The SSI program is a nationwide federal assistance program
administered by the Social Security Administration that guarantees
a minimum level of income for “needy” aged, blind,
or disabled individuals. Economically “needy”
persons who are blind, disabled, or at least 65 years of age
are eligible for monthly cash benefits. “Needy”
blind or disabled children may also be eligible for SSI. As
its name implies, Supplemental Security Income supplements
a person’s income up to a certain level. The level varies
from one state to another and can go up every year based on
SSI is a means-tested program; therefore, income and
resource rules apply in determining eligibility and
payment amounts. Income eligibility depends upon applicant’s
living-arrangement category and whether he/she has any
earned and/or unearned income. The amount of an individual’s
income is used to determine both eligibility for, and
the amount of, his/her SSI benefit. As countable income
increases, an individual’s SSI benefit amount
decreases. Generally, ineligibility for SSI occurs when
countable income equals the Federal benefit rate plus
the amount of applicable Federally-administered State
supplementary payment. These benefit rates are adjusted
annually (in January) to reflect changes in the cost
of living. The individual or couple is allowed income
equal to the maximum payment amount. In using the following
income figures, make certain to consider all of the
income exclusions and explanations of living arrangements,
which are listed at the bottom of the table. Because
of earned-income exclusions, particularly, applicants
could have more than double the amounts shown and still
be eligible for some SSI benefits.
Living Arrangement Monthly Countable Income/Maximum
Monthly Payment 2008 - New York State (includes state supplement)
|Living with others
|Areas A & B
|Areas A & B
|Areas A & B
|Living in the household of another
Area A is New York City
Area B is Nassau, Suffolk, Rockland, and Westchester
Area C is all other counties in New York State
|The Social Security Act defines two kinds of income:
earned and unearned. Earned income is wages and net income
from self-employment. All other income, such as Social
Security benefits, workers’ compensation or income
received in-kind (i.e., food, clothing or shelter-related
items), is unearned.
SSI is a program of last resort for the aged, blind,
or disabled whose income and resources are below specified
levels. Therefore, income and resource exclusions pertain
to the SSI program.
Countable income is earned and/or unearned income after
the following deductions or exclusions (partial list):
The principal earned income exclusions are:
• the first $65 per month plus one-half of
• impairment-related work expenses of the disabled
and work expenses of the blind,
• income set aside or being used to pursue a
plan for achieving self-support by a disabled or blind
• infrequent or irregularly received income
($10 or less a month).
The principal unearned income exclusions are:
• the first $20 per month,
• income set aside or being used to pursue a
plan for achieving self-support by a disabled or blind
• state or locally funded assistance based on
• rent subsidies under HUD programs and the
value of food stamps, and
• infrequent or irregularly received income
($20 or less a month).
It should be noted that the incomes of others on whom
an applicant is dependent (spouse or parent) will be
attributed or “deemed” to the applicant
in considering SSI eligibility and in determining SSI
Living Arrangements are defined as follows:
A. Living alone includes
recipients living either alone, with foster children,
with an authorized homemaker, or with a family care
home placed by an authorized agency. Also includes
recipients living with others but either paying a
flat fee for room and board or preparing their meals
B. Living with others includes
recipients who reside in a dwelling with others and
1. prepare food in common with at least one other
person in the dwelling;
2. are members of a religious community; or
3. are children who have not been included in State
living arrangement C or D.
C. Congregate care I includes
recipients in non-medical family type homes and family
care homes. These homes serve persons who are unable
to function completely independently. Family type
homes are facilities certified by the State Department
of Health, supervised by local departments of social
services, and operated for the purpose of providing
long-term residential care for adults. Family care
homes are private households that provide care for
mentally disabled persons. Eligibility for care in
these homes is based on certification of placement
by a local office of the Department of Social Services,
an office of the State Department of Mental Health (OMH) or the Office of Mental Retardation-Development Disability (OMR-DD).
D. Congregate care II includes
recipients in residential facilities who are aged
or have mental disabilities. Facilities at this level
are certified adult care facilities and certified,
privately operated facilities for the mentally ill
or developmentally disabled which provide care and
services that enable residents to continue to live
in the community.
