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

  • representative payee of record at the time benefits were suspended or erroneously terminated; or

  • representative payee applicant in a delayed initial award.

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.

  1. 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.

  2. 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

  1. Contact the representative payee and or beneficiary before issuing payments following a period of suspension or nonpayment as directed in GN 00504.160B.

  2. 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.

  3. 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

  1. Reinstatement from suspense with the same representative payee

  2. 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