TN 4 (12-06)

GN 02613.450 Protest of Suspension and Deferral of Overpayment Recovery

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. Procedure – FO or PSC processing protests to fugitive felon or probation or parole violation suspension

With the addition of the FFSCF to Title II fugitive felon processing, the advance notice of proposed suspension will be automated. The suspension or closed period of suspension/overpayment notice to the beneficiary will also be automated in most instances. SSA will generally not have contact with the beneficiary until he/she is notified of his/her proposed suspension of future benefits or he/she is notified of the suspension of Title II benefits because of his/her outstanding felony warrant or probation or parole violation warrant.

When the beneficiary contacts SSA after being notified regarding suspension of his/her Title II benefits for the fugitive felon or probation or parole violation suspension provisions, the beneficiary will usually:

  • request information on how to satisfy his/her warrant (see GN 02613.450A.1. for information on deferral of overpayment recovery);

  • request good cause for not suspending his/her Title II benefits (see GN 02613.450A.2); (See also GN 02613.030B for additional instructions regarding the good cause statement that must be obtained if good cause is being requested by the beneficiary.)

  • protest the fact that he/she is a fugitive felon or probation or parole violator (see GN 02613.450A.2);

  • report that he/she satisfied his/her warrant (see GN 02613.450A.2);

  • report that he/she is not the individual identified on the warrant or that he/she never had a warrant (see GN 02613.450A.2).

The procedures contained in this section provide information on processing protests received by SSA offices for fugitive felon or probation or parole violator suspensions.

1. Deferred overpayment recovery

After passage of the original fugitive felon provisions in 1996, certain cases came to the attention of Congress leading to a realization that benefit suspensions may not be appropriate in all cases. Understanding that extenuating circumstances may impact some beneficiaries' ability to resolve outstanding warrants, Congress incorporated “good cause” exceptions to benefit suspension as part of SSPA. Under the “good cause” provision, if good cause is found, SSA is required to resume benefits, if suspended, and repay any previously withheld benefit or overpayment recovered. Good cause must be found if a court finds the individual not guilty, dismisses the charges, or issues any similar exonerating order. Any of these could occur months after a person is suspended. If a person is suspended retroactively for a period during which benefits were paid, the person would be overpaid and we would attempt to recover the overpayment. Later, if the person is acquitted, etc., we would have to repay any recovered overpayment. To prevent unnecessary overpayment development, SSA will defer the recovery of the overpayment in certain circumstances (i.e., see GN 02613.450C for deferred overpayment situations and processing) until we learn of the disposition of the charges or outcome of a trial.

2. General processing of protests to suspension of Title II benefits

SSA receives information that the beneficiary has an unsatisfied warrant and good cause has not established based on SSA records:

Steps

Processing Protest to Suspension of Title II Benefits

1

SSA sends advance notice and diaries 35 days for due process, if the case comes through the computer match and the beneficiary is in current payment status and the warrant is not satisfied. Advance notice of proposed suspension will be automatically generated and sent to the beneficiary. Go to step 2.

If the report is received at another SSA office and from a third party other than through the computer match, the beneficiary gets 15 days due process on the advance notice of proposed suspension if the beneficiary is in current payment status and the warrant is not satisfied. Go to step 2.

If the beneficiary reports the warrant information directly to SSA himself/herself, advance notice is not given, suspension applies. (See GN 02613.150B.3 for processing information).

(See GN 02613.940A for information on due process periods based on who provides SSA with the report). Go to Step 2.

OR

If the beneficiary is in nonpayment status (i.e., suspension, deferred or terminated) or the beneficiary’s warrant is already satisfied, he/she received an initial determination closed period of suspension/overpayment notice, go to Step 3.

2

Beneficiary contacts SSA within 35 days or a 15 day due process period to protest the suspension because of the advance notice of proposed suspension.

a. Annotate the protest to stop suspension of benefits

Determine the WARRANT INFORMATION SOURCE on the warrant. See the FFWQ query screen to determine the WARRANT INFORMATION SOURCE. This factor will determine how the protest must be annotated to the FFSCF and how the protest will be coded.

If THE WARRANT INFORMATION SOURCE is “LEA Batch File,” or the “OIG Initiated or FFAP record.” then post the protest to the benefit suspension via the FFDG screen on the FFSCF to stop suspension from occurring.

Or

If the warrant came from “Third Party Report” then post the DATE of the protest to the benefit suspension via the FFDG screen on the FFSCF to stop the suspension from occurring. Do not code the entry of “allowed” or “denied” until the evidence has been submitted and evaluated per GN 02613.450B.

b. Determine reason for the beneficiary protest

If the beneficiary is in current payment status and warrant is not satisfied during the protest period and the beneficiary:

  • provides SSA with evidence of his/her satisfied warrant, then treat as a deferred overpayment case and process per (GN 02613.450C).

  • provides SSA with good cause statement per (GN 02613.030B) and also provides SSA with evidence to establish good cause, then evaluate the evidence per (GN 02613.025), if good cause is established then process per (GN 02613.025C.6.a).

  • states that he/she can provide good cause and does not have evidence at his/her point of contact with SSA during the due process period (see GN 02613.030B for additional information regarding the good cause statement and subsequent 90 day period for providing good cause evidence), allow the beneficiary to continue receiving benefits for additional 90 days. Process per (GN 02613.450B) step 3 and 4.