E. Congregate care III includes
recipients in non-medical privately operated, State
certified, nonmedical, residential facilities which
are operated for the purpose of providing treatment,
training, and education for mentally retarded or developmentally
F. Living in the household
of another includes all recipients in Federal
code B and for New York State purposes is considered
part of the living with others living arrangement.
G. Living in a Medicaid facility
includes all recipients in Federal code D. An additional
State-administered supplement is provided to those
recipients in Federal code D who are New York State
residents and reside in health facilities defined
in Section 2801 of the New York State Public Health
Law (e.g. nursing homes).
An individual may have assets up to $2,000 in 2009;
a couple may have up to $3,000 (even if only one member
is eligible for SSI). Resources include cash; bank account(s),
stocks, U.S. savings bonds; land; life insurance; personal
property; automobile(s); anything else you own which
could be changed to cash and used for food, clothing,
or shelter; and deemed resources. Assets that are not
counted include the home you live in and the land it
is on; household goods and personal property that are
not worth more than $2,000; one wedding ring and one
engagement ring; burial spaces for you or your immediate
family; burial funds for you and your spouse (each valued
at $1,500 or less); life insurance policies with a combined
face value of $1,500 or less; one car, regardless of
value, if it is necessary for employment or medical
treatment; or modified for use or transportation of
a disabled person; or necessary because of climate,
terrain, distance or similar factors to perform essential
daily activities. If the use of the car does not meet
one of these conditions, then the equity value of such vehicle is a resource. Property essential to self-support;
and resources set aside to fulfill a plan to achieve
self-support are both principal resource exclusions.
Must be 65 or older, unless blind or disabled.
Must be disabled or blind, unless 65 or older.
An individual is considered statutorily blind if his/her
central visual acuity is 20/200 or less in the better
eye, with the use of correcting lens. An eye which has
a limitation in the field of vision so that the widest
diameter of the visual field subtends an angle no greater
than 20 degrees is considered to have a central visual
acuity of 20/200 or less.
A person 18 or older is considered disabled if he/she
is unable to engage in any substantial gainful activity:
due to any medically determinable physical or mental
impairment, or combination of impairments, which can
be expected to result in death; or which has lasted,
or can be expected to last, for a continuous period
of not less than 12 months.
There is no minimum age requirement for SSI eligibility.
A child must be disabled or blind to receive SSI. If
18-22, the adult disability definition applies. If the
child is blind, the same definition of blind applies
as for adults. A child under the age of 18, whether
or not married or head of household, is disabled if
he/she has a medically determinable physical or mental
impairment or combination of impairments that: results
in marked and severe functional limitations, and has
lasted or can be expected to last for a continuous period
of not less than 12 months or can be expected to result
Presence of Spouse:
Not a condition. A spouse is eligible if he/she meets
the same conditions of eligibility as pertain to an
individual. Benefits and eligibility for a couple are
different from those for two individuals.
Presence of Children:
Not a condition.
Not a condition.
Exhaustion of Benefits from Other
SSI applicants must apply for any other benefits due
them. Appropriate coordination of the SSI program with
the Food Stamp, medical assistance, and temporary State
assistance also are important in keeping individuals
from sliding further into poverty. Generally, SSI recipients
are categorically eligible for Medicaid. SSI recipients
in all States, except California, may be eligible for
food stamps. SSA may enter into agreements under which
States or local governments are reimbursed for basic
needs assistance provided during the period that either
an eligible individual’s SSI application for benefits
was pending, or the individual’s SSI benefits
were suspended and subsequently reinstated (the interim
Not a condition.
Participation in Work Program:
Since the beginning of the SSI program, a number of
SSI disabled recipients have worked and received SSI
payments. All SSI disabled recipients who work are considered
section 1619 participants. The 1980 amendments to the
SSA established section 1619, and provided additional
work incentive provisions to assist SSI recipients in
entering the workforce. The law contained a number of
special income exclusions that were intended as work
incentives including: Plans for Achieving Self-Support
(PASS) permit a recipient with an approved PASS to set
aside earned or unearned income and resources for a
work goal. The income or resources set aside are used
to pay for goods or services needed to reach the goal,
such as education, vocational training, starting a business,
or purchasing work related equipment.
