TN 16 (10-01)

GN 00605.001 Overview of Annual Representative Payee Accounting

Citations:

Social Security Act § 205(j)(3) and 1631(a)(2)(C);

Regulations 20 CFR § 404.2035, 404.2065, 416.635 and 416.665

A. Introduction

Representative payee policy for reporting on the use of benefits is the same for title II and title XVI. However, there are some differences between processes and procedures in the two programs. Concurrent title II and title XVI cases are selected and processed as title XVI cases for accounting purposes (e.g., the case is selected based on the Supplemental Security Record, FOs must develop continued eligibility when conserved funds equal or exceed $2,000).

The term “beneficiary” is used generically in this subchapter to refer to both title II beneficiaries and title XVI recipients. Title II and title XVI (or SSI) designations are used where differences exist.

The instructions in this chapter apply to the entire audience unless otherwise specified. This means that if an instruction does not designate FO, PC, CR, etc., it applies to anyone who is involved in or is responsible for performing the work.

B. Policy

1. General

Social Security law and regulations require representative payees to use the benefits they receive for the current needs of the beneficiary and in their best interests. They are responsible for keeping records and reporting on the use of benefits. The payee must complete a paper Representative Payee Report, (SSA-623-OCR-SM, SSA-6230-OCR-SM, SSA-6234-OCR-SM) or an online report (using iRPA) annually. However, we may request a payee complete an accounting report anytime we receive information that raises a question about the payee’s use of monthly benefits or conserved funds.

The accounting report is used to monitor how the payee spent or saved the benefits on behalf of the beneficiary, identify situations where representative payment may no longer be appropriate, or determine if the payee is no longer suitable. We send an accounting report to all representative payees if any benefits were paid during the 12-month report period, except State mental institutions participating in the Onsite Review Program.

NOTE: Representative payees with dedicated accounts are excluded from the annual accounting selection criteria. Field offices (FOs) are responsible for monitoring how these payees used the title XVI benefits and dedicated account funds by sending them a Representative Payee Report of Benefits and Dedicated Account, SSA-6233-BK, to complete. (See GN 00605.200 for monitoring dedicated accounts.)

2. When to complete Representative Payee Evaluation Report, SSA-624-F5

FOs are required to conduct a face-to-face interview when the payee's responses on the accounting report indicate improper use of benefits or a change in custody, or the payee fails to complete the initial and second request SSA-623-OCR-SM, SSA-6230-OCR-SM, or SSA-6234-OCR-SM, or when the payee fails to complete an online report (iRPA) to SSA. In addition to the payee, the beneficiary and custodian (if other than payee) are also interviewed to confirm information provided by the payee and to ensure the beneficiary's current needs are being met. FOs complete a Representative Payee Evaluation Report, SSA-624-F5, to document the interviews, their evaluation and action taken as appropriate. (See GN 00605.085 for processing non-responder alerts and GN 00605.100 for the SSA-624-F5.)

3. When to consider a change of payee

If the payee does not respond after repeated attempts by the FO to obtain the required accounting report, FOs are required to consider a change of payee (see GN 00605.090). When the FO determines that the current payee is no longer suitable and a change of payee is necessary, it develops for a successor payee. If a new payee is not readily available, the beneficiary is either paid directly (unless direct payment is prohibited) while the FO continues payee development. If the FO determines that direct payment would cause substantial harm to the beneficiary, direct pa