  • states that he/she does not have an outstanding warrant and that SSA has identified the wrong person (i.e., EVS code of A case), then process per (GN 02613.150C.1).

  • states that he/she has satisfied his warrant and provides proof the warrant was satisfied, process per (GN 02613.500).

  • protesting the fact that he/she meets the suspension criteria as a fugitive felon or probation or parole violator, then process per (GN 02613.450B.1).

NOTE: If beneficiary protests after suspension already occurs and the beneficiary did not protest during the due process period. SSA will not resume benefits until the warrant is satisfied or the beneficiary provides SSA with good cause for not satisfying his/her outstanding warrant or the beneficiary provides evidence that the warrant was satisfied. The beneficiary will be given 90 days from the date of contact to establish good cause (we will not reinstate benefits while we are awaiting good cause).

3

If beneficiary is in nonpayment status, (e.g., LAF D, S, or T) or the warrant is satisfied

a. Process for Suspending Benefits

No advance notice is sent because SSA is not going to stop the current benefit. The FFSCF will send a finder to T2 to post the RFST of FUGFEL and the S9 closed fugitive felon or probation or parole violator suspension period to the history field to the MBR. A closed period of suspension/overpayment notice or a suspension and overpayment notice will also automatically be sent to the beneficiary.

Protest of the suspension must occur within 60 days after receipt of closed period suspension and overpayment letter and protest will be sent to Recon

NOTE: Deferred overpayment recovery is not considered and will not be allowed.

b. Determine the reason for the beneficiary protest

  • provides SSA with good cause statement per (GN 02613.030B) and also provides SSA with evidence of good cause, then evaluate the evidence per (GN 02613.025), if good cause is established then process per (GN 02613.025C.6.a).

  • states that he/she can provide good cause and does not have evidence at his/her point of contact with SSA during the due process period (See GN 02613.030B for additional information regarding the good cause statement and subsequent 90 day period for providing good cause), allow the beneficiary to continue receiving benefits for additional 90 days. Process per (GN 02613.450B) step 3 and 4.

  • states that he/she does not have an outstanding warrant and that SSA has identified the wrong person (i.e., EVS code of A case), then process per (GN 02613.150C.1).

  • states that he/she has satisfied his warrant and provides proof the warrant was satisfied, process per (GN 02613.500).

  • protesting the fact that he/she meets the suspension criteria as a fugitive felon or probation or parole violator, then process per (GN 02613.450D).

B. Procedure – FO or PSC--beneficiary protests suspension during the due process period

Steps

Action

1

The FO or PSC technician will annotate the FFSCF with the timely protest from beneficiary. See (GN 02613.450A.2) for the actions to take on the FFSCF to annotate a protest action received during the due process period.

2

Forward the protest evidence or information to the FO CR or PSC CA to review and to make a decision on the protest from beneficiary per (GN 02613.450A.2). and (GN 02613.450B.1).

3

Evaluate the protest and evidence per (GN 02613.450B.1). If good cause is alleged, obtain the request for good cause statement and accompanying good cause evidence or information per (GN 02613.030B), then evaluate the information per (GN 02613.025). Determine if good cause is met. If more information is needed, suspension of the benefits will not occur until after 90 days to allow the beneficiary time to provide the necessary information.

If good cause is alleged and the beneficiary did not provide sufficient information when he/she protested the suspension during the due process period, then allow the beneficiary 90 days to obtain the needed evidence. Tickle/diary the case for 90 days via the MDW/PSC diary system to document the protest and to control return of the good cause evidence from the beneficiary. If the beneficiary does not provide the cause evidence within the 90 day period, process per (GN 02613.030C).

4

If after evaluating the protest and the accompanying evidence or information, benefits should be suspended based on the evidence and the protest, then process the case per (GN 02613.450B.2).

or

If after evaluating the protest and the accompanying evidence or information for good cause, benefits should be suspended based on the evidence and the protest, then process the case per (GN 02613.025C.6.b).

If the beneficiary does not respond within 90 days with the good cause evidence or good cause cannot be established (See GN 02613.030C for additional instructions on the good cause request close-out process), closeout the protest by denying good cause on the FFDG screen on the FFSCF and use a good cause denial code reason of QID.

5

If the warrant is satisfied and the beneficiary protested the suspension of his/her benefits during the due process period, then process the deferred recovery overpayment case per (GN 02613.450C).

1. FO or PSC CA review of evidence submitted on protest

If the evidence supports the individual's protest

then,

Document the facts and the final determination on the EVID screen.

See (GN 02613.025D) for instructions on preparing a Special Good Cause Determination if good cause is being alleged by the beneficiary to stop the fugitive felon or probation or parole violator suspension.

If the evidence is discrepant, appears to be fraudulent, altered, or cannot satisfactorily prove that the beneficiary can establish good cause for not satisfying his/her warrant

then,

Record information about the discrepant documents (e.g., how, when and where they were obtained). Develop all available information per (GN 04110.010); prepare a summary of the situation. Document the facts and the final determination per (GN 02613.025). Complete an SSA-8551-U4 per (GN 04111.010).

Send the documentation to the Regional Office of Investigations, Office of the Inspector General. Take the necessary steps to suspend benefits per (GN 02613.010).

