TN 18 (09-11)
GN 00504.160 Required Contacts before Issuing Payments Following a Period of Suspension or Nonpayment
A. Definition of current representative payee
The current representative payee is the
B. Policy for reinstating nonpayment of benefits
If there is a period of suspension or nonpayment of benefits (e.g., for whereabouts unknown) after you have established entitlement, the following policy rules apply:
1. Nonpayment of benefits for less than 3 consecutive months
If the period of nonpayment of benefits is less than 3 consecutive months, assume the current payee remains qualified unless there is evidence to the contrary.
CAUTION: In delayed adjudication cases, the time period begins with the most recent date we established the representative payee applicant's suitability. In most cases, this is the date we sent the advance notice to the beneficiary. If you use a later date there must be supporting documentation on file. For information on requirements for resumption of benefits, see GN 02602.040.
2. Nonpayment of benefits for 3 months or more
If the period of nonpayment of benefits is 3 months or more, do not make payments, until you receive the documentation listed in GN 00504.160C. For SSI cases, if the record has been in nonpayment status for more than one calendar month, conduct an unscheduled redetermination.
Nonpayment for 3 to 5 months - When the representative payee is not a parent or spouse with custody or the legal guardian, you cannot make payments until the beneficiary's whereabouts are known and you have contacted the custodian and beneficiary to verify the payee's continued suitability. In evaluating the payee's suitability, consider whether the payee failed to report the event that resulted in nonpayment.
Nonpayment for 6 or more months - Contact the current payee in all cases to verify custody or that the legal guardian continues in that capacity. Verify the payee's continued suitability. In evaluating the payee's suitability, consider whether the payee failed to report the event that resulted in nonpayment. In addition, send an advance notice if the nonpayment period is 6 months or longer. For information on when to provide an advance notice for nonpayment of benefits for 6 or more months, see GN 00503.100A.1.c.
CAUTION: Consider a review of the beneficiary's continued need for a payee and whether direct payment as an interim measure is appropriate. In addition, you must verify the beneficiary's continued entitlement. For more information on determining capability for adult beneficiaries see GN 00502.020A.
C. Procedure for contacting the representative payee and reinstating benefits
1. Use the following guidelines for representative payee development before reinstating benefits
Contact the representative payee and or beneficiary before issuing payments following a period of suspension or nonpayment as directed in GN 00504.160B.
Document the results of the investigation and the recommendation on the Report of Contact Details screen MS INTRANETERPS 016.002. Develop for a successor payee if necessary.
Verify that the beneficiary is still entitled before reinstating benefits. Verify that no marriage has occurred before reinstating a child over age 15. If we suspend SSI payments for more than one calendar month, conduct an unscheduled redetermination. Determine suitability of the payee during this interview.
2. Reinstatement from suspension or termination
a. Title II reinstatements
Reinstatement from suspense with the same representative payee
We process most reinstatement actions (same payee) via the Post Entitlement Online System (POS)Reinstatement from suspense with a new payee
When processing a change of payee for a beneficiary in suspense S-8 or S-6 status, input the selection of the payee via the Electronic Representative Payee System (eRPS) using normal procedures. The selection of the payee passes to the Master Beneficiary Record (MBR) via Title II Redesign (T2R), and will automatically reinstate the benefits to the new representative payee.
When processing a change of payee action for a beneficiary in S-9 whereabouts unknown (WHRU), input the selection of the representative payee via the eRPS. Once you have posted the new representative payee to the MBR, input the reinstatement action via POS. For more information on how to process whereabouts unknown (WHRU) see SM 03020.290.
Reinstatement from an erroneous termination
The Processing Centers (PC) using Manual Adjustment, Credit, and Award Process/Manual Adjustment Credit and Award Data Entry System (MADCAP/MACADE) must process reinstatement actions for beneficiaries in terminated status (same representative payee). The reinstatement action will cause a eRPS alert to the field office since the eRPS record will now reflect a terminated relationship. After you receive the alert, reestablish an active rep payee record using the questionnaire process as described in MS INTRANETERPS 019.006.
b. Title XVI reinstatements
Reinstate a title XVI benefit from suspension S08 status as shown in SM 01305.001 through SM 01305.020.
If you input an SSA-1719B to reinstate title XVI benefits to an incorrectly terminated beneficiary, complete the Questionnaire screen MS INTRANETERPS 019.006 and add the payee data once you receive the eRPS alert.
If you use the Modernized Supplemental Security Income Claims System (MSSICS) to reinstate incorrectly terminated title XVI benefits, complete an SSA-11 in the eRPS to prevent the eRPS alert that will generate if the payee information on the SSR does not match the eRPS. Suppress advance notice. Process the application as a systems limitation.
GN 00504.105 Direct Payment to Incapable Beneficiaries When Further Payee Development is Needed
SM 03020.080 (S-6) Develop for Address
SM 03020.150 (S-8) Develop for Representative Payee (DPYE)
SM 03020.290 (S-9) Develop for Whereabouts Unknown (WHRU)