Sorn 60-0103

Supplemental Security Income Record and Special Veterans Benefits, Social Security Administration, Office of Systems, Office of Disability and Supplemental Sec...

Effective Date: January 11, 2006
(71 F.R. 1830)

SOCIAL SECURITY ADMINISTRATION NOTICE OF SYSTEM OF RECORDS
REQUIRED BY THE PRIVACY ACT OF 1974
SYSTEM NUMBER: 60-0103
System name:
Supplemental Security Income Record and Special Veterans Benefits, Social Security
Administration, Office of Systems, Office of Disability and Supplemental Security Income
Systems (ODSSIS).

Security classification:
None.

System Location:
Social Security Administration
Office of Telecommunications and Systems Operations
6401 Security Boulevard
Baltimore, MD 21235
Records also may be located in the Social Security Administration (SSA) regional offices
(contact the system manager at the address below or access
http://www.socialsecurity.gov/foia/bluebook/app_c.htm for address information) and field
offices (individuals should consult their local telephone directories for address information).

Categories of individuals covered by the system:
This file contains a record for each individual who has applied for Supplemental Security
Income (SSI) payments, including individuals who have requested an advance payment; SSI
recipients who have been overpaid; and ineligible persons associated with an SSI recipient.
This file also covers those individuals who have applied for and who are entitled to the
Special Veterans Benefits (SVB) under Title VIII of the Social Security Act. (This file does not
cover applicants who do not have a Social Security number (SSN).)

Categories of in the system:
This file contains data regarding SSI eligibility; citizenship; residence; Medicaid eligibility;
eligibility for other benefits; alcoholism or drug addiction data, if applicable (disclosure of this
information may be restricted by 21 U.S.C. 1175 and 42 U.S.C. 290dd-3 and ee-3); income
data; resources; payment amounts, including the date and amount of advance payments;
overpayment amounts, including identifying characteristics of each overpayment (e.g., name,
SSN, address of the individual(s) involved, recovery efforts made and the date of each action

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and planned future actions); and date and amount of advance payments; living
arrangements; case folder location data; appellate decisions, if applicable; SSN used to
identify a particular individual, if applicable; information about representative payees, if
applicable; and a history of changes to any of the persons who have applied for SSI
payments. For eligible individuals, the file contains basic identifying information such as the
applicant's name, Social Security number (SSN), and date of birth (DOB), income and
resources (if any) and, in conversion cases, the State welfare number.
This file also contains information about applicants for SVB. The information maintained in
this system of records is collected from the applicants for Title VIII SVB, and other systems
of records maintained by SSA. The information maintained includes a data element indicating
this is a Title VIII SVB claim. It will also include: identifying information such as the
applicant's name, SSN and DOB; telephone number (if any); foreign and domestic addresses;
the applicant's sex; income data, payment amounts (including overpayment amounts); and
other information provided by the applicant relative to his or her entitlement for SVB.
If the beneficiary has a representative payee, this system of records includes data about
the representative payee such as the payee's SSN; employer identification number, if
applicable; and mailing address.

Authority for maintenance of the system:
Sections 1602, 1611, 1612, 1613, 1614, 1615, 1616, 1631, 1633, 1634 of Title XVI and
Title VIII of the Social Security Act (42 U.S.C. 1382, 1382a, 1382b, 1382c, 1382d, 1382e,
1383, 1383b, 1383c.

Purpose(s):
SSI records begin in Social Security field offices where an individual or couple files an
application for SSI payments. SVB records begin in Social Security field offices and the
Veterans Affairs Regional Office where an individual files an application for SVB payments.
The SSI and SVB applications contain data which may be used to prove the identity of the
applicant, to determine his/her eligibility for SSI or SVB payments and, in cases where
eligibility is determined, to compute the amount of the payment. Information from the
application, in addition to data used internally to control and process SSI and SVB cases, is
used to create the Supplemental Security Income Record (SSR). The SSR also is used as a
means of providing a historical record of all activity on a particular individual's or couple's
record.
In addition, statistical data are derived from the SSR for actuarial and management
information purposes.

Routine uses of records maintained in the system, including categories
of users and the purposes of such uses:
Disclosure may be made for routine uses as indicated below. However, disclosure of any
information defined as ``returns or return information'' under 26 U.S.C. 6103 of the Internal
Revenue Code will not be disclosed unless authorized by a statute, the Internal Revenue
Service (IRS), or IRS regulations.
1. To the Department of the Treasury to prepare SSI, Energy Assistance, and SVB checks
to be sent to claimants or beneficiaries.