If the issue involves interpretation of State law or the nature of a crime, classification of the crime or if the warrant is still unsatisfied

then,

See (GN 02613.175) for obtaining information about criminal charges (i.e., offense codes) on warrants or the classification of crimes.

See (GN 02613.001) and (GN 02613.010) for information on unsatisfied and satisfied warrants and dismissal of the warrant versus dismissal of the criminal charges on the warrant.

2. FO or PSC — denial of protest and suspension of benefits (good cause is not involved)

STEPS

ACTIONS

1

If T2 benefits are in LAF C and a protest was posted on the FFDG screen (DUE PROCESS MATURITY DATE and PROTEST DATE are entered on the FFEQ screen) and a PROTEST DATE is also posted to the MBR in the FFEL line in the PROTESTDT field., then

Update the FFDG screen in the ENTER PROTEST DISPOSITION field with “2-PROTEST DENIED.”

2

If the DUE PROCESS maturity DATE (MMDDCCYY) on the FFDG screen is before the date you are annotating the protest denial code, then the FFSCF will allow the T2 finder that is pending to continue processing the suspension action for the beneficiary. or

If the date you are processing the protest denial is on or after the PROTEST MATURITY DATE posted to the FFDG screen, suspend benefits via the FFEL screen in POS. Use the date of the warrant, or 1/1/2005, or the date of entitlement to Title II benefits as the WARRANT DATE, add an entry in the PROTEST DECISION: 2=DENIED on the FFEL screen per instructions in MSOM COMMON 005.035.

NOTE: An automated T2 suspension/overpayment notice will be generated based on the automated or manual suspension input when the POS/FFEL screen is used for the suspension action.

C. Procedure — FO or PSC — protest to suspension is timely and warrant is satisfied (beneficiary is arrested or surrenders to law enforcement)

Beneficiary contacts SSA during the due process period because of the advance notice of proposed suspension that he/she received from SSA regarding his/her outstanding warrant. The beneficiary provides proof to SSA that he/she has satisfied the warrant. The beneficiary provides proof to SSA in the form of a court docket, or some other official agency document indicating the warrant has been satisfied. The beneficiary’s warrant is now no longer outstanding. The SSA technician will consider deferred overpayment recovery per (GN 02613.450B.2).

1. Factors to allow deferred overpayment recovery

SSA will defer recovery of a Title II fugitive felon/probation or parole violator overpayment for a fugitive felon or probation or parole violator suspension when the beneficiary:

  • protests his/her Title II benefit suspension during the due process protest period and,

  • has surrendered to, or has been apprehended by law enforcement (arrested) for his/her criminal charges cited on the warrant before or during the due process protest period or a judge dismisses, cancels, vacates or otherwise voids the warrant after the date the warrant was issued. (See GN 02613.001B.4 and GN 02613.001B.6 for definitions of when a warrant is satisfied.)

2. Deferred overpayment recovery process

The fugitive felon or probation or parole violator suspension period begins with the date the warrant is issued the date of entitlement to Title II benefits or 1/1/2005 (whichever date is later) and will end the month the warrant is satisfied (i.e., the beneficiary surrenders to the law enforcement agency that issued the warrant or is arrested). When SSA discovers that a beneficiary has an unsatisfied warrant, an Advance Notice of Proposed Suspension is sent to the beneficiary advising him/her that SSA will suspend the monthly Title II benefits in the near future unless the beneficiary can satisfy the outstanding warrant or provide SSA with good cause for not satisfying his/her outstanding warrant. (See NL 00755.200 for the Advance Notice of Proposed Suspension.)

Generally, once a beneficiary protests his/her fugitive felon or probation or parole violator suspension during the appropriate Advance Notice of Proposed Suspension due process period (see GN 02613.940A for the Advance Notice of Proposed Suspension due process period) and he/she also satisfies the outstanding warrant (i.e., the beneficiary surrenders to the law enforcement agency (or is arrested) that issued the warrant), the fugitive felon or probation or parole violator suspension period ends the month the warrant is satisfied. Because the beneficiary was not suspended for the prior fugitive felon or probation or parole violator suspension period and will not now be suspended after the protest to the suspension of benefits is resolved (i.e., the warrant has been satisfied) the overpayment becomes a closed period of fugitive felon or probation or parole violator suspension overpayment. The overpayment for the fugitive felon/probation or parole violator suspension period will not be recovered by SSA until a court or administrative governing body (e.g., parole board) determines the disposition of the charges.

A court of competent jurisdiction or administrative governing body could determine:

  • the beneficiary is not guilty of the criminal offense or probation or parole violation, or,

  • the charges relating to the criminal offense or probation or parole violation are dismissed, or,

  • a proposed plea agreement is acceptable (e. g., individual pleads guilty to a lesser criminal charge classification such as a felony to a misdemeanor).

NOTE: In the instance of a plea bargain (agreement), the prosecutor and the defense counsel will enter into a plea agreement setting forth the scope of the plea bargain. Generally, if an individual is charged with a felony and then pleads to a misdemeanor, the felony is considered dismissed or null and void. The court order should reflect that the individual was convicted of the misdemeanor, not the felony. Generally, the court order should also reflect that the indictment has been dismissed.

