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When Is A Couple Not A Couple?

April 28, 2017

Many individuals living together as couples are improperly categorized as “holding out as married” by SSI under 20 C.F.R. § 416.1806.  As a result, some claimants are considered ineligible for benefits if the couple’s combined income exceeds the statutory limit. That is what happened to a New York City claimant suffering from end-stage renal disease.  Luckily for her, she found Michelle Spadafore, attorney at New York Legal Assistance Group, who represented her at a hearing on the “holding out” issue.

Michelle had to overcome a few obstacles, including the claimant’s allegation that her boyfriend was her husband simply so he would be allowed to accompany her in her SSI appointment.  The claimant and her partner had also registered as domestic partners with the City of New York so the boyfriend’s supportive housing agency would allow her to remain in his apartment.

Michelle argued that under recent case law developments, a domestic partnership is not the same as marriage.  She also refuted SSA’s findings with letters from a social worker from Upper East Side Dialysis where the claimant was treated three days a week, a cab driver the couple uses on a regular basis, the employee at their local pharmacy, and a neighbor.  All of these individuals interact with the couple on a   regular basis and confirmed they introduce themselves to people as boyfriend and girlfriend and not as husband and wife.

The Administrative Law Judge agreed that “a majority of the evidence suggests” couple is cohabitating, as supposed to “holding out” as married status.  In this case, the claimant indicated she was not married on her SSI application, denied being married on subsequent relationship questionnaires, held herself out in public as being unmarried, and had only acquired a domestic partnership certificate to obtain housing.  It was also noted that the couple shared no bills, tax returns, installment contracts or mail addressed to them as a married couple.  As a “majority of the evidence” suggested no martial relationship was established, the ALJ determined the couple was not “holding out” as a married couple.  Therefore, the claimant’s partner’s income could not be included in any calculation determining SSI eligibility.

Thanks to Michelle, the claimant’s application was forwarded on for a disability assessment as an expedited TERI (Terminal Illness) case.


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