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2. To the States to establish the minimum income level for computation of State
supplements.
3. To the following Federal and State agencies to prepare information for verification of
benefit eligibility under section 1631(e) of the Social Security Act: Bureau of Indian Affairs;
Office of Personnel Management; Department of Agriculture; Department of Labor; U.S.
Citizenship and Immigration Services; Internal Revenue Service; Railroad Retirement Board;
State Pension Funds; State Welfare Offices; State Worker's Compensation; Department of
Defense; United States Coast Guard; and Department of Veterans Affairs.
4. To a congressional office in response to an inquiry from that office made at the request
of the subject of a record.
5. To the appropriate State agencies (or other agencies providing services to disabled
children) to identify Title XVI eligibles under the age of 16 for the consideration of
rehabilitation services in accordance with section 1615 of the Act, 42 U.S.C. 1382d.
6. To contractors under contract to the Social Security Administration (SSA), or under
contract to another agency with funds provided by SSA, for the performance of research and
statistical activities directly relating to this system of records.
7. To State audit agencies for auditing State supplementation payments and Medicaid
eligibility consideration.
8. To State agencies to effect and report the fact of Medicaid eligibility of Title XVI
recipients in the jurisdiction of those States which have elected Federal determinations of
Medicaid eligibility of Title XVI eligibles and to assist the States in administering the Medicaid
program.
9. To State agencies to identify Title XVI eligibles in the jurisdiction of those States which
have not elected Federal determinations of Medicaid eligibility in order to assist those States
in establishing and maintaining Medicaid rolls and in administering the Medicaid program.
10. To State agencies to enable those agencies which have elected Federal administration
of their supplementation programs to monitor changes in applicant/recipient income, special
needs, and circumstances.
11. To State agencies to enable those agencies which have elected to administer their own
supplementation programs to identify SSI eligibles in order to determine the amount of their
monthly supplementary payments.
12. To State agencies to enable them to assist in the effective and efficient administration
of the Supplemental Security Income program.
13. To State agencies to enable those which have an agreement with the Social Security
Administration to carry out their functions with respect to Interim Assistance Reimbursement
pursuant to section 1631(g) of the Social Security Act.
14. To State agencies to enable them to locate potentially eligible individuals and to make
eligibility determinations for extensions of social services under the provisions of Title XX of
the Social Security Act.
15. To State agencies to assist them in determining initial and continuing eligibility in their
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income maintenance programs and for investigation and prosecution of conduct subject to
criminal sanctions under these programs.
16. To the United States Postal Service for investigating the alleged theft, forgery or
unlawful negotiation of Supplemental Security Income and Special Veterans Benefit checks.
17. To the Department of the Treasury for investigating the alleged theft, forgery or
unlawful negotiation of Supplemental Security Income and Special Veterans Benefit checks.
18. To the Department of Education for determining the eligibility of applicants for Basic
Educational Opportunity Grants.
19. To Federal, State or local agencies (or agents on their behalf) for administering cash or
non-cash income maintenance or health maintenance programs (including programs under
the Social Security Act). Such disclosures include, but are not limited to, release of
information to:
(a) The Department of Veterans Affairs (DVA) upon request for determining eligibility for,
or amount of, DVA benefits or verifying other information with respect thereto in accordance
with 38 U.S.C. 5106;
(b) The Railroad Retirement Board for administering the Railroad Unemployment Insurance
Act;
(c) State agencies to determine eligibility for Medicaid;
(d) State agencies to locate potentially eligible individuals and to make determinations of
eligibility for the food stamp program;
(e) State agencies to administer energy assistance to low income groups under programs
for which the States are responsible; and
(f) Department of State (DOS) and its agents to assist SSA in administering the Social
Security Act in foreign countries; the American Institute on Taiwan, a private corporation
under contract to DOS, to assist in administering the Social Security Act in Taiwan; and the
DVA, Regional Office, Manila, Philippines , and its agents, to assist in administering the Social
Security Act in the Philippine and other parts of the Asia-Pacific region.
20. To the Internal Revenue Service, Department of the Treasury, as necessary, for the
purpose of auditing the Social Security Administration's compliance with the safeguard
provisions of the Internal Revenue Code of 1986, as amended.
21. To the Office of the President for the purpose of responding to an individual pursuant
to an inquiry received from that individual or a third party on his/her behalf.
22. To the Department of Justice, Criminal Division, Office of Special Investigations, upon
receipt of a request for information pertaining to the identity and location of aliens for the
purpose of detecting, investigating and, where necessary, taking legal action against
suspected Nazi war criminals in the United States.
23. To third party contacts such as private collection agencies and credit reporting
agencies under contract with the Social Security Administration (SSA) and State motor vehicle
agencies for the purpose of their assisting SSA in recovering overpayments.