3. FO or PSC — actions on deferred overpayment recovery

a. Process of protest and determination if deferred recovery of the overpayment can be made

Steps

Action

1

The FO or PSC technician will annotate the FFSCF with the timely protest from beneficiary. See (GN 02613.100B.5) for the actions to take on the FFSCF to annotate a protest action received during the due process period.

2

Forward the protest evidence or information to the FO CR or PSC CA to review and to make a decision on the protest from beneficiary.

3

Evaluate the protest and evidence per (GN 02613.450C.1), (GN 02613.450C.2), and (GN 02613.450B.1) or if good cause is alleged by the beneficiary, process per (GN 02613.030B). Evaluate the good cause information or evidence per (GN 02613.025). If more information is needed, suspension of the benefits will not occur until the beneficiary provides the necessary information.

or

If good cause is alleged (See GN 02613.030B regarding the requirements for officially requesting good cause) and the beneficiary did not provide sufficient information when he/she protested the suspension during the due process period, then allow the beneficiary 90 days to obtain the needed evidence. Tickle/diary the case for 90 days via the MDW/PSC diary system to document the protest and to control return of the good cause evidence from the beneficiary. If the beneficiary does not provide good cause evidence within the 90 day period, process the case per (GN 02613.030C).

4

If after evaluating the protest and the accompanying evidence or information and it was determined that the warrant was not satisfied as the beneficiary alleged, benefits should be suspended based on the lack of evidence and the denial of the protest, then process the case per (GN 02613.450B.2) or

If after evaluating the protest and the accompanying evidence or information and it was determined that the warrant was not satisfied as the beneficiary alleged or that the beneficiary did not establish good cause, benefits should be suspended based on the lack of evidence and the denial of the protest, then process the case per (GN 02613.025C.6.b).

5

If the warrant is satisfied, the beneficiary protested the suspension of his/her benefits during the due process period and good cause is not being requested, then process the deferred recovery overpayment case per step 6.

6

Good Cause Does Not Apply

If the beneficiary cannot meet the conditions for establishing good cause or did not request good cause when protesting his/her suspension, ask the beneficiary when he/she will go to trial for the criminal charges on the warrant.

If the beneficiary will go to trial in the future for his/her crimes, use the FFEL screen to input the closed period of suspension per (GN 02613.450C.3.b.).

Control for the final court disposition of the criminal charges on the warrant per step 7.

NOTE: The final determination regarding the fugitive suspension and overpayment recovery action will be made once there is a verdict or we learn of some other disposition of the felony charge(s) on the warrant. At that time SSA may either find mandatory good cause (if charges dismissed, acquitted, etc.) applies per (GN 02613.025) or SSA will begin overpayment recovery procedures for the closed period of suspension (if the beneficiary is found guilty of the criminal charges on the warrant).

7

Control for Receipt of Final Court Disposition

Establish a Prisoner Update Processing Record (PUPS) for the beneficiary if possible. See MSOM PRISON 003.001 for instructions on establishing a PUPS record for a beneficiary. Annotate the date the beneficiary contacted the law enforcement agency to satisfy the warrant as the DATE OF CONFINEMENT on the PUPS record. Add a REMARK to the PUPS record, FUGITIVE FELON DEFERRED OVERPAYMENT CASE, SEE (GN 02613.450C.3).

NOTE: If the individual has been released pending his/her trial, also add a released date to the PUPS record equal to the date of release from the correctional institution.

Access the Incarceration Reporting Control System (IRCS) database to determine if the law enforcement agency that issued the warrant is also identified on IRCS as an inmate reporter. The law enforcement agency will have a special code identifier (i.e., RID, reporter identification code and FID, facility identification code) on IRCS if they are providers of inmate information in addition to being warrant-issuing agencies. For general information on IRCS, see GN 02607.420, and for specific information about the IRCS system, see MSOM PRISON 001.001.

Use the law enforcement agency code (RID: reporter Identification Code and FID code: facility) annotated on IRCS for the law enforcement agency when posting the beneficiary information to PUPS for the FID and RID fields on the PUPS record. Post the future trial date the beneficiary has provided on the PUPS record. See (GN 02607.720B) for instructions on posting future trial date entries for PUPS.

If the law enforcement agency is not annotated as a reporter on IRCS, use the code of “OTHR” to establish the PUPS record to control the future trial date for the beneficiary by using the PUPS trial pending diary system. If the beneficiary does not know when he/she will go to trial, use the trial pending diary for contact with the beneficiary every 60 days until a future trial date is given.

If the law enforcement agency is not annotated as a reporter on IRCS and you cannot use the OTHR code to establish a PUPS record, control the future trial date for the beneficiary by using the MDW or PSC diary system. Establish a tickle/diary for the beneficiary’s future trial date. If the beneficiary does not know when he/she will go to trial, tickle/diary for contact with the beneficiary every 60 days until a future trial date is given.

Once the beneficiary goes to trial and determination is made on the disposition of the criminal charges on the warrant, process per (GN 02613.450C.3.b.).

NOTE: Developing Representative Payee Suitability — Check RPS in each case where the beneficiary/claimant has an outstanding felony warrant to determine if he/she is serving as a representative payee.

