TITLE XVI-SUPPLEMENTAL SECURITY INCOME FOR THE AGED, BLIND, AND DISABLED 1 Sec. 1601. Sec. 1611. Sec. 1612. Sec. 1613. Sec. 1614. Sec. 1615. Sec. 1616. Sec. 1617. Sec. 1618. Rehabilitation services for blind and disabled individuals Cost-of-living adjustments in benefits ........................ Operation of State supplementation programs Page 682 682 682 692 698 702 711 712 715 716 This Title XVI of the Social Security Act is administered by the Social Security Administra tion. This Title XVI appears in the United States Code as §§1381-1383d, subchapter XVI, chapter 7, Title 42. Regulations with respect to this Title XVI are contained in chapter III, Title 20, Code of Federal Regulations. See Vol. II, 31 U.S.C. 3720 and 3720A, with respect to collection of payments due to Federal agencies. See Vol. II, P.L. 88-525, §11(i), with respect to the acceptance by social security offices of applications for participation in the food stamp program from recipients of supplemental security income. P.L. 94-241, §1 (§502 of Covenant to Establish a Commonwealth of the Northern Mariana Islands in Political Union with the United States of America), approved March 24, 1976, provides that this Title XVI is applicable to the Northern Mariana Islands. See Vol. II, P.L. 95–521, §102(i), with respect to reporting of benefits received under the Social Security Act. See Vol. II, P.L. 96–223, §102, with respect to allocation of funds for programs to assist SSI recipients. See Vol. II, P.L. 97-300, $106(e), with respect to performance standards; and §§501-505, with respect to the payment of a bonus for the successful job placement of certain employable dependent individuals. See Vol. II, P.L. 100-203, §9117, with respect to the demonstration program to assist homeless individuals. See Vol. II, P.L. 100-204, §724(d), with respect to furnishing information to the United States Commission on Improving the Effectiveness of the United Nations; and §725(b), with respect to the detailing of Government personnel. See Vol. II, P.L. 100-235, §§5-8, with respect to responsibilities of each Federal agency for computer systems security and privacy. See Vol. II, P.L. 100-690, §5301(a)(1)(C) and (d)(1)(B), with respect to benefits of drug traffickers and possessors. See Vol. II, P.L. 101-239, $10405, with respect to Agent Orange settlement payments excluded from countable income and resources under Federal means-tested programs. See Vol. II, P.L. 101-508, §5041(2)-(4), with respect to notification of certain individuals eligible to receive retroactive benefits. See Vol. II, P.L. 103-296, §201(c) with respect to demonstration projects designed to explore innovative referral, monitoring, and treatment approaches in disability determinations in which alcoholism or drug addiction is a contributing factor; §202, with respect to the establishment of a Commission on the Evaluation of Disability in children; §207, with respect to disability review for recipients who are 18 years of age; and §208, with respect to continuing disability reviews. 2 This table of contents does not appear in the law. Sec. 1619. Sec. 1620. Sec. 1631. Sec. 1633. Sec. 1634. Sec. 1635. Sec. 1636. Benefits for individuals who perform substantial gainful activ- Part B-Procedural and General Provisions Payments and procedures Administration Determinations of medicaid eligibility Treatment referrals for individuals with an alcoholism or drug Sec. 1637. Annual report on program Part A-Determination of Benefits Page 718 ELIGIBILITY FOR AND AMOUNT OF BENEFITS 3 720 723 725 745 746 747 749 749 PURPOSE; APPROPRIATIONS SEC. 1601. [42 U.S.C. 1381] For the purpose of establishing a national program to provide supplemental security income to individuals who have attained age 65 or are blind or disabled, there are authorized to be appropriated sums sufficient to carry out this title. 749 BASIC ELIGIBILITY FOR BENEFITS SEC. 1602. [42 U.S.C. 1381a] Every aged, blind, or disabled individual who is determined under part A to be eligible on the basis of his income and resources shall, in accordance with and subject to the provisions of this title, be paid benefits by the Commissioner of Social Security. Definition of Eligible Individual SEC. 1611. [42 U.S.C. 1382] (a)(1) Each aged, blind, or disabled individual who does not have an eligible spouse and (A) whose income, other than income excluded pursuant to section 1612(b), is at a rate of not more than $1,752 (or, if greater, the amount determined under section 1617) for the calendar year 1974 or any calendar year thereafter, and (B) whose resources, other than resources excluded pursuant to section 1613(a), are not more than (i) in case such individual has a spouse with whom he is living, the applicable amount determined under paragraph (3)(A), or (ii) in case such individual has no spouse with whom he is living, the applicable amount determined under paragraph (3)(B), shall be an eligible individual for purposes of this title. (2) Each aged, blind, or disabled individual