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PAYMENT-STATUS
Payment Status Code. This three-digit alpha/numeric code identifies the current SSI/SSP eligibility and payment status of an individual and the reason for the status. MEDS uses this code in combination with the ‘SDX Transaction’ and ‘Medicaid Eligibility’ codes to determine a recipient’s eligibility for Medi-Cal. The 1st position of the payment status code identifies the eligibility/payment status and the 2nd and 3rd positions indicate the reason for the status.
The eight (8) payment status categories are as follows:
Status (1st Position) |
Description |
C |
Indicates the recipient is eligible for SSI and/or SSP and payment is due. |
E |
Indicates eligibility for Federal and/or State benefits based on eligibility computation, but no payment is due based on the payment computation. |
H |
Indicates the case is in a “hold” status, final disposition is pending. |
M |
Indicates the case is under manual control. Case is known as “forced payment” although payment may not be involved. |
N |
Indicates the claimant/recipient is not eligible for SSI/SSP or that a previously eligible recipient is not currently eligible. |
P |
Indicates suspension with the probability of reinstatement. “P” is obsolete since June 1987. |
S |
Administrative suspension. Indicates recipient may still be eligible for SSI and/or SSP, but payment is being withheld. |
T |
Indicates SSI and/or SSP eligibility is terminated. A record may be terminated and a new record established in certain situations. |
Values |
Definition |
C01 |
ELIGIBLE - Current Pay |
E01 |
ELIGIBLE, NO PAYMENT DUE - Eligible for federal and/or state benefits based on eligibility computation, but no payment is due based on payment computation. |
E02 |
ELIGIBLE, NO PAYMENT DUE - Eligible for benefits but not payable in that month due to the new application date. |
H10 |
HOLD - Living arrangement change is in progress |
H20 |
HOLD - Marital Status change is in progress |
H30 |
HOLD - Resource change is in progress |
H40 |
HOLD - Student status change is in progress |
H50 |
HOLD - Head of Household change is in progress |
H60 |
HOLD - Pending receipt of date of death |
H70 |
HOLD - Pending transmission of one-time payment data |
H80 |
HOLD - Early input |
H90 |
HOLD - Systems limitation. SSA District Office must manually compute |
M01 |
FORCE PAYMENT - Recipient may be in payment or non-payment status. See SSI-ELIG-AMT and SSP-ELIG-AMT fields for eligible amounts. These two fields contain zeros if the recipient is in non-payment status. |
M02 |
FORCE PAYMENT - Force due |
N01 |
NONPAY - Recipient's countable income exceeds Title XVI payment amount and his/her State's payment standard. |
N02 |
NONPAY - Recipient is an inmate of public institution. |
N03 |
NONPAY - Recipient is outside of United States |
N04 |
NONPAY - Recipient's non-excludable resources exceed Title XVI limitations |
N05 |
NONPAY - Unable to determine if eligibility exists |
N06 |
NONPAY - Recipient failed to file for other benefits |
N07 |
NONPAY - Cessation of recipient's disability |
N08 |
NONPAY - Cessation of recipient's blindness |
N09 |
NONPAY - Recipient refused vocational rehabilitation without good cause |
N10 |
NONPAY - Recipient refused treatment for drug addiction |
N11 |
NONPAY - Recipient refused treatment for alcoholism |
N12 |
NONPAY - Recipient voluntarily withdrew from program |
N13 |
NONPAY - Not a citizen or eligible alien |
N14 |
NONPAY - Aged claim denied for age. |
N15 |
NONPAY - Blind claim denied, applicant not blind |
N16 |
NONPAY - Disability claim denied, applicant not disabled |
N17 |
NONPAY - Failure to pursue claim by applicant |
N18 |
NONPAY - Failure to cooperate |
N19 |
NONPAY - Recipient voluntarily terminated participation in the SSI program |
N20 |
NONPAY - Recipient failed to furnish a required report |
N22 |
NONPAY - Inmate of a correctional institution |
N23 |
NONPAY - Not a legal resident in the United States |
N24 |
NONPAY - Convicted of felony of fraudulently misrepresenting residence in two or more states |
N25 |
