SI and SSDI benefits while in a hospital or institution

Linda Landry, DLC

Here's an e-mail response to a question that recently came in from an advocate. I thought it might be useful to a wider audience.

1. People who receive SSDI can continue to receive their SSDI benefits in facilities, whether public or private, unless they are being held there in connection with a crime, e.g., committed to a psychiatric facility after an NGRI. POMS GN 02607.001, 02607.160.

2. People who receive SSI are not eligible for SSI while living in a public institution (for 30 days or more), whether a public psychiatric facility or a jail or prison. 20 CFR 416.211(a). POMS SI 00520.001

3. People who receive SSI are eligible for SSI while living in a medical treatment institution, including a psychiatric hospital, or nursing home where Medicaid payment is 50% or more. The payment rate, however is not the full SSI payment rate. 20 CFR 416.211(b). Instead, the payment rate is Federal SSI Living Arrangement D, which is only $30 per month (essentially a personal needs allowance), which Massachusetts supplements with $42.80, making the total $72.80. 20 CFR 416.211(b). POMS SI 00520.001.

4. Where either 2. or 3. above applies, "temporary institutionalization" (TI) benefits may be available. TI allows for the individual to continue to receive her full SSI payment where: 1) her doctor certifies in writing within 90 days that she is likely to remain in a public psychiatric institution or medical treatment facility for less than 90 days; and 2) the individual shows that s/he needs to retain the full SSI benefit to maintain a home to which to return. 20 CFR 416.212. Additional certification may also be possible. POMS SI 00520.140.

Linda Landry Disability Law Center