TN 4 (12-06)

GN 02613.840 Granting Requests for Relief Under the Fowlkes Acquiescence Ruling (AR)

A. Process – Factors for Determining if Fowlkes Relief Applies

See criteria for determining whether the Social Security Administration (SSA) can grant Fowlkes AR relief per GN 02613.810B.

B. Process – Residence of Beneficiary

1. Determining Beneficiary Residence for SSA’s Initial or Administrative Review Determination

The SSA technician will use the beneficiary’s or claimant’s address reflected on the initial suspension notice or the administrative review determination notice in conjunction with the beneficiary’s address on the Master Beneficiary Record (MBR) to determine where the beneficiary resided when SSA made its initial fugitive felon suspension decision or a fugitive felon suspension administrative appeal decision. The city and state (or foreign country) reflected on the initial fugitive felon suspension/overpayment notice or the administrative appeal notice will show where the beneficiary was living/and or receiving his/her mail at the time he/she received notification from SSA regarding the fugitive felon suspension determination or decision. See GN 02613.810A.5. for general information on the residence of an individual when considering Fowlkes AR relief.

CAUTION: If the MBR mailing address contains a PO Box or an “in care of “ address, the allegation of residing in CT, NY or VT must be investigated and verified to ensure that SSA can consider granting relief under the Fowlkes AR. See GN 02613.830B.1. step 3, for information on developing for residency verification.

The SSA technician will use the Online Retrieval System (ORS) to view copies of initial fugitive felon suspension letters or administrative appeal letters sent to beneficiaries and claimants.

CAUTION: Do not use the date on the advance notice of proposed suspension as the SSA date for determining if Fowlkes AR relief can be granted to the beneficiary. The notice date on the SSA initial suspension/overpayment notice, or the subsequent reconsideration notice, or the administrative law judge hearing notice or appeals council review decision notice will be the dates considered when evaluating the request for Fowlkes AR relief.

If there is a conflict between the mailing address on the beneficiary initial suspension/overpayment or the administrative review notice and the address on the MBR, residency of the beneficiary must be investigated. SSA must determine if the beneficiary maintains a permanent residence in CT, NY, or VT effective December 2005 or later. See GN 02613.830 for a discussion on residency issues under Fowlkes AR case processing. See GN 02613.850 for instructions on residency in the second circuit when requesting relief under the Fowlkes AR.

2. Determining Residence for Fully Favorable Relief

In order to qualify for fully favorable relief under the Fowlkes AR (i.e., continuing monthly benefit payment without regard to fugitive felon suspension) the beneficiary must reside in CT, NY or VT after December 6, 2005 when the beneficiary files a request for Fowlkes AR relief per GN 02613.810B. The beneficiary must also remain in the Second Circuit until after SSA makes its Fowlkes AR relief determination and sends the beneficiary a notice of the decision in order to continue receiving monthly benefit payments.

CAUTION: If the beneficiary alleges residing in CT, NY, VT and the beneficiary’s mailing address contains a PO Box or an “in care of address,” the allegation of residing in CT, NY or VT must be investigated and verified to ensure that SSA can consider granting relief under the Fowlkes AR. See GN 02613.830B.1. step 3, for information on developing for residency verification.

3. Determining Residence for Partially Favorable Relief

If the beneficiary does not reside in the Second Circuit when he/she files his request or relief under the Fowlkes AR, SSA will only reinstate Title II benefits for the period of time (i.e., closed period of relief) fugitive felon suspension was imposed on the record on or after December 2005 through the month before the beneficiary left the Second Circuit to reside in another State other than CT, NY or VT, or in another country. See GN 02613.810B.2. for further information on partially favorable relief under the Fowlkes AR.

CAUTION: If the beneficiary alleges residing in CT, NY, VT during the closed payment period of Fowlkes AR relief and the beneficiary’s mailing address contained a PO Box or an “in care of address,” the allegation of residing in CT, NY or VT for the closed payment period must be investigated and verified to ensure that SSA can consider granting partially favorable relief under the Fowlkes AR. See GN 02613.830B.1. step 3 and GN 02613.830B.1, step 4, for information on developing for residency verification.

C. Process – Granting Relief Under the Fowlkes AR

If the beneficiary meets the criteria in GN 02613.810B., the beneficiary can be granted relief (i.e., either fully favorable or partially favorable relief) under the Fowlkes AR. Benefits will be resumed retroactive to the month/year fugitive felon suspension was first applied to the record based on SSA’s initial suspension determination or administrative review determination on which the beneficiary is requesting relief under the Fowlkes AR, and ongoing if the beneficiary is granted fully favorable relief. If the beneficiary is granted partially favorable relief, benefits can only be reinstated retroactive to the month/year fugitive felon suspension was first applied to the record through the month before he/she left the Second Circuit (i.e., CT, NY or VT). Benefits will be suspended effective with the month the beneficiary left the Second Circuit until the point in time the outstanding felony warrant is satisfied or good cause is established for not satisfying the warrant.