who has an eligible spouse and 3 See Vol. II, P.L. 93-66, §211, with respect to supplemental security income benefits for essential persons. (A) whose income (together with the income of such spouse), other than income excluded pursuant to section 1612(b), is at a rate of not more than $2,628 (or, if greater, the amount determined under section 1617) for the calendar year 1974, or any calendar year thereafter, and (B) whose resources (together with the resources of such spouse), other than resources excluded pursuant to section 1613(a), are not more than the applicable amount determined under paragraph (3)(A), shall be an eligible individual for purposes of this title. (3)(A) The dollar amount referred to in clause (i) of paragraph (1)(B), and in paragraph (2)(B), shall be $2,250 prior to January 1, 1985, and shall be increased to $2,400 on January 1, 1985, to $2,550 on January 1, 1986, to $2,700 on January 1, 1987, to $2,850 on January 1, 1988, and to $3,000 on January 1, 1989. (B) The dollar amount referred to in clause (ii) of paragraph (1)(B), shall be $1,500 prior to January 1, 1985, and shall be increased to $1,600 on January 1, 1985, to $1,700 on January 1, 1986, to $1,800 on January 1, 1987, to $1,900 on January 1, 1988, and to $2,000 on January 1, 1989. Amounts of Benefits 4 (b)(1) The benefit under this title for an individual who does not have an eligible spouse shall be payable at the rate of $1,752 (or, if greater, the amount determined under section 1617) for the calendar year 1974 and any calendar year thereafter, reduced by the amount of income, not excluded pursuant to section 1612(b), of such individual. (2) The benefit under this title for an individual who has an eligible spouse shall be payable at the rate of $2,628 (or, if greater, the amount determined under section 1617) for the calendar year 1974 and any calendar year thereafter, reduced by the amount of income, not excluded pursuant to section 1612(b), of such individual and spouse. Period for Determination of Benefits (c)(1) An individual's eligibility for a benefit under this title for a month shall be determined on the basis of the individual's (and eligible spouse's, if any) income, resources, and other relevant characteristics in such month, and, except as provided in paragraphs (2), (3), (4), (5), and (6), the amount of such benefit shall be determined for such month on the basis of income and other characteristics in the first or, if the Commissioner of Social Security so determines, second month preceding such month. Eligibility for and the amount of such benefits shall be redetermined at such time or times as may be provided by the Commissioner of Social Security. (2) The amount of such benefit for the month in which an application for benefits becomes effective (or, if the Commissioner of Social Security so determines, for such month and the following month) and for any month immediately following a month of ineligibility for such benefits (or, if the Commissioner of Social Security so determines, for such month and the following month) shall *Changes have been made by publication in the Federal Register:See. Vol. II, Appendix A and B, for 1996 and 1997 Cost-of-Living Increase Information. (A) be determined on the basis of the income of the individual and the eligible spouse, if any, of such individual and other relevant circumstances in such month; and (B) in the case of the month in which an application becomes effective or the first month following a period of ineligibility, if such application becomes effective, or eligibility is restored, after the first day of such month, bear the same ratio to the amount of the benefit which would have been payable to such individual if such application had become effective, or eligibility had been restored, on the first day of such month as the number of days in such month including and following the effective date of such application or restoration of eligibility bears to the total number of days in such month. (3) For purposes of this subsection, an increase in the benefit amount payable under title II (over the amount payable in the preceding month, or, at the election of the Commissioner of Social Security, the second preceding month) to an individual receiving benefits under this title shall be included in the income used to determine the benefit under this title of such individual for any month which is (A) the first month in which the benefit amount payable to such individual under this title is increased pursuant to section 1617, or (B) at the election of the Commissioner of Social Security, the month immediately following such month. (4)(A) Notwithstanding paragraph (3), if the Commissioner of Social Security determines that reliable information is currently available with respect to the income and other circumstances of an individual for a month (including information with respect to a class of which such individual is a member and information with respect to scheduled cost-of-living