(PPS-118)
SSR 85-14
SSR 85-14: TITLES II AND XVI: EXCEPTIONS TO SENDING ADVANCE NOTICE CONCERNING REPRESENTATIVE PAYMENT OF BENEFITS
PURPOSE: To explain the policy and specify situations where the usual advance notice procedure concerning representative payment of benefits and selection of a representative payee does not apply.
CITATIONS (AUTHORITY): Sections 205, 1102, and 1631 of the Social Security Act; Regulations No. 4, sections 404.2001-404.2065 and Regulations No. 16, sections 416.601-416.665.
PERTINENT HISTORY: The Social Security Administration (SSA) will pay benefits directly to a beneficiary unless there is evidence that the beneficiary is not able to manage or direct the management of benefit payments in his or her best interest. In cases where it would better serve the interest of the beneficiary, SSA may select someone else (a representative payee) to receive the payments for the use and benefit of the beneficiary. The principles and procedures that SSA follows in determining whether to make representative payment and in selecting a representative payee are set forth in sections 404.2001-404.2030 and 416.601-416.630 of the regulations.
Generally, advance notice of SSA's proposed determination for making representative payment and proposed determination for selection of a representative payee will be sent to (1) a legally competent adult beneficiary (2) the legal guardian of a legally incompetent adult beneficiary or (3) the legal guardian, parent, or person standing in place of a parent of a minor child (under age 18).
This notice informs the person(s) that SSA intends to make representative payment and to name a payee and provides the opportunity (1) for objection to either proposal and (2) to review the evidence upon which the proposed determinations are based, as well as to submit additional evidence. SSA will review and consider all the information and evidence available before making the determinations. After the determinations are issued, the person may request reconsideration of either determination. (See sections 404.2030 and 416.630 of the regulations.)
The usual procedure of sending advance notice is not followed in some cases and this policy statement is directed to those situations.
POLICY STATEMENT: Advance notice concerning representative payment of benefits will not be sent where the proper individual, as described in the Pertinent History section, has been in contact with SSA during development of the claim and has consented in writing to the proposed payee action. Also, exceptions to the general rule of sending advance notice will occur in the following situations.
Adult beneficiaries (age 18 or older) that are adjudged legally incompetent
Where the beneficiary is adjudged legally incompetent, he or she would have a court-appointed guardian (conservator, committee). Advance notice of the need for representative payment and identity of the proposed payee is not sent to the beneficiary since it would serve no useful purpose.
Advance notice of the need for representative payment will not be sent to the legal guardian because need has already been established by the court. Advance notice of proposed payee identity will not be sent to the legal guardian where he or she has already filed to be representative payee and SSA expects to appoint him or her as the payee.
NOTE: If SSA proposes to name as payee someone other than the legal guardian, advance notice of SSA's intent to name a representative payee and the identity of the proposed payee will be sent to the legal guardian.
Beneficiaries who are minor children (under age 18)
Since there are limitations on the legal capacity of minor children to act on their own behalf, SSA will ordinarily appoint a representative payee for a child beneficiary (see sections 404.2010(b) and 416.610(b) of the regulations for exceptions). Advance notice of the need for representative payment of benefits and identity of the proposed payee is not sent to minor beneficiaries since it would serve no useful purpose.
Advance notice of the need for representative payment is not sent to the parent or person standing in place of the parent because the need for supervision may be assumed. SSA will send notice of the identity of the proposed payee to the individual who represents and acts for the minor child but notice is not sent to:
- 1. A parent whose own benefits are being paid to a representative payee;
- 2. A parent who is legally incompetent or who has a legal guardian;
- 3. A natural or adoptive parent with custody who is being selected as payee. Similarly, advance notice will not be sent to the other parent when that person is living in the same household as the designated payee and the child.
- 4. Natural parents who have either voluntarily relinquished their parental rights or had them terminated by a court; or
- 5. A parent whose location is unknown.
- NOTE: Where parents who live in the same household are not being selected as payee and thus are sent advance notice, the notice will be addressed to both parents. Any response (or no response) will be considered to have come from both parents.
Beneficiaries whose eligibility for supplemental security income is based on disability and who are medically determined to be drug addicts or alcoholics
Because representative payment of benefits for these individuals is required by law and is not an SSA determination, advance notice of the need for representative payment is not provided.
NOTE: Advance notice giving the name of the proposed payee is provided. SSA will send this notice either directly to the beneficiary or to the person(s) acting in his or her behalf, thus assuring an opportunity for an objection to the proposed payee selection if desired.
Beneficiaries/representatives residing outside the U.S.
SSA has decided that it does not serve the best interest of the beneficiary to send advance notice to residents outside the U.S. as the generally lengthy mailing time involved would unduly delay the beneficiary's claim for benefits. Advance notice is merely an alert of SSA's proposed determinations. Where SSA makes a determination for representative payment of benefits, residents outside the U.S. will receive notice. If the person is dissatisfied with the determination(s), he or she may request a reconsideration.
These policies apply to the initial payee appointment determination and also to subsequent payee appointment determinations.
EFFECTIVE DATE: Upon publication.
CROSS-REFERENCES: Program Operations Manual System, sections GN 00502.240-00502.300.