1. FO/ PSC - Resuming Benefits –Fully Favorable Relief Granted

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

a. FO/PSC Instructions - Resuming Benefits From LAF S9 USING POS/FFEL

Use the (FFEL) screen in (POS) system (see MSOMCOMMON 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 below:

Steps

Actions

1

FO instructions: From the POS path, select #8 on the POS Suspensions /Terminations and Reinstatements (PEST) submenu. Go to Step 2.

PSC instructions: Use MACADE to resume benefits. Go to Step 2.

2

Add a “Y” in the RESUME BENEFITS EFFECTIVE WITH FIRST SUSPENSION MONTH on the FFEL screen.

Enter a RESUMPTION REQUEST REASON: 3 = GOOD CAUSE.

(Benefits will be reinstated the month the benefits were first suspended for fugitive felon suspension.)

Enter a good cause reason: IF RESUMPTION REQUESTED FOR GOOD CAUSE, ENTER GOOD CAUSE REASON: DNH

NOTE: The good cause reason DNH has been amended to grant relief under the Fowlkes AR. The DNH reason will now represent the following: DNH – Individual is residing in a long-term nursing home or mental treatment/care facility OR is granted relief under the Fowlkes AR as a resident of the Second Circuit.”

NOTE: Do not prepare a good cause determination.

Annotate the Special Message Field of the MBR, “Fowlkes ARFULLY FAVORABLE Relief is Granted, Eff MM/DD/YYYY for Warrant No. ########, Dated MM/DD/YYYY.”

Complete FFSCF entries on the Felony warrant Due Process/Good Cause screen (FFDG), answer “Y” to GOOD CAUSE ESTABLISHED and enter “DNH” for the GOOD CAUSE REASON.

3

Check the MBR and the THIS Query on MFQ the following day to ensure that your POS input processed successfully. Tickle the Modernized Development Worksheet (MDW) for 7 working days until action updates to the MBR.

4

Send a Fugitive Felon Exclusion Fax Request to the appropriate PSC if a processing exception occurred. Complete the CAN, BOAN, NAME and BIC. Check “OTHER” for Exclusion Category and write in the REMARKS, “PRIORITY – FOWLKES COURT CASE – RESUME BENEFITS EFF MM/YYYY.” See a copy of the FF Exclusion Fax Form for Fowlkes Case Processing at GN 02613.855.

5

Developing Representative Payee Suitability – Check RPS in each case where the beneficiary has self-reported an outstanding felony warrant. Determine if he/she is serving as a representative payee. If so, process per GN 00504.102.

6

An automated Title II reinstatement notice will be sent to the beneficiary by the T2 Notice system if the case successfully processed through the Title II system. This notice will not provide complete resumption information regarding the relief granted under the Fowlkes AR.

SSA must send the beneficiary a second manual notice prepared in accordance with language provided in GN 02613.856A and GN 02613.856C.1.

b. FO Instructions - Resuming Benefits When POS/FFEL Does Not Work

Title II exception cases occur when a resumption action input through POS/FFEL but does not properly resume benefits on the MBR. Title II exceptions are caused in different ways. Some examples are found in GN 02613.600B.1. Title II exception cases will be referred to the PSC for processing per GN 02613.840C.1.a., Step 4.

c. PSC Instructions for Resuming Benefits –Fully Favorable Relief Granted

The PSC must manually resume benefits via MACADE/MADCAP when the POS/FFEL screen does not process correctly. In those instances, process as indicated below:

  • Resume benefits via MACADE.

  • The FFEL data input via POS will be on the T2 Shared database. There is no need to renter data on the screen

  • Add a Special Message Field to the MBR: “FOWLKES AR FULLY FAVORABLE RELIEF IS GRANTED EFF MM/YYYY FOR WARRANT NO ########## DATED MM/DD/YYY.”

  • Complete FFSCF. On the Felony warrant Due Process/Good Cause Screen (FFDG), answer “Y” to GOOD CAUSE ESTABLISHED, and use “DNH” code for the GOOD CAUSE REASON.

