Technical Updates to Applicability of the Supplemental Security Income (SSI) Reduced Benefit Rate for Individuals Residing in Medical Treatment Facilities

Institution Residence Screen Shots
When continued payments are payable for temporary institutionalization, SSA must receive a physician’s
certification and home expenses statement by the recipient, no later than the date of discharge or the 90th
day of medical confinement, whichever is earlier.
The SSA Claims Specialist (CS) confirms the recipient and physician provided this required information
by completing the fields ‘Home expense statement date’ field and ‘Physician certification date’ field on
the Screenshot page ‘Institution Residence – TI Benefits Selected’. These fields tell the SSI system that
the CS has obtained the necessary documentation to determine the SSI recipient is eligible for temporary
institutionalization benefits.
These fields serve as a safeguard to prevent the issuance of incorrect payments to a recipient who does not
meet the requirements to receive temporary institutionalization benefits.

Screenshot 1: Institution Residence – Levings State (Meets Levings Requirement is Yes)

Screenshot 2: Institution Residence – Levings State (Meets Levings Requirement is No)

Screenshot 3: Institution Residence (Non-Levings State)

Screenshot 4: Institution Residence – 1619/1611 Benefits

Screenshot 5: Institution Residence – TI Benefits Selected

Screenshot 6: Institution Residence – Ineligible for TI Benefits

SSA will insert the following revised Privacy Act Statement into the screens as soon as
possible:
Privacy Act Statement
Collection and Use of Personal Information
Section 1611 of the Social Security Act, as amended, allows us to collect this information.
Furnishing us this information is voluntary. However, failing to provide all or part of the
information may prevent us from making an accurate and timely decision regarding
Supplemental Security Income benefits.
We will use the information to determine eligibility or benefit amount. We may also share your
information for the following purposes, called routine uses:

 To representative payees, when the information pertains to individuals for whom they
serve as representative payees, for the purpose of assisting the Social Security
Administration in administering its representative payment responsibilities under the Act
and assisting the representative payees in performing their duties as payees, including
receiving and accounting their duties as payees, including receiving and accounting for
benefits for individuals for whom they serve as payee; and

 To third party contacts, where necessary, to establish or verify information provided by
representative payees or payee applicants.
In addition, we may share this information in accordance with the Privacy Act and other Federal
laws. For example, where authorized, we may use and disclose this information in computer
matching programs, in which our records are compared with other records to establish or verify a
person’s eligibility for Federal benefit programs and for repayment of incorrect or delinquent
debts under these programs.
A list of additional routine uses is available in our Privacy Act System of Records Notices
(SORN) 60-0103, entitled Supplemental Security Income Record and Special Veterans Benefits,
as published in the Federal Register (FR) on January 11, 2006, at 71 FR 1830 and 60-0320,
entitled Electronic Disability (eDIB) Claim File, as published in the FR on December 22, 2003,
at 68 FR 71210. Additional information, and a full listing of all of our SORNs, is available on
our website at www.ssa.gov/privacy/.