TN 8 (07-11)

GN 00503.150 Notice of Suspension for Representative Payee Development

A. Policy for sending a notice of suspension for representative payee development

A decision to suspend a beneficiary's benefits pending payee development is not an initial determination subject to the administrative appeals process. These suspensions are administrative actions rather than adverse actions. When there is a resolution for the representative payee issue, we will release all benefits due. According to provisions of the Omnibus Budget Reconciliation Act of 1990 (OBRA 90), we will reinstate benefits within 1 month unless direct payment is precluded.

Additionally, when we appoint the representative payee, we send them Form SSA–4164, Advance Notification of Representative Payee , containing information on their rights to appeal our decision. The S8/S08 notices mailed when benefits are suspended pending representative payee development no longer contain appeal rights information.

EXCEPTION: Sometimes beneficiaries in direct pay are erroneously suspended. Because they have not received an advance notice with appeal rights, the S8/S08 notice provides them with the right to appeal the need for a representative payee.

B. Process of S8/S08 notice of suspension

For title II claims, the Modernized Claim System (MCS) and the Manual Adjustment Credit and Award Process (MADCAP) will generate the proper suspension notice for beneficiaries in S8. The title II post-entitlement system currently generates suspension notices to payees. It will begin sending notices to beneficiaries after interfacing with the Electronic Representative Payee System (eRPS) to obtain beneficiaries' addresses. If there is no payee, the suspension notice goes to the beneficiary. The title XVI post-entitlement system generates suspension notices to legally competent beneficiaries and payees. However, we send a manual notice for title XVI initial awards in suspension for representative payee development (S08).

Both systems send notices to the payees for legally incompetent beneficiaries, including minor children.

C. Procedure for sending a S8/S08 notice of suspension

When the title II or title XVI systems cannot fully process the S8/S08 suspension (e.g., title XVI initial claim), create a manual notice. Follow the instructions below when sending a suspension notice. (Always send a copy of the notice to the authorized representative.)

1. Beneficiary age 15 or older

Send a suspension notice for a beneficiary age 15 or older (with a copy to the payee) as indicated below:

  • Send title II and title XVI beneficiaries the suspension notice using the language in NL 00730.138 “S” Paragraphs and Captions. Adapt the language as necessary, ensuring that appeals language is not on the notice if the only issue is suspension for payee development. (These notices are on MTEXT/AURORA for Processing Center (PC) users and the Document Processing System (DPS) for field office (FO) users.)

  • Send legally incompetent title XVI beneficiaries the suspension notice, adapting the language in NL 00730.138. Send a copy to the legal guardian.

2. Beneficiary under age 15

Send a notice(s) of suspension for a beneficiary under age 15 as indicated below:

  • Send the notice language in NL 00730.138 to the current payee. The title II notice is in MTEXT/AURORA and the title XVI, in DPS.

  • Send a copy of the notice to the beneficiary's legal guardian, natural or adoptive parent, or person standing in the parent's place, if not the payee.

CAUTION: Check the eRPS to determine if the address of a person higher on the preference list is available. If not, send the notice to the person listed next in order of preference for whom an address is available.

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GN 00503.150 - Notice of Suspension for Representative Payee Development - 04/15/2016
Batch run: 04/25/2016