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24. To contractors and other Federal agencies, as necessary, for the purpose of assisting
the Social Security Administration (SSA) in the efficient administration of its programs. We
will disclose information under this routine use only in situations in which SSA may enter a
contractual or similar agreement with a third party to assist in accomplishing an Agency
function relating to this system of records.
25. To the General Services Administration and the National Archives Records
Administration (NARA) under 44 U.S.C. 2904 and 2906, as amended by the NARA Act of
1984, information which is not restricted from disclosure by Federal law for the use of those
agencies in conducting records management studies.
26. To the Department of Justice (DOJ), a court or other tribunal, or another party before
such tribunal when:
(a) Social Security Administration (SSA), or any component thereof, or
(b) Any SSA employee in his/her official capacity; or
(c) Any SSA employee in his/her individual capacity where DOJ (or SSA where it is
authorized to do so) has agreed to represent the employee; or
(d) The United States or any agency thereof where SSA determines that the litigation is
likely to affect the operations of SSA or any of its components, is a party to litigation or has
an interest in such litigation, and SSA determines that the use of such records by DOJ, a
court or other tribunal, or another party before such tribunal, is relevant and necessary to the
litigation, provided, however, that in each case, SSA determines that such disclosure is
compatible with the purpose for which the records were collected.
27. 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 for benefits for individuals for whom they serve as payees.
28. To third party contacts (e.g., employers and private pension plans) in situations where
the party to be contacted has, or is expected to have, information relating to the individual's
capability to manage his/her affairs or his/her eligibility for, or entitlement to, benefits under
the Social Security program when:
(a) The individual is unable to provide information being sought. An individual is
considered to be unable to provide certain types of information when:
(i) He/she is incapable or of questionable mental capability;
(ii) He/she cannot read or write;
(iii) He/she cannot afford the cost of obtaining the information;
(iv) He/she has a hearing impairment, and is contacting SSA by telephone through a
telecommunications relay system operator;
(v) A language barrier exists; or

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(vi) The custodian of the information will not, as a matter of policy, provide it to the
individual; or
(b) The data are needed to establish the validity of evidence or to verify the accuracy of
information presented by the individual, and it concerns one or more of the following:
(i) His/her eligibility for benefits under the Social Security program;
(ii) The amount of his/her benefit payment; or
(iii) Any case in which the evidence is being reviewed as a result of suspected fraud,
concern for program integrity, quality appraisal, or evaluation and measurement activities.
29. To the Rehabilitation Services Administration (RSA) for use in its program studies of,
and development of enhancements for, State vocational rehabilitation programs. These are
programs to which applicants or beneficiaries under Titles II and or XVI of the Social Security
Act may be referred. Data released to RSA will not include any personally identifying
information (such as names or Social Security numbers).
30. To the Department of Education, addresses of beneficiaries who are obligated on loans
held by the Secretary of Education or a loan made in accordance with 20 U.S.C. 1071, et.
seq. (the Robert T. Stafford Student Loan Program), as authorized by section 489A of the
Higher Education Act of 1965.
31. To student volunteers, individuals working under a personal services contract, and
other workers who technically do not have the status of Federal employees, when they are
performing work for the Social Security Administration (SSA), as authorized by law, and they
need access to personally identifiable information in SSA records in order to perform their
assigned Agency functions.
32. To Federal, State, and local law enforcement agencies and private security contractors,
as appropriate, if information is necessary:
(a) To enable them to protect the safety of Social Security Administration (SSA)
employees and customers, the security of the SSA workplace and the operation of SSA
facilities; or
(b) To assist investigations or prosecutions with respect to activities that affect such safety
and security or activities that disrupt the operation of SSA facilities.
33. To recipient of erroneous Death Master File (DMF), corrections to information that
resulted in erroneous inclusion of individuals DMF.
34. To entities conducting epidemiological or similar research projects, upon request,
information as to whether an individual is alive or deceased pursuant to section 1106(d) of
the Social Security Act (42 U.S.C. 1306(d)), provided that:
(a) The Social Security Administration (SSA) determines, in consultation with the
Department of Health and Human Services, that the research may reasonably be expected to
contribute to a national health interest; and
(b) The requester agrees to reimburse SSA for the costs of providing the information; and

