Upon receiving a representative’s request to rescind an existing assignment, technicians
must:
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•
Identify the date the request was received; and
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•
Check the appropriate claims file to determine whether a determination or decision
has been issued.
If the request contains all the required information listed above, was received timely,
and there are no errors, inconsistencies, or other issues preventing us from processing
the rescission, the technicians will process the rescission request and update the
RASR application to indicate a rescission of assignment.
If the rescission request does not meet the above requirements, technicians will not
process the rescission request and will inform the representative that we are unable
to process the rescission request, and that unless the representative submits a rescission
request that meets the above requirements, the previously established assignment will
remain in effect.
Technicians must use the following dictated language:
“We received your request to rescind your assignment but are unable to process your
request because it is incomplete, contains incorrect information, or was untimely.
The most recent valid assignment remains in effect. Unless we receive a valid rescission
request, we will pay your authorized fee to [Entity Name] in accordance with agency
policy. To be valid, a rescission request must meet the requirements explained in
GN 03920.021B.4.a, and we must receive it before the date we notify the claimant of our first favorable
determination or decision.
If you are rescinding a prior assignment without making a new one, you must submit
an updated, current version of Form SSA-1696 with the claimant’s name and SSN, the
representative’s name and RepID, the “rescission of prior assignment” box checked
(in section 5, Part C), and the representative’s signature and date.
If you are rescinding a prior assignment by making a new one, you must submit an updated,
current version of Form SSA-1696 with the claimant’s name and SSN, the representative’s
name and RepID, the new entity’s name and EIN (in section 5, Part B), the “assignment”
box checked (in section 5, Part C), and the representative’s signature and date.”
NOTE: If technicians receive an SSA-1696 with a new entity listed in Part B and the “Assignment”
box in Part C is checked, this constitutes the rescission of any prior assignment.
We will rescind the previous assignment and reassign the direct payment to the new
entity listed in Part B of the form. Technicians can refer to the RASR User Guide
for instructions on rescinding an assignment.