  • Send a reinstatement notice. GN 03501.015D provides information on the inclusion of appeal rights in the notice. It also provides notice language for the different decisions that may result in the case review. Remember to send a copy of the notice to the Online Retrieval System (ORS). See GN02613.840C.1.d for additional language to add to the resumption notice to explain the Fowlkes AR.

d. PSC MACADE Resumption Notice Actions

Include the following approved language (from GN 03501.015D.6) in reinstatement or repayment notices in Fowlkes cases in the Program Centers on the basis of (MACADE) transactions:

“You asked us to look at the earlier decision on your claim because you thought the Fowlkes v Adamec acquiescence ruling could change the prior determination or decision we made. We have looked at your case and decided that application of the Fowlkes v. Adamec acquiescence ruling does change the prior determination or decision in your case and we will grant all benefits you requested in your application. If you believe this decision is not correct you have 60 days from the date you receive this notice to request appeal of our decision.”

See GN 02613.856.D.3. for additional information on language that must be added to the resumption notice.

2. FO/PSC Instructions - Beneficiary Is Not/Was Not Suspended for Fugitive Felon Suspension

Beneficiary is granted relief under the Fowlkes AR. SSA never suspended Title II benefits for fugitive felon suspension but there is an outstanding warrant on the FFSCF database:

  • Update the FFDG screen, answer “Y” to the GOOD CAUSE REASON field and add “DNH” as the GOOD CAUSE REASON. See GN 02613.930A for information on the Good Cause Establishment Reasons.

  • Send the beneficiary a notice advising him/her that the request for Fowlkes AR relief is being granted. The notice will contain administrative appeal rights. See GN 02613.856A.1. for notice instructions when fully favorable relief is granted under the Fowlkes AR. See also an example of the notice as reflected in GN 02613.856C.1.

  • Annotate the Special Message Field of the MBR, “Fowlkes AR Fully Favorable Relief is Granted, effective MM/DD/YYYY for Warrant No. ########, Dated MM/DD/CCYY.” if not already done by the FO.

3. FO/PSC Processing—Reinstating Benefits For a Closed Period When Partially Favorable Relief Granted Under Fowlkes AR

a. FO Processing When Granting Partially Favorable Relief

Cases that require payment of benefits for a partially favorable relief closed payment period under the Fowlkes AR will be processed by the PSC after the FO makes the partially favorable relief determination based on the instructions in GN 02613.810B. and GN 02613.830B.1.using the method indicated below:

Steps

Actions

1

Process the case per GN 02613.830B.1. Go to Step 2.

2

Send a Fugitive Felon Exclusion Fax Request to the appropriate PC if a processing exception occurred. Complete the CAN, BOAN, NAME and BIC. Check “OTHER” for Exclusion Category and write in the REMARKS, “PRIORITY – FOWLKES COURT CASE – RESUME BENEFITS EFF MM/CCYY THROUGH MM/CCYY--PARTIALLY FAVORABLE RELIEF GRANTED.” See a copy of the FF Exclusion Fax Form for Fowlkes Case Processing at GN 02613.855.

3

Developing Representative Payee Suitability -- Check RPS in each case where the beneficiary has an self-reported an outstanding felony warrant. Determine if he/she is serving as a representative payee. If so, process per GN 00504.102.

b. PSC Instructions on Partially Favorable Relief Granted Case

The PSC should process partially favorable relief closed period payment cases as indicated below:

The PSC must manually resume and suspend benefits via MACADE/MADCAP using the instructions below:

Steps

Actions

1

From the MACADE path, Select #5 (ENTITLEMENT AND ELIGIBILITY MENU) is selected on the TRANS TO field and select #31 FUGITIVE FELON (FFEL) on the ENTITLEMENT AND ELIGIBILITY MENU,

2

Add a “Y” in the RESUME BENEFITS EFFECTIVE WITH FIRST SUSPENSION MONTH on the FFEL screen.

Enter a RESUMPTION REQUEST REASON: 3 = GOOD CAUSE.

(Benefits will be reinstated the month the benefits were first suspended for fugitive felon suspension.)

Enter a good cause reason: IF RESUMPTION REQUESTED FOR GOOD CAUSE, ENTER GOOD CAUSE REASON: DNH

NOTE: The good cause reason DNH has been amended to grant relief under the Fowlkes AR. The DNH reason will now represent the following: DNH – Individual is residing in a long-term nursing home or mental treatment/care facility OR is granted relief under the Fowlkes AR as a resident of the Second Circuit.”

Annotate the Special Message Field of the MBR, “Fowlkes PARTIALLY FAVORABLE AR Relief is Granted, effective MM/DD/YYYY for Warrant No. ########, Dated MM/DD/YYYY.”

3

Benefits to the beneficiary must be suspended because the beneficiary is no longer residing in the Second Circuit. Go to Step 4.