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(c) The requester agrees to comply with any safeguards and limitations specified by SSA
regarding re-release or re-disclosure of the information.
35. To a Federal, State, or congressional support agency (e.g., Congressional Budget
Office and the Congressional Research Staff in the Library of Congress) for research,
evaluation, or statistical studies. Such disclosures include, but are not limited to, release of
information in assessing the extent to which one can predict eligibility for Supplemental
Security Income (SSI) payments or Social Security disability insurance benefits; examining
the distribution of Social Security benefits by economic and demographic groups and how
these differences might be affected by possible changes in policy; analyzing the interaction of
economic and non-economic variables affecting entry and exit events and duration in the Title
II Old Age, Survivors, and Disability Insurance and the Title XVI SSI disability programs; and
analyzing retirement decisions focusing on the role of Social Security benefit amounts,
automatic benefit recomputation, the delayed retirement credit, and the retirement test, if the
Social Security Administration (SSA):
(a) Determines that the routine use does not violate legal limitations under which the
record was provided, collected, or obtained;
(b) Determines that the purpose for which the proposed use is to be made:
(i) Cannot reasonably be accomplished unless the record is provided in a form that
identifies individuals;
(ii) Is of sufficient importance to warrant the effect on, or risk to, the privacy of the
individual which such limited additional exposure of the record might bring;
(iii) Has reasonable probability that the objective of the use would be accomplished;
(iv) Is of importance to the Social Security program or the Social Security beneficiaries or
is for an epidemiological research project that relates to the Social Security program or
beneficiaries;
(c) Requires the recipient of information to:
(i) Establish appropriate administrative, technical, and physical safeguards to prevent
unauthorized use or disclosure of the record and agree to on-site inspection by SSA's
personnel, its agents, or by independent agents of the recipient agency of those safeguards;
(ii) Remove or destroy the information that enables the individual to be identified at the
earliest time at which removal or destruction can be accomplished consistent with the
purpose of the project, unless the recipient receives written authorization from SSA that it is
justified, based on research objectives, for retaining such information;
(iii) Make no further use of the records except:
(1) Under emergency circumstances affecting the health and safety of any individual,
following written authorization from SSA;
(2) For disclosure to an identified person approved by SSA for the purpose of auditing the
research project;
(iv) Keep the data as a system of statistical records. A statistical record is one which is

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maintained only for statistical and research purposes and which is not used to make any
determination about an individual;
(d) Secures a written statement by the recipient of the information attesting to the
recipient's understanding of, and willingness to abide by, these provisions.
36. To the Secretary of Health and Human Services or to any State, the Commissioner
shall disclose any record or information requested in writing by the Secretary for the purpose
of administering any program administered by the Secretary, if records or information of such
type were so disclosed under applicable rules, regulations and procedures in effect before the
date of enactment of the Social Security Independence and Program Improvements Act of
1994.

Disclosure to Consumer Reporting Agencies:
Disclosure pursuant to 5 U.S.C. 552a(b)(12) may be made to consumer reporting agencies
as defined in the Fair Credit Reporting Act (15 U.S.C. 1681a(f)) or the Federal Claims
Collection Act of 1966 (31 U.S.C. 3701, et seq.), as amended. The disclosure will be made in
accordance with 31 U.S.C. 3711(e) when authorized by sections 204(f), 808(e) or 1631(b)(4)
of the Social Security Act (42 U.S.C. 404(f), 1008(e) or 1383(b)(4)). The purpose of this
disclosure is to aid in the collection of outstanding debts owed the Federal Government,
typically, to provide an incentive for debtors to repay delinquent Federal
Government debts by making these debts part of their credit records. The information to be
disclosed is limited to the individual's name, address, SSN, and other information necessary
to establish the individual's identity; the amount, status, and history of the debt and the
agency or program under which the debt arose.

Policies and practices for storing, retrieving, accessing, retaining and
disposing of records in the system:
Storage:
Records are maintained in magnetic media (e.g., magnetic tape) and in microform and
microfiche form.

Retrievability:
Records are indexed and retrieved by SSN.

