Department of Health and Human Services
Departmental Appeals Board
AFDC QUALITY CONTROL REVIEW PANEL
SUBJECT: Wisconsin Department
of Health and Social Services
Docket No. 92-245
Decision No. QC29
DATE: November 20, 1992
DECISION
The Wisconsin Department of Social Services (Wisconsin)
appealed the
quality control (QC) review determination of
the Regional Administrator of
the Administration for
Children and Families (ACF) in State QC review
number
431802. ACF determined that the
assistance unit (AU)
in this case was ineligible for an Aid to Families with
Dependent Children (AFDC) grant for the July 1991 review
month.
ACF's determination was based on a federal QC
review finding that the
recipient did not furnish a
social security number (SSN) for one of her
children as
required by applicable law and regulations.
For the reasons discussed below, we uphold ACF's
determination.
The facts of the case are undisputed. The recipient
first applied
for a SSN for her son through the
enumeration at birth (EAB) procedure,
which allows a
parent to apply for a SSN for the newborn while in the
hospital. The SSN was issued on November 14, 1990, and
the
recipient acknowledged that she received the SSN
about ten weeks after it
was issued. However, the
recipient did not report the SSN to Wisconsin
and stated
at the time of the State QC review on August 19, 1991
that
she had lost the SSN. The recipient subsequently
applied for a
duplicate SSN by filing an application
directly with Wisconsin.
We conclude that the AU was clearly ineligible on these
facts.
Section 1137(a) of the Social Security Act (Act)
provides that, as a
condition of eligibility for AFDC
payments under title IV-A of the Act, a
state shall
require that "each applicant for or recipient of benefits
.
. . furnish to the State his social security account
number . . . ."
In a number of prior decisions, the AFDC
QC Review Panel has held that this
provision, which is
implemented by regulations at 45 C.F.R. � 205.52,
requires that a recipient report the SSN of each member
of the AU upon
receipt, unless the recipient has applied
for the SSN under agreement state
procedures where the
Social Security Administration reports the SSN directly
to the state or local agency. See, e.g., Nebraska Dept.
of Social
Services, DAB QC25 (1992); Missouri Dept. of
Social Services, DAB QC22
(1992); and New Mexico Human
Services Dept., DAB QC15 (1992).* Here,
the unreported
SSN was received approximately five months before the
review date, giving the recipient more than ample time to
report the SSN
or to apply for a duplicate SSN after the
original SSN was lost.
Wisconsin nevertheless argued that the EAB procedure
through which the
recipient originally applied for the
SSN was an agreement state procedure,
and that it was
therefore unnecessary for the recipient to report the
SSN. However, the EAB procedure does not constitute an
agreement
state procedure since it is not based on an
agreement between the state and
the Social Security
Administration through which the state accepts
applications for SSNs. See AFDC Quality Control Manual
(QCM) at
Appendix W, Element 170 (transmitted by FSA-AT-
90-21 dated August 30,
1990). Moreover, recipients who
apply for a SSN through agreement
state procedures are
not required to report the SSN to the state because the
Social Security Administration reports the SSN directly
to the
state. There is no such arrangement under the EAB
procedure; thus, the
rationale for not requiring
recipient reporting under agreement state
procedures does
not apply here. See DAB QC22, at 5; DAB QC15, at
9.
Wisconsin also asserted that it was
"not surprising" that
the recipient lost the child's SSN because she was
under
"a lot of stress" due to the fact that her child was born
prematurely and that she was engaged in a dispute with
the "child
support agency." Appeal request, Attachment
at 3. In our view,
however, these circumstances are not
sufficient to excuse the recipient's
failure to report
the SSN or to apply for a duplicate SSN at any time
during the five months between her receipt of the
original SSN and the
review date.
Wisconsin argued further that it was put in an untenable
position by
"the federal QC interpretation that a case is
in error, as soon as the SSN
is received if not
reported," because it is impossible to determine the
exact date on which a SSN will be issued and a state is
required to give
notice before terminating benefits.
Appeal request, Attachment at
3. However, it is implicit
in the enumeration requirement that the
recipient has a
reasonable time to report the SSN after receipt. See
DAB
QC15, at 7. Moreover, ACF's policy is that no error
exists as
long as a SSN is reported by the review date.
See QCM at Appendix W,
Element 170. Thus, Wisconsin
clearly had adequate time to notify the
recipient in this
case that her benefits were being terminated.
Wisconsin argued in addition that the recipient satisfied
the enumeration
requirement by applying for a duplicate
SSN after losing the original
SSN. A recipient who
cannot furnish a SSN because a SSN has not been
issued or
is not known can comply with the enumeration requirement
by
verifying that application for a SSN has been made.
See 45 C.F.R. �
205.52(a)(2). However, since the
recipient in this case did not apply
for a duplicate SSN
until after the review date, this does not establish
compliance with the enumeration requirement during the
review
month. See DAB QC25, at 3, n. 2.
Finally, Wisconsin argued that the AU was eligible if
eligibility was
determined prospectively as authorized by
Chapter IV of the QCM in
situations where the budget or
intervening month's circumstances render the
AU
ineligible. However, as ACF pointed out, under the QCM,
prospective eligibility determinations must be based on
circumstances in
the month for which payment is made. As
of July 1991, the recipient
had neither reported the SSN
which had been issued nor applied for a
duplicate SSN.
Thus, these provisions do not support Wisconsin's
position.
Conclusion
For the reasons discussed above, we conclude that the AU
was ineligible
for the review month payment.
Accordingly, we affirm ACF's
determination.
____________________________
Leslie A.
Sussan
____________________________
Maxine M.
Winerman
_____________________________
Carolyn
Reines-Graubard
* * * Footnotes * * *
* The State was given copies of these
decisions.
However, the State declined an opportunity to comment on
them.
(..continued)