again annually, unless they specifically request no further contact.

Pickle Forms

The client must complete the following forms:

  • MC Application or Renewal form (when applicable)
  • MC 13 - Statement of Citizenship, Alienage and Immigration Status (when applicable)
  • DHCS 7044- Statement of Living Arrangements, In-Kind Support and Maintenance, (ISM).
  • MC 210B - Supplement to Statement of Facts (PICKLE Eligibility Determination)

Form (MC 219) - The “Important Information for Persons Requesting Medi-Cal” must be provided; however, the client is not required to sign and return the form. It must be documented in the Journal section that the MC 219 was provided and the date given.

Note: When determining Pickle eligibility for individuals who are potentially eligible for the IHSS Personal Care Services Program (PCSP), either the IHSS form “Application for Social Services” (SOC 295) or MC application may be used. The MC 210 or the SOC 310 may be used as the Pickle Statement of Facts form, both at initial application and RD

Verification of SSI/SSP Termination Date

The date that the client last received and was eligible for SSI and/or SSP must be verified using any of the following:

  • The date listed on the monthly Exception Eligibles Report/503 Leads Report
  • The “SSI-LAST-RECEIVED” date from the MEDS [INQE] screen or IEVS
  • The client's SSI/SSP discontinuance notice from the Social Security Administration
  • Any other verification that establishes the date of SSI discontinuance and that the client was covered by the “Craig v Bontá” court order.

An individual may have received an SSI/SSP approval and/or discontinuance NOA, but was never actually eligible to receive the SSI/SSP cash grant and he/she may have been required to repay SSA for the cash received.

Note: If both spouses are potentially eligible, their individual SSI/SSP discontinuance dates must be verified. Their discontinuance dates may be different.

When the SSI/SSP discontinuance date cannot be verified by any of the methods listed above, use the “Referral To/From Social Security” (SCD 169) to request the SSI/SSP discontinuance date from SSA. Do NOT use the State-issued Lynch v Rank letter (Notice Type 52) to verify the date of SSI/SSP discontinuance.

It may be necessary to check further if it appears the applicant may have never actually been eligible to receive SSI/SSP; e.g., an overpayment is currently being recouped from RSDI income. Send an SCD 169 requesting specific information in these instances, as the client is not potentially Pickle eligible unless eligible for SSI/SSP and RSDI at the same time.

Exception: When a person applies for RSDI and SSI/SSP at the same time, sometimes SSI/SSP is granted first. RSDI will then be granted several months later, retroactive to the date of application. In these instances, the person may be required to reimburse the SSI/SSP program for any benefits received. However, he/she is still considered to have been eligible for and entitled to receive both RSDI and SSI/SSP in the same month.

Related Topics

Pickle Definitions

Manual Pickle Eligibility Determination Process