Federal regulations do not allow DHS to recover TANF payments to SSI applicants. When the TANF individual becomes eligible for SSI, the SSA adjusts the amount of TANF received to the SSI payment as unearned income. The initial SSI check is sent to the individual. The SSA will send an SSI-TANF Information Exchange Form (PA 177-SSI) to the CAO.
NOTE: The SSA usually takes an application for RSDI benefits at the same time an SSI application is completed. Because reimbursement requirements apply to RSDI benefits, the CAO must obtain the individual's signature on an Agreement and Authorization to Pay Claim Form (FIRM 176-K). See Supplemental Handbook Chapter 915.
The SSA district office uses the PA 177-SSI to provide the CAO with information concerning the TANF individual's SSI eligibility and to request information about the amount of TANF the individual has received. When the CAO completes the form and returns it to the SSA, the SSA will remove the TANF adjustment from the person's SSI check. The CAO must also use the information to make the necessary budget actions.
The SSA will send the PA 177-SSI to the CAO. When the CAO receives the form, it must do the following:
Determine the amount of the TANF payment with and without the SSI claimant for each month requested by the SSA, and indicate the amounts on the PA 177-SSI.
If the amounts are the same for each month requested, indicate the amount with and without the claimant only once, and state that the amounts are the same for each month.
The computation must take into consideration any other income the SSI claimant has adjusted to the TANF payment.
If the CAO cannot meet the deadline for returning the PA 177-SSI, it must include any additional month in which a TANF payment is authorized that exceeds the months requested by the SSA.
Example: On the PA 177-SSI, the SSA requests the amount of the TANF payment with and without the SSI claimant for the months of September to December. The CAO cannot meet the deadline date, but it does provide the information to the SSA within 15 days after the deadline date. The CAO also includes the month of January on the PA 177-SSI. The effective date of the first regular SSI check will be one month later than the date SSA indicated on the PA 177-SSI.
Send the individual an Advance Notice advising him or her about the closing or reduction of the TANF payment. Attach a copy of the "Notice to Client" (see Appendix A). The "Notice to Client" must include the following:
The effective date of the first regular SSI check
The signature of CAO worker
The date
The name and address of the CAO
Forward the SSA copy of the PA 177-SSI to the SSA district office listed on the form by the deadline.
NOTE: Mark the envelope “Urgent PA 177-SSI.”
Keep a copy of the PA 177-SSI in the individual’s case record.
When a GA or SBP recipient becomes eligible for SSI, the SSA will notify the Office of State Inspector General (OSIG) through the Government Service Online (GSO) system. The OSIG will provide the amount of the assistance the individual received to SSA. SSA will do the calculation and send the initial check to the individual minus the reimbursable amount calculated. SSA provides OSIG with their calculations and the amount of reimbursement owed to the Commonwealth. OSIG enters a claim in the OSIG Avoidance and Recovery System (OARS) so that the state can be reimbursed for the interim assistance. OSIG will send the Supplemental Security Income (SSI) Benefit Claim (OIG 128C) which will explain to the individual what was collected from their Social Security. The CAO will receive a copy of the OIG 128. The OSIG will determine whether the GA or SBP budget is open or has been automatically closed as a result of the State Data Exchange/Client Information System (SDX/CIS) electronic interface. If the GA or SBP budget is open, the OSIG will determine the effective date of discontinuance.
The SSA will determine:
the amount of reimbursement owed to the Department; and
the amount due the individual.
To ensure that reimbursement occurs, the CAO must do the following:
Have the individual sign the following forms:
Authorization for Reimbursement of Assistance (OIG 176-SSI)
The OIG 176-SSI is designed to authorize the SSA to pay the reimbursable portion of the individual's initial or reinstated SSI check to DHS (through OSIG).
NOTE: If the SSI applicant is receiving Refugee Cash Assistance (RCA), print the following notation in red on the upper right corner of the OIG 176-SSI before distributing it: “REFUGEE – Eligibility period for 100% federal reimbursement expires on (date of expiration).”
Discontinuance Authorization (PA 162-S)
The PA 162-S authorizes DHS to discontinue the individual’s GA or SBP when SSI is authorized. File the original in the case record, and give a copy to the individual.
SSA usually takes an application for RSDI benefits at the same time the SSI application is completed. The CAO must get the individual’s signature on a FIRM 176-K for delayed RSDI benefits. See Supplemental Handbook Chapter 915.
Complete a DAP Referral Form (PA 731).
NOTE: CAOs are no longer required to send their local SSA offices the SSA copy of the signed OIG 176 SSI form. Under the IAR automated process, the state notifies SSA that it has received a signed reimbursement authorization through SDX/CIS, which establishes a grant reimbursement code on the individual's SSI record. The CAO must notify the SSA within 30 days of the date the individual signed the OIG 176 SSI by completing the “Date 176 SSI signed” field on the CADISB screen in CIS and completing the remaining case action screens in the session. The “Date 176 SSI signed” field displayed on CADISB must have the actual date the individual signed the OIG 176 SSI form.
Full completion of the OIG 176 SSI, including the individual’s signature, is still required. The individual will continue to receive a copy of the signed OIG 176 SSI, and the remaining copies will be kept in the CAO case record.
CAOs must continue to send the Disability Advocate form (PA 731) to the SSA along with any supporting medical documentation available.
After the SSA determines eligibility, the OSIG will provide the amount of assistance the individual received to SSA. SSA will do the calculation and send the initial check to the individual minus the reimbursable amount calculated. OSIG will send the Supplemental Security Income (SSI) Benefit Claim (OIG 128C) which will explain to the individual what was reported to SSA to do the calculation. The CAO will receive a copy of the OIG 128.
The CAO may refer any questions about the claim or the refund to the OSIG representative handling the matter. The OSIG representative's phone number is listed on the OIG 128.
Reissued November 2, 2018, replacing November 14, 2013