Effective 4/2005, persons having an outstanding felony warrant are prohibited from serving as a payee. There are no exceptions to this prohibition. Refer to (GN 00502.133).

b. FO and PSC processing of the deferred overpayment recovery cases

FO processing of deferred overpayment recovery cases is described in the chart below:

Steps

Action

1

Do not use the FFEL screen in POS to process the closed period of suspension. Notify the PSC to post the deferred overpayment suspension via MADCAP/MACADE.

Go to step 2

2

In FFSCF on the FFDG screen, update the FFDG screen and annotate a PROTEST DISPOSITION 1=PROTEST ALLOWED.

If good cause was requested during the protest and the request was denied, then annotate GOOD CAUSE ESTABLISH: N, GOOD CAUSE DENIAL REASON and annotate the appropriate good cause denial code per (GN 02613.930B).

3

Because the closed period of suspension cannot be processed using the FFEL screen, forward the case to the PSC via the 2795 fugitive Felon Processing Exclusion FAX instructions found in (GN 02613.980).

In the instructions in (GN 02613.980A.1.) on completing the form, the entries on the form are modified as follows:

DATE OF SUSPENSE: MM/YY through MM/YY--Show the closed period of fugitive felon suspension for the beneficiary. (The closed period will comprise: Date of the warrant or 1/1/2005 or DOEI to T2 benefits through the Date the Warrant Was Satisfied.)

NOTICE: PSC must send a deferred overpayment notice to the beneficiary per (NL 00755.800).

EXCLUSION CATEGORY: Other

REMARKS: Deferred Overpayment Case. Do use MADCAP/MACADE to process the S9 suspension action to the MBR and post an RFST of FUGFEL to the benefit line on the MBR. Send a deferred overpayment notice to the beneficiary per (NL 00755.800).

For deferred overpayment cases change the instructions for processing in (GN 02613.980B) to:

Tickle the MDW for 20 days to give time for the closed period suspension action to show on the MBR for the deferred overpayment cases. Call the PSC using the PSC contact information in (GN 02613.990) when the tickle matures and there is no suspension.

For deferred overpayment cases change the instructions for processing in (GN 02613.980C) to:

Forward copies of the protest documentation to the jurisdictional PSC. Do not fax this material. Annotate the material “Fugitive Felon Deferred Overpayment Case”—Drop-file Material. Mail the documentation to the jurisdictional PSC.

Go to step 4

4

On ROAR input a “Protest/Stop Recovery Request” code of “14” per MSOM DMS 006.003.

PSC processing of deferred overpayment recovery cases is described in the chart below:

Steps

Actions

1

Review the entries on the FO initiated 2795 Fugitive Felon FAX form to make sure of the periods of closed period suspension and the additional case processing instructions as illustrated in (GN 02613.980). Also review the FFSCF to make sure that the FO posted a PROTEST DISPOSITION 1=PROTEST ALLOWED to the FFDG and added Good Cause Indicator of "N" if the beneficiary had requested good cause and good cause has been denied.

2

Post the deferred overpayment suspension S9 action via MADCAP/MACADE. Post a RFST of FUGFEL to the benefit line on the MBR.

3

Review the ROAR record to make sure there is a ROAR input of "Protest/Stop Recovery Request code 14" per MSOM DMS 006.003. If this code is not present on ROAR, input the Protest/Stop code 14.

4

Send a deferred overpayment notice to the beneficiary per (NL 00755.800).

NOTE: Developing Representative Payee Suitability --Check RPS in each case where the beneficiary/claimant has an outstanding felony warrant to determine if he/she is serving as a representative payee.

Effective 4/2005, persons having an outstanding felony warrant are prohibited from serving as a payee. There are no exceptions to this prohibition. Refer to (GN 00502.133).

c. FO or PSC — SSA learns of the disposition of the criminal charges on the warrant

Steps

Action

1

When SSA learns of the disposition of the criminal charges and the beneficiary can now establish mandatory good cause (see GN 02613.025 for mandatory good cause) for not satisfying his/her outstanding warrant because he/she was found not guilty of the criminal charges or the charges are dismissed or the beneficiary receives a plea agreement that changes the charges from a felony to a misdemeanor, process the case per (GN 02613.025C.6.a).

2

If the beneficiary is found guilty for his/her criminal charges on the warrant, the suspension currently reflected on the MBR is accurate. Update the FFSCF with the good cause denial information. Update the GOOD CAUSE DETERMINATION fields on the FFDG screen, enter a GOOD CAUSE ESTABLISHED N and enter a GOOD CAUSE DENIAL CODE: AAA per information found in (GN 02613.930B) and MSOM PRISON 006.007.

Go to step 3

3

Initiate recovery of the overpayment via ROAR (the overpayment is currently in protest status on ROAR) because the individual has been found guilty of the criminal charges and will be sentenced by the court to confinement at a correctional institution, if appropriate. ROAR will send the beneficiary a notice that we are going to start recovery of the overpayment.

NOTE: In the instance of a plea bargain (agreement), the prosecutor and the defense counsel will enter into a plea agreement setting forth the scope of the plea bargain. Generally, if an individual is charged with a felony and then pleads to a misdemeanor, the felony is considered dismissed or null and void. The court order should reflect that the individual was convicted of the misdemeanor, not the felony. Generally, the court order should also reflect that the indictment has been dismissed. Title II benefits are not suspended if the criminal charges are changed from a felony crime to a misdemeanor.

4. FO or PSC — beneficiary protest to suspension is timely and warrant is not satisfied

Process the protest to the suspension per (GN 02613.450D).

