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SSA-8000, Parts 5, 6, 7 & 8

Part 5 concludes the necessary non-medical information. It inquires about whether the person receives food stamps or has other sources of income, including pensions. Also, it requires applicants to provide information that can help the state identify other sources that can pay for medical care.

SSA-8000: Parts 5-8

This article covers the final question in Part 5 about income. It also reviews the final three sections of the SSA-8000: Miscellaneous, Remarks, and Important Information and Signatures. It is the "Remarks" section you will use to indicate that the application you are submitting is a SOAR application, if this has been negotiated in your community.

Part 5 - Potential Eligibility for Supplemental Nutrition Assistance Program (SNAP)/Medical Assistance/Other Benefits

Question 58: SNAP (also known as Food Stamps)

Congress enacted the Food Stamp Act of 1977 to try to lessen the barriers that SSI applicants/recipients encounter when dealing with two different offices to obtain SSI and food stamp benefits. As a result, SSA jointly files food stamp applications for SSI applicants and recipients.

  • While SSA still refers to the benefit as “food stamps,” the program is officially named Supplemental Nutrition Assistance Program (SNAP). You will hear people use “food stamps” and “SNAP benefits” interchangeably
  • Applicants residing in an institution and applying for SSI before release are able to apply for food stamps/SNAP with their SSI application. They will not be eligible to receive food stamps/SNAP until they are released from incarceration
  • Note: Not all parts of question 58 need to be answered. Based on the applicant’s answers, you may leave some parts of this question blank

Question 59: Medical Assistance

  • SSI applicants may be eligible for Medicaid. They must also help the state identify other sources that pay for medical care for themselves and medical support for any children. The state cannot provide Medicaid to the applicant if he/she does not agree to this Medicaid requirement. If the applicant has had recent uncompensated medical experiences or evaluations, answer “yes” to 59c. Providers may be eligible for Medicaid reimbursement for these services if the applicant is approved for SSI.

Question 60: Leads for Other Benefits

For question 60a, SSA is asking if the applicant has ever worked in a job where they paid into SSDI through contributions to FICA or OASDI from their paycheck.

Question 60b inquires about any sources of “pension,” which includes:

  • Worked for a railroad
  • Been in military service
  • Worked for the federal government
  • Worked for an employer with a pension plan
  • Belonged to a union with a pension plan
  • Worked under a Social Security system or pension plan of a country other than the U.S.

It also asks if the applicant has filed for benefits from these programs. Veterans applying for SSI must attest that they’ve also applied for any VA disability benefits to which they may be eligible. If the applicant answers “yes” to any of the questions in 60b, they should provide brief details in 60c. For example, if a Veteran has applied for VA benefits, they would put their dates of service and their date of VA benefits application in 60c.

Part 6 – Miscellaneous

Question 61: Requesting Benefits

This is relevant only to agencies or individuals who are requesting benefits on behalf of someone else. For example, a parent on behalf of a child or a legal conservator on behalf of a court-ordered legally incompetent adult.

  • In the SOAR model, the case manager is assisting individuals with applications, but the applicant is applying on his or her own behalf.

Part 7 – Remarks

This section can be a useful place to include additional information that helps to support the benefit claim.

  • This is where you should indicate that this is a SOAR-assisted application!
  • Use this space to make additional comments or further explain a specific question.
  • You may want to indicate that the information provided represents the best recollection of the applicant. If the applicant had trouble recalling specific information explain this to SSA.
  • You can also include the SOAR representative's contact information and a statement that the representative assisted the applicant with completing the form.

Part 8 – Important Information and Signatures

This section brings the applicant’s attention to the importance of providing accurate information. Any information offered will be cross-checked with other Federal and state agencies or financial institutions.

Finally, there is a place for the applicant and his/her spouse to sign the application. It should be witnessed. Then a receipt is provided.

The final page of the SSA-8000 reminds the applicant that they must report any changes to information they provided, including where they live, how they live, income, and help from others. It also requests information about any changes to immigration status, marital, or legal status.


Adult Course
May, 2022

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