TN 29 (02-03)

GN 00502.137 DDS Notification of Allegations That Could Cast Doubt on Payee Suitability

A. Process

In disability cases, the State DDS may document the file any time there is an indication that:

  • the beneficiary is being abused, or

  • that a substance abuse condition is occurring in the beneficiary's home, or

  • there is an indication that a person close to the potential payee may have an undesirable influence over the payee's use of benefits, or

  • the applicant who filed a claim for benefits on behalf of a beneficiary is unable to pursue the claim.

This information may be meaningful in determining the payee applicant's suitability.

B. Policy

You must decide whether the information provided by the DDS is relevant to the current situation surrounding the case and whether it casts doubt on the payee applicant's suitability. Information is relevant if it pertains to the payee applicant or anyone who still has access to or influence over the beneficiary or proposed payee and the information is current. A report of possible abuse is a very sensitive matter, however there may be instances where it seems necessary to report suspected abuse to the proper authorities.

C. Procedure

Review the DDS information and any supporting documentation. If you determine the information is relevant (e.g., a report from a social service agency, doctor, police department or court order for removal of a child from the home, etc.), determine the impact it has on the payee applicant's suitability, as described in GN 00502.137C.1.a. or GN 00502.137C.1.b.

If you determine the information is not relevant, (i.e., an unsubstantiated report of abuse by a third party), proceed with normal investigation and appointment procedures.

1. Alleged Abuser is Payee Applicant

If the alleged abuser is the payee applicant, determine whether he/she can still be considered a suitable candidate using normal investigation procedures found in GN 00502.100 - GN 00502.164.

EXAMPLE 1

DDS reports that the beneficiary has been physically abused by her daughter, who has applied to be her mother's payee. During the payee interview you learn that the beneficiary resides in the payee applicant's home and the payee applicant takes care of all the beneficiary's needs. The payee applicant has no felony convictions and has never served as payee before. The beneficiary, who was present throughout the interview, agreed that her daughter be named her payee. In this example, the payee applicant would be considered suitable notwithstanding the allegation of abuse. Where possible, FOs should question the beneficiary alone to ensure that the beneficiary agrees with the payee selection.

EXAMPLE 2

DDS reports that the beneficiary was physically abused while residing in a nursing home. The nursing home, which is an unlicensed board and care facility and a creditor of the beneficiary, has filed to be payee. In this example, the payee applicant would not be considered suitable.

a. Payee Applicant is Considered Suitable

  • If you decide that the payee applicant is suitable:

    • Conditionally appoint him/her AND schedule a 3-month followup per GN 00504.185.

    • Contact the beneficiary and payee to determine if current needs are being met and if the payee is performing satisfactorily, bearing in mind the sensitivity of the alleged abusive situation.

    • Contact neighbors, local officials and school officials, as you deem necessary.

  • At the completion of the 3-month followup, take one of the following actions:

    • Determine that the payee is proper and additional followups are unnecessary.

    • Continue to question the payee's suitability and schedule an additional followup.

    • Determine that benefits are not being disbursed for the use and benefit of the beneficiary. Develop for an alternative payee and prepare a misuse determination in accordance with GN 00604.030. Report abuse situations as explained in GN 00502.138C.

b. Payee Applicant is Not Considered Suitable

If your review and the information provided by the DDS confirms the applicant's unsuitability, develop for an alternative payee. Use the Rep Payee Applicant “Note Type” on the Make