Safeguards:
Systems security for automated records has been established in accordance with the
Systems Security Handbook. This includes maintaining all magnetic tapes and magnetic disks
within an enclosure attended by security guards. Anyone entering or leaving that enclosure
must have special badges which are only issued to authorized personnel. All authorized
personnel having access to the magnetic records are subject to the penalties of the Privacy
Act. The microfiche are stored in locked cabinets, and are accessible to employees only on a
need-to-know basis. All SSR State Data Exchange records are protected in accordance with
agreements between SSA and the respective States regarding confidentiality, use, and redisclosure. Access http://www.socialsecurity.gov/foia/bluebook/app_g.htm for additional

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information relating to SSA data security measures.

Retention and disposal:
Original input transaction tapes received which contain initial claims and posteligibility
actions are retained indefinitely although these are processed as received and incorporated
into processing tapes which are updated to the master SSR tape file on a monthly basis. All
magnetic tapes appropriate to SSI information furnished to specified Federal, State, and local
agencies for verification of eligibility for benefits and under section 1631(e) are retained, in
accordance with the Privacy Act accounting requirements, for at least 5 years or the life of
the record, whichever is longer.

System manager(s) and address(es):
Associate Commissioner
Office of Disability and Supplemental Security Income Systems (ODSSIS)
Social Security Administration
6401 Security Boulevard
Baltimore, Maryland 21235

Notification procedures:
An individual can determine if this system contains a record about him/her by writing to or
visiting any Social Security field office (FO) and providing his or her name and SSN. (FO
addresses and telephone numbers can be found in local telephone directories under Social
Security Administration, or by accessing http://frwebgate.access.gpo.gov/cgi-bin/leaving.cgi?
from=leavingFR.html&log=linklog&to=http://www.ssa.gov/regions/regional.html.) Applicants
for SVB who reside in the Philippines should contact Department of Veterans Affairs (DVA),
Regional Office, Manila, Philippines . (Furnishing the SSN is voluntary, but it will make
searching for an individual's record easier and prevent delay.)
An individual requesting notification of records in person should provide the same
information, as well as provide an identity document, preferably with a photograph, such as a
driver's license or some other means of identification. If an individual does not have any
identification documents sufficient to establish his/her identity, the individual must certify in
writing that he/she is the person claimed to be and that he/she understands that the knowing
and willful request for, or acquisition of, a record pertaining to another individual under false
pretenses is a criminal offense.
If notification is requested by telephone, an individual must verify his/her identity by
providing identifying information that parallels information in the record to which notification
is being requested. If it is determined that the identifying information provided by telephone
is insufficient, the individual will be required to submit a request in writing or in person. If an
individual is requesting information by telephone on behalf of another individual, the subject
individual must be connected with SSA and the requesting individual in the same phone call.
SSA will establish the subject individual's identity (his/her name, SSN, address, date of birth
and place of birth, along with one other piece of information, such as mother's maiden name)
and ask for his/her consent in providing information to the requesting individual.
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If a request for notification is submitted by mail, an individual must include a notarized
statement to SSA to verify his/her identity or must certify in the request that he/she is the
person claimed to be and that he/she understands that the knowing and willful request for, or
acquisition of, a record pertaining to another individual under false pretenses is a criminal
offense. These procedures are in accordance with SSA Regulations (20 CFR 401.40(c)).

Record access procedures:
Same as Notification procedures. Requesters should also reasonably specify the record
contents being sought. An individual who requests notification of, or access to, a medical
record shall, at the time he or she makes the request, designate in writing a responsible
representative who will be willing to review the record and inform the subject individual of its
contents at the representative's discretion. A parent or guardian who requests notification of,
or access to, a minor's medical record shall, at the time he or she makes the request,
designate a physician or other health professional (other than a family member) who will be
willing to review the record and inform the parent or guardian of its contents at the
physician's or health professional's discretion. These procedures are in accordance with SSA
Regulations (20 CFR 401.40(c) and 401.55).

Contesting record procedures:
Same as Notification procedures. Requesters should also reasonably identify the record,
specify the information they are contesting and the corrective action sought, and the reasons
for the correction, with supporting justification showing how the record is incomplete,
untimely, inaccurate or irrelevant. These procedures are in accordance with SSA Regulations
(20 CFR 401.65(a)).

Record source categories:
Data contained in the SSR are obtained for the most part from the applicant for SSI and
SVB payments and are derived from the Claims Folders System, 60-0089 and the Modernized
Supplemental Security Income Claims System. The States and other Federal agencies such as
the DVA also provide data affecting the SSR.

Systems exempted from certain provisions of the Privacy Act:
None.

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