D. Procedure - FO or PSC — beneficiary protest to suspension after due process period expired and suspension occurred

See (GN 03001.025) for information on protests against advance notice of benefit suspension. See also (GN 02210.006) for information on protest cases when overpayments are involved. If the beneficiary protests the suspension before the end of the 30-day due process period process the protest as follows.

Steps

Action

1

If the intent of the protest is not clear, verify with the beneficiary if they are:

  • requesting good cause, process per (GN 02613.030B) and evaluate the good cause request per (GN 02613.025);

  • protesting the fact that he/she is subject to the fugitive felon suspension provision criteria, (i.e., requesting reconsideration of the initial determination) see (GN 02613.450D.1.a);

  • reporting that he/she satisfied his/her warrant (for information regarding reinstating benefits see GN 02613.500.)

Forward the protest and evidence or information to the FO CR or PSC CA to review and to determine the next action on the protest from beneficiary per (GN 02613.450D.1).

2

If the beneficiary is requesting good cause, (see instructions in GN 02613.030B when the beneficiary is officially requesting good cause), evaluate per (GN 02613.025) (see Step 3).

If the beneficiary is requesting good cause and the beneficiary did not provide sufficient information, (See GN 02613.030B for instructions on processing requests for good cause), allow the beneficiary 90 days to obtain the needed evidence. Tickle/diary the case for 90 days via the MDW/PSC diary system to document the protest and to control return of the good cause evidence from the beneficiary. After additional documentation is received or at the end of 90 days, go to step 3.

If the beneficiary is protesting the fact that fugitive felon criteria are met, this is a reconsideration request. If it is received within the time frame for filing reconsideration, forward it to the appropriate PC Reconsideration Reviewer for action. If the request has been received after the close of the 60 day appeal period, also include any explanation provided by the beneficiary for failure to file a timely request. Reconsideration Reviewer should process per (GN02613.450D.1).

If the beneficiary is reporting satisfaction of a warrant, process per (GN 02613.500).

If the beneficiary has satisfied the warrant and is requesting deferral of overpayment recovery, evaluate and process per (GN 02613.450C).

3

If good cause has been requested and after evaluating the protest and the accompanying evidence or information, good cause can be granted, (see instructions in GN 02613.030 for information on processing requests to establish good cause), then process the case per (GN 02613.025C.6.a).

If good cause has been requested and after evaluating the protest and the accompanying evidence or information, good cause cannot be granted, process the case per GN 02613.025C.6.b.

NOTE: If SSA receives a timely protest before the end of the 30-day due process period but does not process it before the suspension occurs, reinstate benefits and evaluate the protest per the instructions in (GN 02613.450B).

1. FO or PSC actions necessary on the protest after suspension occurs

If a protest is received by the SSA FO or the PSC and the due process period has expired and the beneficiary is in suspension status, then the case will be processed per (GN 02613.450D). The SSA FO will forward the protest information to the jurisdictional PSC that handles the beneficiary’s claim based on the PCOC annotation in the ACCOUNT line on the MBR if the request (see GN 02613.450D for instructions on evaluating the protest) is for a reconsideration of the fugitive felon or probation or parole violation suspension decision. See (GN 02613.980C) for addresses for the PSC centers. If the protest is because the beneficiary wants to establish good cause (see GN 02613.030B for instructions on processing requests to establish good cause) or the protest is regarding the beneficiary satisfying his/her warrant, process per (GN 02613.450D).

2. FO or PSC CA review of evidence submitted on protest

If the evidence supports the individual's protest

then,

Document the facts and the final determination on the EVID screen.

See (GN 02613.025D). For instructions on preparing a Special Good Cause Determination if good cause is being alleged by the beneficiary to stop the fugitive felon or probation or parole violator suspension.

If the evidence is discrepant, appears to be fraudulent, altered, or cannot satisfactorily prove that the beneficiary can establish good cause for not satisfying his/her warrant or that the suspension criteria are not met

then,

Record information about the discrepant documents (e.g., how, when and where they were obtained). Develop all available information per (GN 04110.010); prepare a summary of the situation. Document the facts and the final determination per (GN 02613.025). Complete an SSA-8551-U4 per (GN 04111.010).

Send the documentation to the Regional Office of Investigations, Office of the Inspector General. Take the necessary steps to suspend benefits per (GN 02613.010).

If the issue involves interpretation of State law or the nature of a crime, classification of the crime or if the warrant is still unsatisfied

then,

See (GN 02613.175) for obtaining information about criminal charges (i.e., offense codes) on warrants or the classification of crimes.

See (GN 02613.001) and (GN 02613.010) for information on unsatisfied and satisfied warrants and dismissal of the warrant versus dismissal of the criminal charges on the warrant.

3. PSC — request for reconsideration — protest not received in due process period, beneficiary is in suspension status

If a protest is received by the SSA FO and the due process period has expired and the beneficiary is in suspension status, then the case will be processed as per (GN 02613.450D). If the beneficiary is protesting the fugitive felon or probation or parole violator suspension, forward to the information or protest to the appropriate PSC Reconsideration Reviewer for action.

PSC Reconsideration Reviewer actions on protest not received in due process period, beneficiary in suspension status.

