GN PHI00504.100 C Payment of Benefits Pending Investigation Commonwealth of Pennsylvania's DPW Facilities
See GN 00504.100
The mental facilities of Pennsylvania's Department of Public Welfare (DPW) will use
a standard report form to report the transfers, discharges, and deaths of Social Security
recipients for whom the guardian officers serve as representative payee. The reports
will be faxed to the field office serving the mental facility at which the recipient
was a resident. They are first party reports because the reporter is the payee. Therefore,
in the instance of a report of discharge or transfer, confirmation with the recipient
is not required. A facsimile of the report is included on the next page.
The field office will take the following actions:
If Item 1 is completed, the payee is advising that the recipient has been transferred
to another DPW facility. A payee application from the guardian officer of the new
facility should be secured, and advance notice is required since the payee is changing.
General instructions for processing RPS applications can be found in MSOM chapters
238 through 244.
If Item 2 is completed, the recipient has been discharged from the DPW facility and
is in the care of a new custodian. You should contact the recipient and the new custodian,
whose name, address, and phone number are being provided, to determine who should
be appointed the new payee. If the DPW is also reporting that it has conserved funds
of the recipient, you should contact the reporter, whose name and phone number are
at the bottom of the form, and advise him/her either to return the money to SSA or
to forward the money to the new payee. See GN 00603.055 through GN 00603.130 for additional procedure for transfers of conserved funds. If the DPW is reporting
an outstanding care and maintenance balance, you should advise the new payee of this
fact. See GN 00602.030 for procedure concerning claims of creditors.
If Item 3 is completed, process the report of death according to the instructions
in GN 02602.050.
TO: Social Security Field Office,
FROM: ______________________(facility name), ________________________,
NOTICE OF CHANGE IN STATUS OF SOCIAL SECURITY RECIPIENT
SOCIAL SECURITY NUMBER: _________________________________
1. TRANSFER DATE: ________________________________________
Transferred to: _______________________________________________
2. DISCHARGE DATE: _______________________________________
His/her new custodian is: _____________________________________
Phone Number: ______________________________________________
Amount of conserved SSA funds at date of discharge: ___________
Outstanding care and maintenance charges: ___________________
3. DATE OF DEATH: ____________________________________
Signed: ________________________________________ (facility representative)
Phone #: _________________________Date: ____________________________