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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 “P” is obsolete since June 1987.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 |
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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 |
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S07 |
SUSPENDED - Returned check for other than death, address, payee change or death of payee |
|
S08 |
SUSPENDED - Representative payee development pending |
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S09 |
SUSPENDED - Miscellaneous suspense code |
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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 |
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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 |