SSA - POMS: SI 00515.003 - Good Cause - Failure to Cooperate

A. Introduction

An individual cannot be eligible for SSI benefits unless they give SSA permission to contact any financial institution and request any financial records that financial institution may have about them. In addition, an individual cannot be eligible for SSI benefits unless their deemors give SSA permission to contact any financial institution and request any financial records that financial institution may have about them. In some situations, an SSI claimant may act in good faith to obtain permission from a deemor, but is unable to do so through no fault of their own.

B. Policy

1. Overview

In certain situations, we may provide a good cause exception from the requirement that the deemor provide us with financial permission if the claimant acted in good faith to obtain permission and cooperated with us in our efforts to obtain permission from the deemor.

2. Exceptions - When Good Cause Cannot Apply

Good cause for failure to cooperate cannot apply if the deemor is one of the following:

•

Prospective or current representative payee and legal guardian of the claimant.
•

Prospective or current representative payee and custodial parent of a claimant who is a minor child.
•

Sponsor of a claimant who is an alien, or the sponsors living-with spouse.

C. Procedure

It is the responsibility of the claimant to help obtain the deemors permission to contact financial institutions. In addition, SSA must offer assistance to the claimant in obtaining permission from a deemor.

NOTE:

In any situation where the applicant/recipient alleges harassment, abuse, or life endangerment, develop good cause per SI 00515.002. In such cases, we do not want to put the applicant/recipient in a potentially dangerous situation by asking them to contact the deemor.

1. Deemor Fails to Cooperate

If a deemor has failed to cooperate, take the following action:

•

Explain to the claimant that may not be eligible for SSI unless we receive permission from the deemor.
•

Assist the claimant in obtaining permission from the deemor. For example, attempt to obtain permission by calling the deemor or mailing a financial permission request letter.
•

If possible, explain to the deemor that their permission is needed for the SSI claimant to be eligible for benefits.

NOTE:

In cases where the deemor who fails to cooperate is also the recipients representative payee, consider the need for developing a new payee (see GN 00504.100).

2. Good Cause Established

If the case facts and the evidence indicate that the claimant has acted in good faith to obtain permission from the deemor, document good cause as follows:

•

Record good cause in MSSICS on the Financial Institutions Permission page (see MS 08108.020).
•

Document via a Person Statement or on a signed SSA-795, the steps the claimant took to obtain permission from the deemor and why were unable to obtain permission.
•

On a Report of Contact or on the EVID screen in shared processes, record the type of good cause (i.e., failure to cooperate) and the steps taken by the field office to assist the claimant in obtaining permission from the deemor and document any evidence relevant to making the good cause determination.

3. Allegation of Status Change

Be alert to situations where good cause has been established, but the material facts appear to have changed. Re-develop good cause if a report of change is received that indicates a prior good cause determination based on failure to cooperate may no longer apply.

4. Redeveloping Good Cause During a Redetermination

When completing a redetermination, note whether or not good cause was previously established for a deemor. If good cause was previously established, redevelop good cause since the material facts may have changed since the prior determination.

D. Good Cause Situations

1. Examples of When Good Cause Would Apply

a. A claimant is applying for SSI benefits as an aged individual

During the interview the claimant agrees to give SSA permission to contact financial institutions. The CS informs the claimant that their spouse, who is not present at the time of the interview, must give SSA permission to contact financial institutions because their income and resources are available to the claimant. The CS gives the claimant a financial permission request letter for the spouse to complete and sign. The claimant indicates they will try to get their spouse to read and sign the document. During the 15-day follow up, the CS calls and speaks to the claimant, who indicates that their spouse, who was recently diagnosed with Alzheimers disease, refuses to sign any type of document. The claimant completes a signed SSA-795 describing their spouse's condition. The CS finds that good cause exists in this case.

b. A claimant is applying for SSI benefits as a disabled individual

During the interview the claimant agrees to give SSA permission to contact financial institutions. The CS informs the claimant that their spouse, who is not present at the time of the interview, must give SSA permission to contact financial institutions. The claimant states that they will try to get the spouse to give permission but is not sure if they will because the couple is having marital difficulties and they are considering divorce. The CS explains the importance of obtaining permission from the spouse and gives the claimant a financial permission request letter for the spouse to complete and sign. During the 15-day follow-up, the CS calls the and speaks to the claimant's spouse. The spouse tells the CS that they have nothing to do with the claimants SSI claim and hangs up the phone. The CS finds that good cause exists in this case.

2. Example of When Good Cause Would Not Apply

A claimant is applying for benefits as a disabled individual. During the interview the claimant agrees to give SSA permission to contact financial institutions. The CS informs the claimant that permission is also required from the spouse because the spouse's income and resources are available to the claimant. The claimant's spouse tells the CS that they are not applying for SSI and thus should not have to agree to anything. The claimant agrees and says the spouse should not have to give permission. The CS explains again that permission is required in order to receive SSI benefits. The claimant states that they do not think it is fair that the spouse has to give permission. The CS finds that good cause does not exist in this case.

E. References

SI 00515.001, Requirement to Give Permission to Contact Financial Institutions

SI 00515.002, Good Cause Harassment or Abuse

MS 08108.020, Financial Institutions Permission

Social Security

Program Operations Manual System (POMS)

SI 00515.003 Good Cause - Failure to Cooperate