TN 34 (10-15)

GN 02607.330 Title II Incompetent to Stand Trial (IST) Provisions

A. What is IST

The legal system considers a defendant IST when the defendant, because of a mental illness or a developmental disability, is unable to understand his or her legal situation or assist in preparing for her or his defense. When a court determines that a defendant is IST, it also decides if mental health treatment will help restore the defendant’s competence. If so, the court commits the defendant to a mental health hospital or other setting to receive restorative treatment.

Periodically, the court may order the beneficiary to undergo psychological reevaluation to determine the beneficiary’s competency to stand trial. If the treatment is successful and restores the defendant’s competence, he or she returns to court to face criminal charges.

If the mental health treatment is unsuccessful and the court declares the beneficiary unrestorable to competency, the court’s commitment order changes from criminal to civil or voluntary commitment. When this change occurs, the court generally drops the criminal charges against the IST beneficiary. The change from a criminal to a civil commitment does not affect the beneficiary’s suspension status. The beneficiary’s benefits remain in suspense regardless of the commitment status until the institution officially releases the beneficiary and the institution ceases to provide him or her with basic living needs.

NOTE: A mental assessment called “competency to stand trial evaluation” focuses on how a person is mentally functioning at the time of the mental health examination. Another mental assessment called “NGRI sanity evaluation” examines a person’s mental condition at the time of the alleged crime.


Joan suffered mental trauma while committing a crime. The police arrested Joan for her crime. Joan's attorney was concerned about her mental state and petitioned the court to declare Joan IST because she was not able to help in her defense. The judge ordered Joan to undergo psychological evaluation and treatment to determine if she was competent to stand trial. Joan’s evaluation determined that Joan was now capable of aiding in her own defense. Her condition was temporary and the court found she was competent to stand trial. We will suspend Joan's benefits if the court convicts her in the criminal trial and confines her for more than 30 continuous days.


Bob suffers from behavioral problems stemming from a brain injury. After committing a crime and undergoing psychological evaluation for competency to stand trial, the court declared Bob IST and ordered him confined to a mental health institution. Upon remaining confined in the mental institution for more than 30 continuous days, we suspended Bob’s Title II benefits effective the date the court declared him IST and confined him to a mental institution.

One year later, upon reevaluation, the mental health institution reported to the court that Bob was unrestorable to competency. At that point, the court changed the commitment order from criminal to civil. The court also dropped the criminal charges. However, Bob’s IST suspension remains in force.

B. IST suspension policies beginning 4/1/2000

1. Suspension requirements

a. Beneficiaries affected

All Title II beneficiaries are affected.

b. Rules for suspension

Suspend benefits when a court:

  • finds that the beneficiary is IST; and

  • issues an order confining a beneficiary to a mental health institution for more than 30 continuous days at public expense.

2. Confinement date

For a definition of confinement, see GN 02607.001.

a. Confinement begins

Confinement begins on the later of the date:

  • a court issues an order to confine a beneficiary in a United States mental institution for more than 30 continuous days after a finding of IST; or

  • a mental institution admits and confines the beneficiary after a finding of IST.

b. Confinement ends

Confinement ends with:

  • conditional release (official release from an institution, which no longer provides for the beneficiary's basic living needs, but the beneficiary continues to receive supervision or treatment); or

  • unconditional release from an institution.

3. Suspension effective date

Suspension is effecti