Whenever a State Data Exchange (SDX) file comes in from SSA, it is matched against CIS by Social Security number, name, and date of birth. The SDX file has information on new SSI cases and on changes to current SSI records.
If the individual is not known to CIS or is inactive, then the process assumes that this is a new SSI recipient and opens a new case in the SDX county of residence in the right category. The case is given a new record number and individual number. The system uses the SDX individual name for the case and budget payment name. Defaults are provided by county/district for caseload, worker, unit, civil subdivision, and school district. Case numbers and individual numbers are assigned.
NOTE: If the individual is known to CIS but is inactive, the old individual number is used. CAOs can access the TSCR Schedule Cross Reference Table for default values. CAOs must distribute new cases to correct caseloads. The CAO will reassign records to workers to equal their caseload and also to assign the records to correct unit, i.e. LTC, SSI, etc.
If the individual is found on the Application Processing (AP) database and the application is registered (an individual number is assigned), the case is opened using the AP county code, no matter whether there is an AP/SDX county mismatch. The system uses the AP case record number, if one is available, or assigns a new record number in the AP county.
NOTE: The AP case record number could be different from the record number of the closed case. If the individual is found in AP and the application is not registered, the system uses the SDX federal county code to open the case with a new record number.
If the individual is currently active in CIS, the system uses existing information for a budget opening. This includes existing record number, caseload, worker ID, and unit. New elements will be posted to the individual's data base records. (For example, an ETP code of 22 is set if the SSI individual is age 60 or older.)
In all cases of automated openings, the open effective date for category A, J, or M is the Medicaid date on the SDX screen (IEVS Exchange #6). If a currently active budget is closed because of an automated SSI opening, the closing date is the day before the next payment day that can be met. Whenever SNAP is involved in the case, the automated process creates an alert.
The process uses the following rules to handle SSI openings:
Action: The system closes the budget and opens an SSI budget.
The individual is active in a multiple-individual MNO/NMP case.
Action: The system processes an individual delete and opens an SSI budget. CIS Alert 118 is set. Alert 119 is set when there is a related SNAP budget.
The individual is active in a one-individual D case.
Action: The system closes the D budget and opens an SSI budget. CIS Alert 119 is set when there is a related SNAP budget.
The individual is active for SNAP only.
Action: The system opens an SSI budget. CIS Alert 119 is set.
When the process has trouble identifying the individual, it uses the following rules:
There is a match on the Social Security Number, but the date of birth and the name do not match.
Action: The case is not opened on CIS. IEVS disposition 10 is set.
There is a match on the Social Security Number and the name, but the SDX date of birth differs from the CIS date of birth and the case status is active.
Action: The case is not opened on CIS. IEVS disposition 10 is set.
There is a match on the Social Security Number and the date of birth, but there is no match on the name and the case status is active.
Action: The case is not opened on CIS. IEVS disposition 10 is set.
NOTE: In the above cases, the date of birth must be different by 15 or more days.
In these situations, the CAO must figure out whether the individual is currently active in CIS and open SSI manually.
In the following situations where cash budgets are included in the case, the SSI budget must not be opened:
A C or U budget is included in the case.
Action: An SSI budget is not opened. CIS alert 115 is set.
A multiple-individual D budget or multiple D budgets are connected with the case.
Action: An SSI budget is not opened. CIS alert 115 is set.
A multiple-individual MNO/NMP case has a future delete action set for processing.
Action: An SSI budget is not opened. CIS alert 141 is set.
The CAO must open SSI manually when there is cash assistance activity in these cases or when a future delete action is pending.
Every week, the SDX file is matched against CIS by Social Security number, name, and date of birth. SSI records on which the SDX payment status code equals TOI (termination due to death) are looked at for possible processing. If the process closes the SSI case, the closing date for the A, J, and M budget is the day before the next payment day that can be met. The system must process the case or budget closing for the following:
One-person SSI cases
One-person SSI budgets
SNAP is not closed if there are two or more individuals in the SNAP budget. CIS alert 122 is set.
Multiple A, J, or M budgets with or without a related SNAP budget.
CIS alert 147 is set if there is a related MNO/NMP budget. CAOs must review the case record for death of the payment name or head of household.
The automated closing process does not close SSI cases that meet the following conditions:
There is no exact match on the Social Security number, name (excluding the “Mrs.,” Ms.,” or “Mr.” title and the middle initial), and date of birth.
Action: The individual is not included in the file for closing. The CAO must follow existing IEVS processes for closing on CIS.
There is a match on the Social Security number, name, and date of birth, but the CIS category is not A, J, or M.
Action: The system does not close the case or budget. CIS alert 121 is set.
There is a match on the Social Security number, name, and date of birth and the category equals A, J, or M, but there is a related cash budget.
