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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>

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