TN 16 (10-01)

GN 00605.106 SSA-624-F5 Evaluation of Payee Performance

A. INTRODUCTION

The FO summarizes in Part IV all interviews, problems encountered, and observations. The FO makes and records in Part IV a determination about payee performance, and specifies any further action that is required.

B. PROCEDURE

Use chapters GN 00602.000. and GN 00603.000. to evaluate use of benefits and conservation of funds.

1. Evaluate Payee Responses

Decision Factors: When evaluating information obtained during the payee interview, also consider these issues, if appropriate:

a. Guardianship

  • What influence does the guardianship have on benefits?

  • Are fees taken and are they reasonable (see GN 00602.040)?

  • Who has final say over how benefits are spent if the guardian is other than the payee?

b. Custody

Unreported custody changes may indicate misuse, especially if the beneficiary is now living alone.

c. Concern

Does the payee have knowledge about the beneficiary's total needs? Does the payee use this knowledge to decide the best way to use the benefits to meet those needs?

d. Other Income

Does the beneficiary have other income that does or could affect how the payee uses benefits, or the beneficiary's entitlement or benefit amount?

2. Evaluate Beneficiary Responses

Use the information collected from the beneficiary to validate information provided by the payee.

a. Current Needs

Use the information to evaluate the payee's performance.

b. Other Information

Be alert to events that affect the beneficiary's continuing entitlement especially in cases where the payee did not respond to requests for annual accounting.

3. Evaluate Custodian Responses

Use the information from the custodian to:

  1. Determine whether the payee kept in touch with and showed concern for the beneficiary; and

  2. Corroborate the amounts the payee reported using for the beneficiary's personal use.

4. Evaluate Payee Performance

Consider all observations or other knowledge about the case which affect the determination about payee performance.

Record any action taken and/or recommendations for future actions; e.g., change of payee, future recontact, misuse investigation, etc.

Decision Factors: Evaluate all information that is available. A particular event or issue may be given different weight under various conditions.

  1. Consider a change of payee if:

    • A substantive discrepancy exists about expenditures.

    • The payee is turning benefits over directly to a third party without any direction about how to use the funds.

    • An institutional payee (e.g., hospital, nursing home, etc.) charges care and maintenance in excess of the legal maximum.

    • An institution is the payee and the beneficiary has been on leave for more than 3 months, or has been permanently discharged.

    • The payee has not contacted the beneficiary in more than 3 months.

  2. Consider establishing a diary to recontact the payee or custodian in the following situations:

    • A change in custody is anticipated.

    • The payee has demonstrated marginal management of benefits and/or poor recordkeeping.

    • Conserved funds are not properly held.

    • Payee contact with the beneficiary is infrequent; i.e., the last contact was more than 3 months ago (or, if a social agency is the payee for a beneficiary in a foster home, a caseworker last had contact more than 6 months ago).

  3. Consider developing capability to make direct payment to the beneficiary if:

    • The payee is turning funds over directly to the beneficiary.

    • The beneficiary lives alone and the payee has not made contact for more than 3 months.

    • The beneficiary has been permanently discharged from an institution.

5. Clear Control

Clear the title II system and title XVI (and concurrent) AR diary control as appropriate following the instructions in GN 00605.050B.

6. Record Amount of Conserved Funds