NONPAY - Claimant is fleeing to avoid prosecution for, or custody or confinement after con- viction for, a crime which is a felony under the laws of the place from which he/she flees, or is violating a condition of probation or parole imposed under Federal or State law. |
N27 |
NONPAY - Disability terminated due to Substantial Gainful Activity (SGA) |
N30 |
NONPAY - Slight impairment, medical condition alone, no visual impairment |
N31 |
NONPAY - Capacity for SGA, customary past work, no visual impairment. |
N32 |
NONPAY - Capacity for SGA, other work, no visual impairment |
N33 |
NONPAY - Engaging in SGA despite impairment, no visual impairment. |
N34 |
NONPAY - Impairment is no longer severe at time of adjudication and did not last 12 months, no visual impairment. |
N35 |
NONPAY - Impairment is severe at time of adjudication but not expected to last 12 months, no visual impairment. |
N36 |
NONPAY - Insufficient or no medical data furnished, no visual impairment |
N37 |
NONPAY - Failure or refusal to submit to consultative examination, no visual impairment. |
N38 |
NONPAY - Applicant does not want to continue development of claim, no visual impairment. |
N39 |
NONPAY - Applicant willfully fails to follow prescribed treatment, no visual impairment. |
N40 |
NONPAY - Impairment(s) does not meet or equal listing (disabled child under age 18 only), no visual impairment. |
N41 |
NONPAY - Slight impairment, medical condition alone, visual impairment |
N42 |
NONPAY - Capacity for SGA, customary past work, visual impairment |
N43 |
NONPAY - Capacity for SGA, other work, visual impairment. |
N44 |
NONPAY - Engaging in SGA despite impairment, visual impairment. |
N45 |
NONPAY - Impairment no longer severe at time of adjudication and did not last 12 months, visual impairment. |
N46 |
NONPAY - Impairment is severe at time of adjudication but not expected to last 12 months, visual impairment. |
N47 |
NONPAY - Insufficient, or no medical evidence furnished, visual impairment. |
N48 |
NONPAY - Failure or refusal to submit to consultative examination, visual impairment. |
N49 |
NONPAY - Applicant does not want to continue development of claim, visual impairment. |
N50 |
NONPAY - Applicant willfully fails to follow prescribed treatment, visual impairment. |
N51 |
NONPAY - Impairment(s) does not meet or equal listing, disabled child under age 18 only, visual impairment. |
N52 |
NONPAY - Deleted from State rolls before 12/73 payment |
N53 |
NONPAY - Deleted from State rolls after 12/73 payment |
N54 |
NONPAY - District office unable to locate applicant |
N55 |
NONPAY - Impairment due to DAA, no visual impairment |
N56 |
NONPAY - Impairment due to DAA, visual impairment |
S01 |
SUSPENDED - Death reported by Treasury, potential automated death case |
S04 |
SUSPENDED - System is awaiting disability determination, system generated |
S06 |
SUSPENDED - Recipient's address unknown |
S07 |
SUSPENDED - Returned check for other than death, address, payee change or death of payee |
S08 |
SUSPENDED - Representative payee development pending |
S09 |
SUSPENDED - Miscellaneous suspense code |
S10 |
SUSPENDED - Adjudicative suspense (systems generated) |
S20 |
SUSPENDED - Potential rollback case or no disability made prior to 7/73, inactive |
S21 |
SUSPENDED - Recipient is presumed disabled or blind and has received three months pay- ments |
T01 |
TERMINATED - Death of recipient |
T20 |
TERMINATED - Received payment under two different numbers |
T22 |
TERMINATED - Same definition as code T20 except that termination resulted from elec- tronic screening |
T30 |
TERMINATED - Manual termination, payment previously made. Change in record composi- tion requires termination of existing record. |
T31 |
TERMINATED - System generated termination, payment previously made |
T32 |
TERMINATED - System generated termination of large records |
T33 |
TERMINATED - Manual termination, no previous payment made. Will eventually replace T30. |
T50 |
TERMINATED - Manual termination, no previous payment made |
T51 |
TERMINATED - System generated termination, no previous payment made |