TN 16 (10-01)

GN 00605.105 SSA-624-F5 Face-To-Face Interview

A. PROCESS

The FO conducts face-to-face interviews with the payee, the beneficiary, and/ or the custodian. If the payee and the beneficiary or custodian are served by separate FO's, the FO serving the payee completes Parts I and IV, and the FO serving the beneficiary or custodian completes Parts II and III. (See GN 00501.015E. for discussion of resident FO.) Each claims or service representative who conducts an interview will sign Part IV. The SSA-624-F5 is available electronically via eForms.

B. EXHIBIT

Form SSA-624-F5, Representative Payee Evaluation Report, Part I (Page 1)

G-SSA-624-F5-1

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Page 2

G-SSA-624-F5-2

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C. PROCEDURE-PART I

REFERENCE: Follow GN 00605.061C. to complete identifying data preceding the interview questions.

1. Interview the Payee

While interviewing the payee:

  1. Obtain and record the payee's response to every question.

  2. Note in Remarks (item 8) or in appropriate response blocks what records, if any, the payee used to support responses.

  3. Obtain the payee's signature following item 8.

2. Determine the Amount of Conserved Funds

Compute the amount of conserved funds as instructed in Part I, item 5 of the SSA-624-F5.

D. EXHIBIT

Form SSA-624-F5, Representative Payee Evaluation Report, Part II (Page 3)

G-SSA-624-F5-3

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E. WHEN TO USE PART II

Interview the beneficiary and complete Part II unless  it is medically impractical or the beneficiary is under age 15.

F. PROCEDURE-PART II

If possible, interview the beneficiary and obtain responses to the items in Part II. Otherwise, explain in Remarks (item 5) why a beneficiary interview is not possible or is not complete.

G. EXHIBIT

Form SSA-624-F5, Representative Payee Evaluation Report, Part III (Page 4)

 

G-SSA-624-F5-4

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H. WHEN TO USE PART III

Use Part III if the payee and the custodian are not the same person or organization and:

  • the FO could not complete Part II; or

  • there is a discrepancy between the payee's responses (Part I) and the beneficiary's responses (Part II).

I. PROCEDURE-PART III

If there was more than one custodian during the report period, interview the one who had custody for the longest period of time.


To Link to this section - Use this URL:
http://policy.ssa.gov/poms.nsf/lnx/0200605105
GN 00605.105 - SSA-624-F5 Face-To-Face Interview - 10/29/2008
Batch run: 01/27/2009
Rev:10/29/2008