SSI Notice of Interim Assistance Reimbursement (IAR)

OMB 0960-0546

OMB 0960-0546

Section 1631(g) of the Act authorizes SSA to reimburse an IAR agency from an individual's retroactive Supplemental Security Income (SSI) payment for assistance the IAR agency gave the individual for meeting basic needs while an SSI claim was pending or SSI payments were suspended or terminated. The State or local agency needs an IAR agreement with SSA to participate in the IAR program. The individual receiving the IAR payment signs an authorization form with an IAR agency to allow SSA to repay the IAR agency for funds paid in advance prior to SSA's determination on the individual's claim. The authorization represents the individual's intent to file for SSI, if they did not file an application prior to SSA receiving the authorization. Agencies who wish to enter into an IAR agreement with SSA needs to meet the following requirements: (a) Reporting Requirements - Each IAR agency agrees to: (1) Notify SSA of receipt of an authorization for initial claims or cases they are appealing, and submit a copy of that authorization either through a manual or electronic process; (2) inform SSA of the amount of reimbursement; (3) submit a written request for dispute resolution on a determination; (4) notify SSA of interim assistance paid (using the SSA–L8125–F6); (5) inform SSA of any deceased claimants who participate in the IAR program and ; (6) review and sign an agreement with SSA. (b) Recordkeeping Requirements - The IAR agencies agree to retain all notices, agreement, authorizations, and accounting forms for the period defined in the IAR agreement for the purposes of SSA verifying transactions covered under the agreement. (c) Third Party Disclosure Requirements: Each participating IAR agency agrees to send written notices from the IAR agency to the recipient regarding payment amounts and appeal rights. (d) Periodic Review of Agency Accounting Process - The IAR agency makes the IAR accounting records of paid cases available for SSA review and verification. SSA conducts reviews either onsite or through the mail of the authorization forms, notices to the claimant and accounting forms. Upon completion of the review, SSA provides a written report of findings to the IAR agency director. The respondents are State IAR officers.

The latest form for SSI Notice of Interim Assistance Reimbursement (IAR) expires 2021-01-31 and can be found here.

OMB Details

a) State Notification of Receipt of Authorization (Electronic Process)

Federal Enterprise Architecture: Income Security - General Retirement and Disability


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