Supplemental Security Income &
Redeterminations

Cameron Lindahl, M.S. & Sara Toor, M.A.

What is a Redetermination?

A redetermination is when the Social Security Administration (SSA) reviews an individual’s income, resources, living arrangements to determine continued eligibility for Supplemental Security Income (SSI) benefits with the correct benefit payment amount.

If an individual is married or is a disabled child under the age of 18 who is living with his/her parent(s), income, resources, and living arrangements are still reviewed. If the individual is married the spouse’s income, resources and living arrangements are analyzed and if the individual is a disabled child under the age of 18 his/her parent(s) income, resources, and living arrangements are looked at.

When is a Redetermination Performed?
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A redetermination for continued benefit eligibility and benefit payment amounts for most individuals are once every 1 to 6 years. However, if a change is reported that can affect benefit payment amount or the individual’s eligibility the Social Security Administration (SSA) will review income, resources, and living arrangements as well.

An individual who receives benefits has a legal obligation for reporting the following immediately and no later than 10 days after the end of the month in which the change occurred:

  • Change of address
  • Change in living arrangements
  • Change in income (earned and unearned)
  • Change in resources
  • Death of spouse or anyone in household
  • Change in marital status
  • Change in citizenship status or immigration status
  • Change in help with living expenses from friends or relatives
  • Eligibility for other benefits or payments
  • Admisstion to or discharge from an institution (hospital, nursing home, correctional institution)
  • Change in school attendance, if under age 22
  • Change in legal alien status
  • Sponsor or (sponsor’s spouse) changes of income, resources, or living arrangement for aliens
  • Leaving the U.S. for a full calendar month or for 30 consecutive days or more
  • An unsatisfied felony or arrest warrant from custody, flight to avoid prosecution or confinement, or flight escape

If a change is not reported accurately and in a timely matter an individual is at risk for being underpaid, or overpaid (which would have to be paid back to SSA).

According to the Social Security Administration (SSA), “If an individual knowingly fails to report or knowingly makes a false or misleading statements, a sanction could be imposed against benefit payments. The first sanction period is withholding of payments for 6 months and subsequent sanction periods are 12 months and then 24 months.”

There could also be fines, penalties, and even imprisonment for not reporting changes or making false statements.

How is a Redetermination Conducted?

The Social Security Administration (SSA) conducts a redetermination in three ways:

  • Telephone interview
  • In person; or
  • By mail

A letter is sent to an individual if the redetermination is to be done over the phone or in person. The letter will inform the individual that they (SSA) will call the individual on a particular day and time, or the letter will request the individual to come into his/her local Social Security Administration (SSA) office. During the redetermination, a representative will fill out forms based on the information the individual provides. If an individual has a representative payee, an appointment letter will be sent to the representative payee.

If a redetermination is conducted by mail, redetermination forms are sent to the individual’s address on record that need to be completed, signed, and returned.


Time is of the Essence

An individual has 30 days to respond to the appointment letter, complete and return the forms, or inform the Social Security Administration (SSA) office that he/she cannot keep the appointment or is having difficulty completing the forms.

If the individual does not reply within the time frame the following could result:

  • Benefit payments stopped
  • An individual could be overpaid
  • An individual could be underpaid

Also, if an individual loses Supplemental Security Income (SSI) eligibility, he/she may also lose Medicaid eligibility as well.

Documentation for Redeterminations

Certain documentation may be requested for a redetermination. Possible documentation needed may include:

  • Savings account, checking account, or bank statements
  • Pay stubs or income tax returns
  • Proof of other income (pension, annuities, unemployment compensation, worker’s compensation, etc.)
  • Life insurance policies
  • Burial contracts
  • Household receipts and bills to show monthly expenses (utilities, lease, etc.)

If specific documentation is need the Social Security Administration (SSA) office will inform you and assist an individual with obtaining such information.

Correspondence and responding to mail received from the Social Security Administration (SSA) Office as well as reporting specific changes are vital to obtaining and maintaining eligibility for Supplemental Security Income (SSI). Remember individuals, who receive Supplemental Security Income (SSI) benefit payments, have the legal responsibility to report any changes and accurate information to the Social Security Administration (SSA).

DISCLAIMER: The information provided by CPT is for informational purposes only and is intended to be used as a non-legal guide prior to consultation with an attorney familiar with your specific legal situation. CPT is not engaged in the practice of law or in rendering legal advice or counsel. No such legal advice or counseling is either expressly or impliedly intended. This form is not a substitute for the advice or counsel of an attorney. If you require legal advice, you should seek the services of an attorney. © 2017 CPT All rights reserved.

Resources/Further Reading:

https://www.ssa.gov/ssi/text-redets-ussi.htm

https://blog.ssa.gov/reporting-changes-is-your-responsibility/

https://www.ssa.gov/ssi/text-report-ussi.htm

https://www.ssa.gov/pubs/EN-05-11011.pdf

Urbatsch, K., & Fuller, M. (2016). Administering the California special needs trust: A guide for trustees and those who advise them (2nd ed.). Bloomington, IN: IUniverse.