Steps

Actions on Records and Evaluation of Information on Records

1

If T2 benefits are in suspension and a protest was received by SSA after suspension has occurred and due process has expired, then

Refer the case to the PSC Reconsideration Reviewer to process the protest from the beneficiary on SSA’s initial determination that the beneficiary has an outstanding fugitive felon or probation or parole violator warrant. No action is necessary to annotate the FFSCF system because the due process protest period has expired.

If the information or evidence submitted by the beneficiary is trying to provide information about the beneficiary’s suspension because of his/her outstanding warrant, then see (GN 02613.001) and (GN 02613.010) for additional information about outstanding warrants and SSA’s policy on suspending benefits for fugitive felon or probation or parole violator outstanding warrants.

If the evidence submitted by the beneficiary is trying to establish good cause for not satisfying the outstanding warrant (see instructions in GN 02613.030 for processing requests to establish good cause), then (see GN 02613.025 for requirements to establish good cause).

Go to step 3

If the Reconsideration Reviewer does not find sufficient evidence to establish good cause for not satisfying the warrant, then go to step 2.

If the Reconsideration Reviewer determines that the initial determination should be revised because good cause has been established for not satisfying the warrant, then resume benefits effective with the date of the warrant per (GN 02613.600B) (the resumption action cannot be done using the FFEL screen, a manual notice must be sent to the beneficiary), and update the FFDG screen, GOOD CAUSE DETERMINATION field on the FFSCF. Enter a GOOD CAUSE REASON per (GN 02613.930A) and MSOM PRISON 006.007.

NOTE: A manual resumption notice must be sent to the beneficiary to provide the next level of appeal. See the language used in (NL 00755.700) for a resumption action.

2

Update the FFDG screen GOOD CAUSE DETERMINATION field on the FFDG screen, enter a GOOD CAUSE DENIAL REASON per (GN 02613.930B) and MSOM PRISON 006.007, if not already completed.

A manual notice must be sent to the beneficiary notifying him/her of the reconsideration denial of his/her protest. The letter must provide the next level of appeal (i.e., ALJ hearing or appeals council review) since reconsideration of the initial determination regarding the fugitive felon or probation or parole violator suspension has already been accomplished. See language in (NL 00755.400) for suspension information to add to the notice.

3

If the Reconsideration Reviewer determines that the initial determination should be revised because the evidence provided by the beneficiary proves the warrant was satisfied before 1/1/2005 or before the beneficiary’s date of entitlement to Title II benefits or that SSA identified the wrong individual on the warrant (e.g., EVS code of A case) or the charges on the warrant are for a misdemeanor crime, not a felony, then resume benefits effective with the date of the warrant per (GN 02613.600B) (the resumption action cannot be done using the FFEL screen), a MADCAP/MACADE action must be done to resume benefits effective with the date of first month of fugitive felon suspension.

A manual notice must be sent to the beneficiary

NOTE: A manual resumption notice must be sent to the beneficiary to provide the next level of appeal. See (NL 00755.700) for language to use in the resumption notice.

NOTE: If SSA receives a timely protest before the end of the 30-day due process period but does not process it before the suspension occurs, reinstate benefits and evaluate the protest.

4. FO or PSC — suspension was in error without advance notice

See instructions in GN 03001.025C for processing if a suspense action (LAF S9 with RFST of FUGFEL) was taken without the required advance notice. See (GN 02613.940) for instances where advance notice is required for fugitive suspension processing. Process the case per (GN 02613.600).

5. FO or PSC good cause protest after suspension notice sent to the beneficiary

The beneficiary can request to establish mandatory good cause at any time (see GN 02613.025B.3.a for information on requesting mandatory good cause evidence). SSA will allow the beneficiary a 12 month period to request discretionary good cause. (See GN 02613.025B.3.b. and GN 02613.025B.3.c. for information on the 12-month period and requirements for discretionary good cause evidence). If good cause is requested within the 12 month discretionary good cause period (after the due process period has expired, SSA will not reinstate benefits pending the outcome of the request to establish good cause. SSA will accept an official request for good cause and allow the beneficiary 90 days from the date of contacting SSA to supply the good cause evidence. See (GN 02613.030) for instructions for processing requests for good cause.

E. Procedure- resume benefits

1. Rules for resuming benefits

Resume benefits the first month benefits were erroneously suspended LAF S9 on MBR with an RFST of FUGFEL on the MBR.

2. FO/PSC instructions - resuming benefits from LAF S9 using POS/FFEL

When we discover that a beneficiary has been erroneously suspended because the beneficiary:

  • established good cause (see GN 02613.025 for information on good cause) for not satisfying his/her warrant after suspension had occurred, or

  • protested timely during the due process period and benefits were inadvertently suspended by T2 R Finder before SSA could act on the protest, take the following actions; or

  • provides evidence that the warrant was satisfied within 30 days after the date it was issued.

Use the FFEL screen in POS system (see MSOM COMMON 005.035 for systems processing instructions for the FFEL screen) to resume benefits from LAF S9 to the beneficiary. Follow the instructions in the chart to resume benefits.

Steps

Action

1

From the POS path, select #8 on the POS Suspensions /Terminations and Reinstatements (PEST) submenu or

2

Add a “Y” in the RESUME BENEFITS EFFECTIVE WITH FIRST SUSPENSION MONTH on the FFEL screen. Enter a RESUMPTION REQUEST REASON: 4 = ERRONEOUS SUSPENSION. Benefits will be reinstated the month the benefits were first suspended for fugitive felon suspension.