adjustments under other benefit programs), the benefit amount of such individual under this title for such month may be determined on the basis of such information. (B) The Commissioner of Social Security shall prescribe by regulation the circumstances in which information with respect to an event may be taken into account pursuant to subparagraph (A) in determining benefit amounts under this title. (5) Notwithstanding paragraphs (1) and (2), any income which is paid to or on behalf of an individual in any month pursuant to (A) a State program funded under part A of title IV5, (B) section 472 of this Act (relating to foster care assistance), (C) section 412(e) of the Immigration and Nationality Act (relating to assistance for refugees), (D) section 501(a) of Public Law 96-422 (relating to assistance for Cuban and Haitian entrants), or (E) the Act of November 2, 1921 (42 Stat. 208), as amended (relating to assistance furnished by the Bureau of Indian Affairs), shall be taken into account in determining the amount of the benefit under this title of such individual (and his eligible spouse, if any) only for that month, and shall not be taken into account in determining the amount of the benefit for any other month. 6 SP.L. 104–193, §108(j), amended subparagraph (A) in its entirety, effective July 1, 1997. Until then, subparagraph (A) reads: “(A) a State plan approved under part A of title IV of this Act (relating to aid to families with dependent children),". "See Vol. II for P.L. 82-414, §412(e), 96-422, §501(a), and P.L. 67-85, the Act of November 2, 1921. (6) The dollar amount in effect under subsection (b) as a result of any increase in benefits under this title by reason of section 1617 shall be used to determine the value of any in-kind support and maintenance required to be taken into account in determining the benefit payable under this title to an individual (and the eligible spouse, if any, of the individual) for the 1st 2 months for which the increase in benefits applies. (7) For purposes of this subsection, an application of an individual for benefits under this title shall be effective on the later of (A) the first day of the month following the date such application is filed, or (B) the first day of the month following the date such individual becomes eligible for such benefits with respect to such application.7 (8) The Commissioner of Social Security may waive the limitations specified in subparagraphs (A) and (B) of subsection (e)(1) on an individual's eligibility and benefit amount for a month (to the extent either such limitation is applicable by reason of such individual's presence throughout such month in a hospital, extended care facility, nursing home, or intermediate care facility) if such waiver would promote the individual's removal from such institution or facility. Upon waiver of such limitations, the Commissioner of Social Security shall apply, to the month preceding the month of removal, or, if the Commissioner of Social Security so determines, the two months preceding the month of removal, the benefit rate that is appropriate to such individual's living arrangement subsequent to his removal from such institution or facility. Special Limits on Gross Income (d) The Commissioner of Social Security may prescribe the circumstances under which, consistently with the purposes of this title, the gross income from a trade or business (including farming) will be considered sufficiently large to make an individual ineligible for benefits under this title. For purposes of this subsection, the term "gross income" has the same meaning as when used in chapter 1 of the Internal Revenue Code of 1954 8. Limitation on Eligibility of Certain Individuals (e)(1)(A) Except as provided in subparagraphs (B), (C), (D), (E), and (G), no person shall be an eligible individual or eligible spouse for purposes of this title with respect to any month if throughout such month he is an inmate of a public institution. (B) In any case where an eligible individual or his eligible spouse (if any) is, throughout any month (subject to subparagraph (G)), in a medical treatment facility 9 receiving payments (with respect to such individual or spouse) under a State plan approved under title XIX, or an eligible individual is a child described in section 7P.L. 104-193, §204(a), amended subparagraphs (A) and (B) in their entirety, applicable with respect to applications for benefits under title XVI filed on or after August 22, 1996, without regard to whether regulations have been issued to implement such amendments. 8 P.L. 83-591. P.L. 99-514, $2, provides, except when inappropriate, any reference to the Internal Revenue Code of 1954 shall include a reference to the Internal Revenue Code of 1986. "P.L. 105-33, §5522(c)(1)(A), struck out "hospital, extended care facility, nursing home, or intermediate care facility" and substituted "medical treatment facility", effective as if included in the enactment of title II of P.L. 104-193, August 22, 1996. |