Appendix B: State Blind Pension Notice Text and Reason Code

State Blind Pension Authorization

Eligible - (PA/FS 162) Manual Notice

Notice Reason Code Option 001/0, Notice Type Eligible

You qualify for Cash Assistance.  Your payment of [Calculated Benefit Amount] per month will begin [Next payment date after a deadline date that can be met].

Citation:  55 Pa. Code § 451.3

State Blind Pension Rejections
(most commonly used)

Ineligible - Does not meet Categorical Requirements (PA/FS 162) Automated Notice 

Select System Notice Reason Code Option 069/4, Notice Type - Ineligible, from Cash Notice dropdowns on the Client Notice Screen.

Ineligible - Resources (PA/FS 162) Manual Notice

Notice Reason Code Option 083/1, Notice Type - Ineligible

You do not qualify for State Blind Pension due to your countable resources exceeding the resource limit. Your countable resources are [total resources – minus allowable deductions]. The resource limit for the State Blind Pension is $7,500.

Citation:  55 Pa. Code § 451.3

Ineligible - SSA Income (PA/FS 162) Manual Notice

Notice Reason Code Option 012/3 - Notice Type - Ineligible

You do not qualify for State Blind Pension due to your countable income exceeding the State Blind Pension Income limit. Your countable income is [gross income – minus allowable deductions]. The income limit for the State Blind Pension is $4,260 after allowable deductions.

Citation:  55 Pa. Code § 451.3

Ineligible - VA Income (PA/FS 162) Manual Notice

Notice Reason Code Option 015/3 - Notice Type - Ineligible

You do not qualify for State Blind Pension due to your countable income exceeding the State Blind Pension Income limit. Your countable income is [gross income – minus allowable deductions]. The income limit for the State Blind Pension is $4,260 after allowable deductions.

Citation:  55 Pa. Code § 451.3

Ineligible - Earned Income (PA/FS 162) Manual Notice

Notice Reason Code Option 001/3, Notice Type - Ineligible

You do not qualify for State Blind Pension due to your countable income exceeding the State Blind Pension Income limit. Your countable income is [gross income – minus allowable deductions]. The income limit for the State Blind Pension is $4,260 after allowable deductions.

Citation:  55 Pa. Code § 451.3

Ineligible - Non-Citizen Status - Automated Notice

Select System Notice Reason Code Option 620/1, Notice Type - Ineligible, from Cash Notice dropdowns on the Client Notice Screen.

Ineligible - Age (PA/FS 162) Manual Notice

Notice Reason Code Option 049/3, Other Regulations - Notice Type - Ineligible

You do not qualify for State Blind Pension because you are not over 21 years old.

Citation:  55 Pa. Code § 451.3 (d) (1)

Ineligible - Residency Requirements - Automated Notice

Select System Notice Reason Code Option 052/1, Notice Type - Ineligible, from Cash Notice dropdowns on the Client Notice Screen.

State Blind Pension Change in benefit amount

Change in Benefit amount - Change in Income (PA/FS 162) Manual Notice (advance notice for decrease or confirming notice for increase).

Notice Reason Code Option 001/5, - Notice Type – Change

Your State Blind Pension payment is changing to [new payment amount] per month beginning [First monthly payment date that can be met with proper notice] due to a change in your income.

Citation:  55 Pa. Code § 451.3

Change in Benefit amount - Change in SSA Income (PA/FS 162) Manual Notice

(advance notice for decrease or confirming notice for increase).

Notice Reason Code Option 012/7 - Notice Type – Change

Your State Blind Pension payment is changing to [new payment amount] per month beginning [First monthly payment date that can be met with proper notice] due to a change in your income.

Citation:  55 Pa. Code § 451.3

Change in Benefit amount - Change in VA Income (PA/FS 162) Manual Notice

(advance notice for decrease or confirming notice for increase).

Notice Reason Code Option 015/7 - Notice Type – Change

Your State Blind Pension payment is changing to [new payment amount] per month beginning [First monthly payment date that can be met with proper notice] due to a change in your income.

Citation:  55 Pa. Code § 451.3

State Blind Pension Closures:

Cash Assistance State Blind Pension -- Discontinue -- No longer meets categorical requirement (PA/FS 162 9/08 version) (give advance notice)

You no longer qualify for Interim Cash Assistance effective [date of closure] because you no longer meet categorical requirements to qualify for State Blind Pension.

Citation: 55 Pa. Code § 451.3

Cash Assistance State Blind Pension – Discontinue -- Excess Income (PA/FS 162 9/08)

You no longer qualify for State Blind Pension due to a change in your income. Your countable income is [gross income - allowable deductions]. The income limit for the State Blind Pension is $4,260 after allowable deductions.

Citation:  55 Pa. Code § 451.3

Cash Assistance State Blind Pension – Discontinue -- Excess Resources (PA/FS 162 9/08)

You no longer qualify for State Blind Pension due to your countable resources exceeding the resource limit. Your countable resources are [total resources - allowable deductions]. The resource limit for the State Blind Pension is $7,500.

Citation:  55 Pa. Code § 451.3