For Establishment of Good Cause, post the following entries on the FFEL screen:

Add a “Y” in the RESUME BENEFITS EFFECTIVE WITH FIRST SUSPENSION MONTH on the FFEL screen. Enter a RESUMPTION REQUEST REASON: 3=Good Cause. Enter a GOOD CAUSE 3-digit CODE PER (GN 02613.930A).

3

Do not post a protest on the FFDG screen since the DUE PROCESS MATURITY DATE on the FFDG screen already matured.

For Establishment of GOOD CAUSE Cases, process information to the FFDG screen per (GN 02613.025C.6.a.) and MSOM PRISON 006.007. A good cause determination must also be made annotated to the EVID screen per (GN 02613.025C.6.a.).

4

Tickle the MDW for 7 working days until action updates to the MBR. If action does not work reinstatement action must be accomplished using MADCAP/MACADE FFEL screen will create a PCACS issue (see GN 02613.770C. for PCACS TOEL codes used in fugitive felon case processing) if the reinstatement input does not work. See (GN 02613.500B.2.) for processing instructions if the FFEL reinstatement action does not process correctly.

5

Check MBR to make sure beneficiary is in current payment status effective with the first month of suspension. (See GN 02613.600A.2., step 2.

6

Developing Representative Payee Suitability -- Check RPS in each case where the beneficiary/claimant has an outstanding felony warrant determining if he/she is serving as a representative payee.

Effective 4/2005, persons having an outstanding felony warrant are prohibited from serving as a payee. There are no exceptions to this prohibition. Refer to (GN 00502.133).

7

An automated reinstatement notice will be sent to the beneficiary by the T2 Notice system if the case successfully processes through T2. See (NL 00755.700) for the language that should be included in this notice.

F. Process - FO instructions - resuming benefits when POS/FFEL does not work

T2 exception cases occur when a resumption action input through POS/FFEL but does not properly resume benefits on the MBR. T2 exceptions are caused in different ways. Some examples are found in (GN 02613.600B.1).

1. Some systems processes resulting in a T2 exception

  • Processing limitations found in MSOM MCSEC 001.001; or,

  • An error exists on the Master Beneficiary Record (MBR).

These types of T2 exceptions will be generated to the PSC.

2. POS/FFEL processing resulting in a T2 exception

When FFEL resumption is input to POS, a T2 transaction is created. If an exception occurs:

  • T2 will not resume the benefit on the MBR;

  • It will create a PCACS Action Control Record (ACR) with Type of Event Level (TOEL). The TOEL Codes used in fugitive felon case processing are found in (GN 02613.770C).

When you input a Title II resumption action to the FFEL screen, T2 processes the resumption transaction and annotates the MBR that the beneficiary is in current payment status. If the MBR cannot be annotated with the resumption action, an exception is sent to the PSC.

G. Procedure - FO processing of T2 exception cases for FFEL - PCACS established

  • Tickle the case for 15 working days after PCACS is established to ensure the MBR is in LAF C.

  • If MBR does not reflect current payment status when diary matures, send a Fugitive Felon FAX follow-up on the resumption action to the PSC as indicated in the chart below:

Steps

Action

1

Prepare a Fugitive Felon Fax Form. (See the Fugitive Felon Fax Form and instructions in GN 02613.980.) Notify the PSC to resume benefits to the beneficiary and the date the resumption should begin.

2

Fax the form to the PSC that has jurisdiction over the beneficiary's SSN for action on the form.

3

Tell the PSC to send the appropriate resumption notice to the beneficiary.

4

Tickle the case via MDW for 7 working days. Check the MBR after 7 working days to ensure that benefits have been reinstated. Call the PSC when the diary matures and there is no resumption per (GN 02613.600C).

5

Forward all case materials to be associated with the folder after resumption has taken place for the beneficiary. Do not fax material. Annotate the material “Fugitive Felon Resumption Processed—Drop File Material. “Mail the documentation to the jurisdictional PSC address.

6

After Resumption action places the beneficiary in current pay, the case should be processed per (GN 02613.450C). SSA must consider the timely protest from the beneficiary.

H. FO processing –T2 FFEL exception — no PCACS issue exists

If no PCACS ACR exists, there should still be a record on the Transaction History Summary Screen (THIS), but assume that T2 did not create a TOEL transaction and

  • Use the Fugitive Felon FAX procedure (see GN 02613.980 for processing instructions). (Wait 1-2 days after the 35 advance notification period expires before faxing the PSC);

  • Check to ensure the resumption action is posted to the MBR.

NOTE: Developing Representative Payee Suitability -- Check RPS in each case where the beneficiary/claimant has an outstanding felony warrant to determine if he/she is serving as a representative payee.

Effective 4/2005, persons having an outstanding felony warrant are prohibited from serving as a payee. There are no exceptions to this prohibition. Refer to (GN 00502.133).


To Link to this section - Use this URL:
http://policy.ssa.gov/poms.nsf/lnx/0202613450
GN 02613.450 - Protest of Suspension and Deferral of Overpayment Recovery - 06/13/2014
Batch run: 06/13/2014
Rev:06/13/2014