Action: The system does not close the case or budget. CIS alert 120 is set.
The following alerts are used in the new process. Alerts must be created and made available for review the day the case is processed. CAOs can look at the TTYP Alert Type System Reference Table for more information.
IEVS Disposition 10—Notifies the case worker that there is a demographic mismatch and SSI must be opened manually. The worker must figure out whether the SSI individual is currently active on CIS.
Alert 115—Notifies the case worker that there is cash assistance activity in the case and SSI must be opened manually. The alert is cleared by the system after the SSI budget is opened. The alert stays in the disposed file for one month.
Alert 116—Instructs the case worker to compare SDX demographic information with CIS and enter correct CIS codes. (For example, CIS does not have a sex code of "U," for unknown. The worker must figure out the correct codes for CIS update.) The alert is cleared by the worker. The alert stays in the disposed file for one month.
Alert 117—Notifies the case worker of a Personal Care or Domiciliary Care case (facility code 75 or 76). The alert is cleared by the worker. The alert stays in the disposed file for one month.
Alert 118—Instructs the case worker to check who is in the household, as SSI was opened in a multiple-individual MNO/NMP case. The alert is cleared by the worker. The alert stays in the disposed file for one month.
Alert 119—Instructs the case worker to check who is in the household and run SNAP EDBC. SSI is opened automatically. The alert is cleared by the system after SNAP income EDBC is run. The alert stays in the disposed file for three months.
Alert 120—Instructs the case worker to stop individual benefits (because of the death of an SSI individual) and make other case changes. The case includes cash, MNO, NMP, or other A, J, or M budgets. The alert is cleared by the system after the individual is closed in CIS. The alert stays in the disposed file for three months.
Alert 121—Instructs the case worker to stop benefits and make other case changes. The SDX file shows the death of an individual, but the category is not A, J, or M. The alert is cleared by the system after the individual is closed on CIS. The alert stays in the disposed file for three months.
Alert 122—Instructs the case worker to check who is in the household and run SNAP EDBC. SSI is closed automatically. The alert is cleared by the system after SNAP income EDBC is run. The alert stays in the disposed file for three months.
Alert 130—Lets the case worker know that the SSI individual is a refugee and that nonfinancial screens require updates. The alert is cleared by the worker. The alert stays in the disposed file for three months.
Alert 136—Informs the case worker that the SSI individual was a GA individual sharing a family size allowance (FSA) with another GA budget and that the FSA should be checked. The alert is cleared by the worker. The alert stays in the disposed file for three months.
Alert 141—Instructs the case worker to open SSI with a future delete action pending on the MNO/NMP budget. The alert is cleared by the system after the individual is opened for SSI. The alert stays in the disposed file for one month.
Alert 146—Instructs the case worker to review third-party liability (TPL) information and update the TPL. The alert is cleared by the worker. The alert stays in the disposed file for three months.
Alert 147—Instructs the case worker to review who is in the household and who is the payment name. SSI is closed automatically. The alert is cleared by the worker. The alert stays in the disposed file for three months.
The process will create the following notices when it takes action on a case.
NOTE: No stop notice is created if an MNO/NMP case or budget is closed and SSI is opened for one individual.
For all automated openings, the system generates an Automated Notice of Eligibility (162M). The notice code and option are not set. The notice indicator is set to N. This notice is created with a copying process and does not run through the notice module.
For a D closing with an SSI opening, the system creates an Automated Stop Notice (162C). The notice code is set to 414 Option 1.
For an SSI closing due to death, the system creates an Automated Stop Notice (162C). The notice code is set to 490 Option 1. A separate notice using the same code and option is sent if the SNAP budget is closed by the process.
Two MAPPER reports are generated by the automated SSI opening and closing process.
Automated SSI Opening and Closing Report—This report lists cases opened and closed by the automated process. The following data are included:
County/district code
Record number
Category/grant group
Caseload
MAPPER
Processing date
Opening/closing date
Open (O) or close (C) indicator
The file is first sorted by county/district and case number. Sort options are provided for county, district, and caseload. The file is updated on MAPPER weekly, and data is kept for thirty days. Any data older than thirty days is deleted. The report provides subtotals for categories opened and closed for each county/district and area. Statewide totals are included. CAOs can use this file to check on the process, identify and study problems, and look at workload issues.
OIG Retroactive SSI Report—This report lists General Assistance (GA) individuals who did not sign an agreement to pay back the Commonwealth for retroactive SSI. The file is loaded to MAPPER on a weekly basis. The Office of Inspector General uses the file to seek repayment of retroactive SSI benefits. The repayment process does not require CAO involvement.
Updated February 14, 2012, Replacing November 30, 2008