4

Warrant information must be added to the FFSCF to allow SSA to reimpose the fugitive felon suspension once the beneficiary moves out of the Second Circuit. In order to suspend the beneficiary once again for the outstanding warrant, a dummy warrant must be added to the FFSCF that contains almost the same warrant information as previously record on the FFSCF. Prepare the dummy warrant as follows:

Establish a new warrant on the FFSCF per MSOM PRISON 006.003.

Use the warrant data already existing on the FFSCF for the felony warrant on which Fowlkes AR relief was granted to populate the new fictitious warrant, except for the warrant date and warrant number.

Establish the dummy warrant information on the FFMN screen, add:

  • SSN—SSN of the account on which SSA will suspend benefits

  • WARRANT DATE -- (add in a date equal to the MMDDCCYY that the beneficiary left the Second Circuit—month the beneficiary no longer resided in CT, NY or VT)

  • Originating Agency Indicator (ORI) –use SSA000000 instead of the existing ORI number for the outstanding felony warrant on which the Fowlkes AR relief was granted.

Go to the FFWI screen and add the following:

  • WARRANT NUMBER: use the warrant number on the FFSCF on which Fowlkes AR relief was granted

  • WARRANT ISSUING STATE: place the State code from the warrant on which the Fowlkes AR relief warrant was granted.

  • OIG REFERRAL (Y/N): Enter “N”

Add in any other information from the felony warrant on which the Fowlkes AR relief was granted. The additional warrant information from this warrant can be obtained from the query screen (FFWQ) for this warrant.

Go to the FFWD Screen and add the following:

  • SELECT FUGITIVE FELON STATUS: 1 FELONY CHARGE(S)/OUTSTANING WARRANT

  • ENTER WARRANT STATUS: 1 = OPEN

5

Annotate the Special Message Field of the MBR, “BIC Xx left 2nd Cir eff MM/DD/CCYY --Fowlkes AR No Longer Applies Reinstate Warrant No. ########, Dated MM/DD/CCYY.”

Suspend benefits using MACAP/MACADE using the FFEL per MSOM COMMON 005.035. The warrant date for this action should be the date the beneficiary left his/her residence in the Second Circuit, not the original warrant date. See GN 02613.840C.3 for information regarding partially favorable relief determinations and residency.

6

Generate an incomplete notice using MADCAP/MACDE. Include in the notice information regarding the partially favorable period of relief granted under the Fowlkes AR. See information in GN 02613.840C.3.c. and GN 02613.856A.1.b. for the notice language to use in the manual notice to the beneficiary explaining the partially favorable relief granted under the Fowlkes AR.

NOTE: The PSC will continue to be responsible for MADCAP/MACADE inputs.

c. PSC MACADE Partially Favorable (Closed Payment Period) Fowlkes AR Notice Actions

Include the following approved language (from GN 03501.015D.6) in reinstatement or repayment notices on Fowlkes cases in the Program Centers on the basis of MACADE transactions:

“You asked us to look at the earlier decision on your claim because you thought the Fowlkes v Adamec acquiescence ruling could change the prior determination or decision we made. We have looked at your case and decided that application of the Fowlkes v. Adamec acquiescence ruling does change the prior determination or decision in your case for the period MM/YYYY through MM/YYYY while you resided in CT, NY or VT. We will grant these benefits to you for this period based on your application. If you believe this decision is not correct you have 60 days from the date you receive this notice to request appeal of our decision.”

Add to the notice suspension paragraph below to explain the resumption of suspension status due to the outstanding warrant and the fact that Fowlkes AR relief can no longer be granted because the beneficiary is now residing outside of the Second Circuit. Fill-in #2 of the paragraph should be completed with the date (MM/CCYY) the beneficiary left the Second Circuit (i.e., CT, NY or VT).

“We cannot pay benefits to *F1 beginning *F2 because *F3 an outstanding arrest warrant for a felony crime and *F4 no longer lives in Connecticut, New York or Vermont.”

*F1 – pronoun (you/beneficiary name)

*F2 – MM/CCYY (date beneficiary left Second Circuit)

*F3 – pronoun (you have/he has/she has/beneficiary name has)

*F4 – pronoun (you/beneficiary name)

Also add in the following language and caption in the notice about the original information on the outstanding felony warrant on which SSA is reimposing suspension.

INFCO1

FUG057 (use the warrant information from the original outstanding warrant on which SSA suspended the beneficiary)

Add in reconsideration and appeals language as appropriate.

See an example of the notice to send to the beneficiary in partially favorable relief cases in GN 02613.856C.4.


To Link to this section - Use this URL:
http://policy.ssa.gov/poms.nsf/lnx/0202613840
GN 02613.840 - Granting Requests for Relief Under the Fowlkes Acquiescence Ruling (AR) - 12/04/2006
Batch run: 01/27/2009
Rev:12/04/2006