The income and resources are set aside under a PASS
are excluded from SSI income and resource tests.
The Ticket to Work and Work Incentives Improvement Act
of 1999 (“the Ticket Legislation”) established
a Ticket to Work program under which a disabled beneficiary
will be able to obtain vocational rehabilitation, employment
and other support services from a qualified private
or public provider. By expanding the pool of providers
and giving the providers incentives for achieving success,
this program seeks to expand a disabled beneficiary’s
access to these services in order to assist the beneficiary
in finding, entering, and retaining employment and reducing
his/her dependence on cash benefits.
The Ticket program provides that as long as the beneficiary
is “using a ticket” as defined by the Commissioner,
SSA will not initiate a continuing disability review.
Individuals receiving SSI benefits, who improve medically
and, therefore, are no longer considered disabled or
blind can continue to receive SSI benefits if they are
actively participating in the Ticket to Work program,
or another approved VR program, and continuation or
completion of the program would increase the likelihood
that they will be permanently removed from the SSI rolls.
SSI benefits and Medicaid generally continue until the
rehabilitation services are completed or until the individual
ceases to participate in the program.
A child is defined for SSI purposes as an unmarried
blind or disabled individual who is not the head of
a household and who is either under age 18 or aged 18-21
and regularly attending school.
Generally, noncitizens in one of certain immigration categories granted by the Department of Homeland Security, may be eligible for SSI if: they were lawfully living in the United States on August 22, 1996, and are blind or disabled; they were receiving SSI on August 22, 1996, and were lawfully living in the United States; or were lawfully admitted for permanent residence under the Immigration and Nationality Act (INA) and have a total of 40 credits of work in the United States. (A spouse's or parent's work also may count.)
Some other noncitizens who may be eligible for SSI payments are: Active duty members of the U.S. armed forces; Noncitizen members of federally recognized Indian tribes; Certain noncitizens admitted as Amerasian immigrants; and Cuban/Haitian entrants under the Refugee Education Assistance Act.
7-year limit for some noncitizens :
Some refugees and other noncitizens can get SSI for up to 7 years. If SSI payments are limited to 7 years because of particular noncitizen status, Social Security will send a letter advising when the 7 year period ends, as well as a letter explaining rights to appeal before payments stop.
Other Eligibility Conditions:
Modifications were made as to when redeterminations
must be done for SSI recipients who turn age 18 and
when continuing disability reviews are to be done for
certain low-birth-weight babies. In addition, although
not an SSI provision, States are required to provide
Medicaid coverage for disabled children who were receiving
SSI payments and would have continued to be eligible
for such payments except that their eligibility terminated
because they did not meet the more strict childhood
The SSI drug addict and alcoholic provision was clarified
and the applicability of the treatment and representative
payee provision was expanded. Any individual who is
receiving SSI based on a disability where drug addiction
or alcoholism is a contributing factor material to the
finding of disability must comply with the DA&A
treatment requirements. Instances of noncompliance with
the requirements result in progressively longer payment
Monthly cash payments.
SSI benefits are not the only form of assistance available
to “needy” aged, blind, or disabled individuals.
Medicaid, food stamps, and temporary state assistance are
also important in keeping individuals from sliding further
into poverty. SSA plays a limited but important role in helping
states with regard to administration of the Medicaid and Food
Stamp programs, and provisions in the SSI statute ensure that
payments made by states or under the Social Security program
are not duplicated by SSI benefits. SSI recipients may be
eligible for other financial assistance in NYS. This includes
Emergency Assistance for Adults (EAA), which is a state program
set up to help SSI recipients who have an emergency such as
a utility shut off, or a lost, stolen or unreceived SSI check.
There are other social services that are available to SSI
recipients in NYS through local departments of social services.
These include: homemaker and housekeeper services; personal
care; money management; or assistance in making living arrangements
in group residences or family-type homes.
Interim Assistance Payment:
Some states and local subdivisions
make “interim assistance payments” to people while
they wait for a decision on whether they can get SSI. The
state or local government is reimbursed from the person’s
first SSI payment.
Benefit levels depend upon living-arrangement categories.
In determining the actual benefit that a recipient gets, the
Social Security Administration subtracts countable income
from the maximum benefit for the recipient’s living-arrangement
category. A recipient with no countable income gets the maximum
benefit for his/her living-arrangement category.
