TN 37 (06-13)
GN 00605.090 Payee Fails To Complete Annual Accounting Report
A. Policy for a payee who fails to account
SSA is required to obtain an annual accounting report from all payees, except for state mental institutions participating in the Onsite Review Program. If the payee does not respond to, or will not cooperate with efforts to obtain and approve an accounting report, a change of payee or direct payment may be in the beneficiary's best interest.
The field office (FO) must evaluate the current payee for continued suitability, consider if a beneficiary is capable of managing his or her own benefits, and document any suspected misuse or fraud. You will need to consider all beneficiaries served by this payee.
B. Evaluating the current payee’s suitability
1. Attempt to contact the payee
Use the following steps to contact and evaluate the current payee:
Make every reasonable effort to contact the payee by phone or mail before considering appointing a successor payee. Advise the payee that failure to complete and return the accounting report may result in paying benefits directly to the beneficiary, or to another individual.
Document your contacts with the payee, using the Make Notes screen, as described in MS INTRANETERPS 015.002 and MS INTRANETERPS 015.003.B.
Develop for a successor payee, if you determine the current payee is no longer suitable, as described in GN 00605.085D.
NOTE: Do not suspend benefits as a tool for achieving contact with a representative payee. If you cannot contact the current payee, begin developing for a successor payee or begin paying the beneficiary directly, as described in GN 00605.090C.
2. Decision factors
Consider a change of payee in these situations:
Undeliverable mail may indicate the payee’s whereabouts are unknown, refer to GN 00605.045.
Unacceptable responses on the accounting form may indicate poor payee performance, refer to GN 00605.066 through GN 00605.069.
Not responding to accounting requests and additional attempts at contact may indicate poor performance, misuse or fraud, refer to GN 00605.085.
C. Determining the current payee is no longer suitable
1. Selecting a successor payee
If you decide to appoint a successor payee, review the following information:
To determine whether to consider a successor payee, follow GN 00504.100.
For information on selecting a qualified payee, see GN 00502.132.
Always consider direct payment to the beneficiary, while trying to find a new payee, as described in GN 00605.090C.3.
Always consider if the beneficiary is now capable of managing his or her own benefits, by following the guidelines in GN 00502.055.
2. Suspending benefits while developing for a successor payee
Do not suspend benefits as a tool for achieving contact with a representative payee. Consider direct pay as described in GN 00605.090C.3.
Suspension of benefits is only permissible in the situations described in GN 00504.110. Do not penalize the beneficiary for the payee’s behavior. Valid suspension reasons are described in GN 00504.150.
3. Consider direct payment to beneficiary
If a new payee is not readily available and the beneficiary is a legally competent adult, you must pay the beneficiary directly while you continue payee development, unless one of the following exceptions exists:
If you decide that direct payment will cause substantial harm to the beneficiary, direct payment can be delayed for a maximum of 30 days, as described in GN 00504.105A.2.a.
EXCEPTION: For California residents, see GN 00504.105A.3.
If the beneficiary is legally incompetent or under age 15 (unless he or she has been legally emancipated), you must suspend benefits while developing for a new payee, as referenced in GN 00504.105A.2.b.
If the beneficiary’s whereabouts are unknown and you are unable to make a determination about direct payment, refer to GN 02602.320.
NOTE: Do not suspend benefits if the payee’s whereabouts are unknown.
If suspending a child's benefits, follow RS 01310.001 to determine if another beneficiary's entitlement continues based on child-in-care. This is most common when a parent payee does not respond to accounting requests.
D. When you suspect misuse or fraud
If, at any time during the development process, you suspect misuse or fraud, you must clearly document the full details of the case in the Electronic Representative Payee Accounting system (eRPA) using the “Make Note” and the “Report of Contact” screen, as described in GN 00605.090E.1.
1. Misuse and annual accounting
You must enter the misuse allegation into the Electronic Representative Payee System (eRPS) Misuse and complete your development by following the misuse procedures in GN 00604.001 through GN 00604.075.
2. Fraud and annual accounting
Determine if a fraud referral to the Office of the Inspector General (OIG) is appropriate. Follow the instructions in GN 04101.010.
E. Documentation in eRPA, RAC, eRPS Misuse, and eRPS assists with payee selection and suitability
We use past payee performance information in determining a prospective payee’s suitability. You need to make clear case notes and remarks, and provide detailed reports of contact. Include any other relevant documentation. This information helps technicians select future representative payees.
It is important to document your contact with the payee and your development in one or more of the following systems. When you clearly document information in one system, reference it in the other systems. Use a descriptive reference. For example:
1. eRPA (Electronic Representative Payee Accounting)
Document your development in eRPA by following the instructions for completing the:
“Make Note” screen as described in MSOM INTRANETERPA 003.008; and
“Report of Contact” screen as described in MSOM INTRANETERPA 003.011.
2. RAC (Representative Payee Accounting)
Document the RAC system by following the instructions for completing the “Make Remark” screen in MSOM INTRANETERPA 005.011.
3. eRPS Misuse (Electronic Representative Payee System)
Refer to the misuse procedures in GN 00604.001 through GN 00604.075.
4. eRPS (Electronic Representative Payee System)
Use the Make Note screen, as described in MS INTRANETERPS 015.002 and MS INTRANETERPS 015.003.B, to document information useful in determining a person’s suitability to serve as a payee.