2506. What is the New Initial Determination Process?

A new initial determination is a new decision made by SSA that does not require reopening or revising a prior initial determination during a specified period. New initial determinations are only used in the Income-Related Monthly Adjustment Amount (IRMAA) process.

In order for SSA to make a new initial determination of IRMAA:

• the beneficiary must have a qualifying circumstance, and

• the beneficiary must request, either verbally or in writing, that SSA use other tax information.

2506.1 When can a beneficiary request a new initial determination?

There are five qualifying circumstances when SSA may use modified adjusted gross income (MAGI) provided by the beneficiary rather than the information received from IRS to make a new initial determination about the income-related monthly adjustment amount.

The five circumstances are:

• Amended Tax Return

• Correction of IRS information

• Use of two-year old tax return when SSA used IRS information from three years prior to the premium year

• Report of a change in living arrangement when tax filing status is "Married filing separately"

• Life-changing event(s) from the list in §2507.

Last Revised: May 22, 2007