Change in Recipient Status:
Redeterminations are reviews of all of the nonmedical factors
of eligibility to determine whether a recipient is still eligible
for SSI and still receiving the correct payment amount. There
are two types of redeterminations: scheduled and unscheduled.
Scheduled redeterminations are selected periodically depending on the likelihood of payment error in the
case. Except for certain institutionalized individuals, all
recipients are periodically scheduled for a redetermination.
Unscheduled redeterminations are completed on an as needed
basis when recipients report, or it is discovered, certain
changed in circumstances that could affect the continuing
SSI payment amount.
SSI recipients are required to have their nonmedical eligibility
factors redetermined periodically depending on their specific situation.
In addition to these nonmedical reviews, medical reviews are
conducted on disabled or blind recipients in order to determine
if they continue to be disabled or blind. For administrative
efficiency the medical reviews are done most often on those
disabled or blind recipients whose medical conditions are
considered likely to improve. Medical reviews are required
for disabled or blind recipients, for example, under the following
• when earnings of recipients exceed the substantial
gainful activity level;
Changes in Benefit Levels:
• at least once every 3 years for recipients under age
18 whose medical conditions are considered likely to improve;
• within 12 months after birth for recipients whose
low birth weight is a contributing factor material to the
determination of their disability unless the Commissioner
determines that the impairment is not expected to improve
within 12 months of the child’s birth; and
• within 1 year after attainment of age 18 and using
adult eligibility criteria, for recipients whose eligibility
for SSI benefits was established under the disabled child
Maximum Federal Supplemental Security Income (SSI) payment amounts
increase with the automatic cost-of-living increases that apply
to Social Security OASDI benefits. The latest such increase,
5.8%, became effective January 2009. The new federal amounts
are $674 for an eligible individual, $1,011 for an eligible individual
with an eligible spouse, and $312 for an essential person. Some
states supplement the SSI benefit for certain categories of
recipients. Not all states administer its own supplemental payments.
If a state does then an application for the supplement must
be made separately with the state agency.
Where and How
Individuals can make appointments to apply for SSI
benefits at any one of the approximately 1,300 SSA field offices
around the country or through SSA teleservice centers. The
claims process includes the application interview, the obtaining
of necessary evidence and documentation, and the adjudication
of the claim. Although the eligibility requirements of the
Social Security program and the SSI program are different,
the application process is very similar. Many times, individuals
file for benefits under both programs at the same time. Potential
claimants initially contact SSA by phone, mail or in person.
Field office personnel conduct an interview with the claimant
and/or his/her representative.
SSA corroborates information provided by applicants for SSI
through independent or collateral sources. Generally, the
basic responsibility for obtaining evidence lies with the
claimant, although SSA often gives advice on ways to obtain
the needed information. Because of the special circumstances
of the SSI population (for example, financial need, old age,
or illness), SSA makes special efforts to assist claimants
in obtaining the necessary proofs.
An applicant should supply the following documentation: Social
Security card or a record of applicant’s Social Security
number; birth certificate or other proof of age; information
about the home of the applicant (mortgage, lease, or landlord’s
name); payroll slips, bank books, insurance policies, burial
fund records, other information regarding income and assets;
names, addresses, and telephone numbers of doctors, hospitals,
and clinics that have seen the applicant; and proof of U.S.
citizenship or eligible citizenship status.
With regard to disability and blindness claims, SSA makes
determinations of all of the nonmedical eligibility factors
while each State’s Disability Determination Service
(DDS) makes determinations of the medical eligibility factors.
The process for making the disability decision is the same
for both Social Security and SSI disability claims. The definition
of disability is the same. However, under the SSI program
there is no statutory waiting period of five months. If the
SSI claim is approved benefits are payable the first full
month after the application.
If the person applying seems to meet all the requirements
and needs money right away due to an emergency, the Social
Security office may issue an emergency advance payment. Usually
SSA collects the amount of the advance payment from the SSI
back pay or the first six SSI payments. If, however, the person
is not eligible for benefits, the advance payment may have
to be repaid.
