TN 4 (12-06)

GN 02613.030 Beneficiary Wants to Establish Good Cause

NOTE: On April 1, 2009, SSA changed its policy of not paying fleeing felons. Follow the instructions below only for felony warrants with offense codes 4901, 4902, or 4999. Follow the Martinez settlement instructions in GN 02613.860 GN 02613.885 for all other felony warrant codes.

On May 9, 2011, SSA changed its policy and no longer suspends or denies benefits or payments based solely on a probation or parole violation warrant (i.e., warrants with offense codes 5011, 5012, 8101, 8102, or 9999 or “Blank” and an offense charge symbol of “probation or parole violation”). Follow the Clark Court Order instructions in GN 02615.100 GN 02615.190 for all probation or parole violation warrants.

We will make additional changes to this section, as necessary, in the future.

A. Policy – request for good cause

If the beneficiary asks SSA to find the beneficiary had good cause for not satisfying an outstanding warrants, as provided in section 202(x)(1)(B) of the Social Security Act, SSA will issue an initial determination based on the evidence furnished by the beneficiary and contained in the SSA record. Beneficiaries may assert mandatory good cause at any time and discretionary good cause within 12 months of certain events. These initial determinations about good cause are governed by the rules of reopening and administrative finality. (See GN 04001.100 for information on reopenings and changes in rulings or legation interpretations regarding change of position.)

See GN 02613.025B.3.a for a description of mandatory good cause. See GN 02613.025B.3.b. for a description of discretionary good cause.

B. Process - beneficiary statement of good cause

1. Statement requesting establishment of good cause

Effective November 1, 2006, on a beneficiary request to establish good cause must include the following:

  • a signed, dated, written statement requesting the opportunity to provide evidence that the beneficiary had good cause for not satisfying the outstanding warrant (i.e., felony warrant or probation or parole violation warrant), and

  • the type and nature of evidence or facts that the beneficiary plans to provide or try to provide to SSA to show why the beneficiary did not satisfy the warrant.

IMPORTANT: The evidence provided by the beneficiary that accompanies this request for good cause should be new evidence or information.

Upon receipt of the statement and information concerning the type of evidence to be provided by the good cause applicant, SSA will:

  • indicate on the statement if the beneficiary is requesting Mandatory Good Cause, or Discretionary Good Cause (Option A) and/or Discretionary Good Cause (Option B)

  • advise the beneficiary of any additional specific evidence or information requirements needed to establish good cause, and

  • inform the beneficiary that the beneficiary has 90 days to present the evidence or information to SSA in order to establish good cause, and

  • establish a 90 day tickle/diary for return of the good cause evidence.

2. Beneficiary presents evidence to establish good cause

If the beneficiary provides SSA with evidence, review it per GN 02613.025B.4. and make an initial determination about whether the beneficiary had good cause for not satisfying the outstanding warrant per GN 02613.025C.6.

3. 90 days good cause proof period has expired or beneficiary has not provided good cause proof to SSA

If no good cause evidence is provided to SSA by the end of the 90 period, SSA will not make a good case initial determination on the beneficiary’s/claimant’s request. See GN 02613.030C for instructions on closing-out the request for good cause. If the beneficiary provides less evidence than necessary to establish good cause for not satisfying his/her outstanding warrant, SSA will deny the request for good cause per GN 02613.025B.3.c and GN 02613.025C.6.

C. Process - good cause request close-out notice—beneficiary did not provide evidence of good cause to SSA within 90 days of protest

After a beneficiary c