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 contacts SSA to request good cause for not satisfying the outstanding warrant, the beneficiary has 90 days to provide the good cause evidence or information to SSA.
If at the end of the 90-day period the beneficiary has not submitted any evidence to establish good cause for not satisfying his/her warrant, then the request to establish good cause will be closed-out and SSA will not make a new initial determination because no evidence was submitted by the beneficiary. See NL 00755.330A.3. for additional information about the good cause close-out notice to the beneficiary.
SSA will send the beneficiary a close-out notice (see example of close-out to send the beneficiary in NL 00755.330E.3.) to tell him/her that SSA is closing out his/her request to establish good cause for not satisfying his/her outstanding warrant. SSA will send this notice after 90 days have elapsed from the date the beneficiary contacted SSA to request good cause.
Because SSA is neither making a new initial determination nor reopening or revising an initial suspension determination that would allow payment again if good cause had been established, the close-out notice does not provide the beneficiary information on requesting reconsideration or a hearing per NL 00601.150B.1.