Expenditures by Different Levels of Government
Expenses incurred by the SSA in administering the SSI program
are initially paid from the OASI and DI Trust Funds. The trust
funds are subsequently reimbursed for such expenditures from
the General Fund of the Treasury. Federal SSI payments and
administrative costs are financed from Federal Government
general revenues. Some states provide optional supplements
to help persons meet needs not fully covered by Federal SSI
payments. The State determines whether it will make a payment,
to whom, and in what amount. These supplements, paid on a
regular monthly basis, are intended to cover such items as
food, shelter, clothing, utilities, and other daily necessities
determined by the individual States. Some States provide optional
supplementary payments to all persons eligible for SSI benefits.
Others may limit them to certain SSI recipients such as the
blind or residents of domiciliary care facilities, or they
may extend payments to persons ineligible for SSI because
of excess income. When a State chooses Federal administration
of its supplementation, SSA maintains that State’s payment
records and issues the Federal payment and the State supplement
in one check. Since passage of the Omnibus Budget Reconciliation
Act (OBRA) of 1993, States are required to pay fees for Federal
Federal: Currently, in New
York State, the federal government contribution amounts to
90% or more of assistance to recipients living in households.
For example, in 2009, a couple in the “living
alone” category will get $1011 per month from the federal
government and $104 supplementation from the State, for a
total of $1038, the federal share being 90%. For congregate
care, which is more expensive than community living, the state
government pays a larger share.
State: Between 4% and 14% of
the benefits for recipients not in congregate care is a supplement
that is paid by the state government. The state supplements
for levels I-III in Congregate Care category amount to between
30% and 51%. The federal government pays the highest federal
benefit rate for these congregate-care recipients, and the
state pays the additional costs, which amount to more than
the state supplement for recipients living in households.
Local: There are no local funds
Types of Taxes:
Federal: Even though SSA runs
the program, SSI is not the same as Social Security. SSI is
a Federal income supplement program funded by general tax
revenues (not Social Security payroll taxes) 89% of which
were derived from individual and corporate income taxes (2005).
State: State general revenues
are 95% of which are derived from:
income taxes (45%); sales tax (28%); charges for education, hospitals, etc. and miscellaneous taxes (22%) (2003-2004). The state of New York adds money to the federal payment.
The state of New York and the federal government have agreed
to include the amount in the federal payment. One payment
is received during the first week of each month that includes
both federal and state money. State general
Local: There are no local funds for SSI.
The SSI program, including the state supplement in
New York State, is administered by the Social Security Administration
and the New York State Office of Temporary and Disability
Money for SSI payments comes from the general fund of the
U.S. Treasury, not the Social Security trust funds. The state
of New York adds money to the federal payment. The state of
New York and the federal government have agreed to include
the amount in the federal payment. One payment is received
during the first week of each month that includes both federal
and state money.
Procedures for Appeal:
Recipients must be informed in writing in advance of
adverse actions SSA plans to take and must be given the opportunity
to request that their benefits continue pending a decision
at the first level of appeal.
At any time, an individual may appoint a representative in
any dealings with the Social Security Administration. If such
a representative is an attorney, he/she must be in good standing,
have the right to practice law before a court, not be disqualified
or suspended from acting as a representative in dealings with
Social Security and not be prohibited by any law from acting
as a representative. If the individual is not an attorney,
he/she must meet qualifications specified by the Commissioner
(e.g., be of good character and able to provide valuable service
A representative may charge and receive a fee for his/her
services, but the SSA generally decides how much the fee shall
be. While the Social Security Act does not establish a maximum
fee, most attorneys use an options process that limits their
maximum fee to the lesser of 25% of the retroactive payment
or $5,300. A representative cannot charge or receive more
that the fee amount authorized. The SSI program differs from
the Social Security program in that amounts cannot be withheld
from an individual’s SSI benefits to pay for attorney
fees. SSI claimants are responsible for paying such fees directly
to their attorneys.
Requests for an appeal must be in writing within 60 days from
the date you receive
the letter. There are four levels of appeal. They are (1)
reconsideration, (2) hearing by an administrative law judge,
(3) review by the Appeals council and, (4) federal court review.
When a letter is sent with a decision on a claim enclosed
will be an explanation on how to appeal the decision.