TN 64 (09-09)
DI 11055.215 Resolving Representative Payee Issues
The field office (FO) has the responsibility for resolving representative payee issues, per GN 00501.015. For additional guidance in determining capability, see GN 00502.020.
Be alert to the possibility of having the Disability Determination Services (DDS) develop for capability.
A. Policy for an FO request for DDS capability development
If the FO cannot make a capability determination, but capability is questionable (e.g., allegation of schizophrenia or intellectual disability, other allegation of mental disorders, or other noticeable abnormal behavior of the individual), the FO can request the DDS to give an opinion on the issue of capability when making a disability determination. The FO may also simultaneously initiate and develop evidence of capability or evidence from the claimant’s doctor using an SSA-787 (Physician’s/Medical Officer’s Statement).
To request that the DDS develop capability, the FO must:
Check the box on SSA-3367 in the Electronic Disability Collect System (EDCS) Capability/Rmk section;
Document the most obvious mental abnormalities in the Observations section of the SSA-3367 (Disability Report – Field Office) in EDCS; and
Explain in the Remarks section of the SSA-3367 in EDCS why the DDS needs to develop capability.
NOTE: If the claim is an Electronic Folder exclusion, use the paper SSA-3367 to record observations (Section 9), explaining in the Remarks section (Section 11) the reason for the request for capability development. For additional information about electronic processing exclusions, see DI 81010.030. If the case is an MSSICS exclusion, include the remark “Capability Development Needed” in Section 11 (Remarks) of the SSA-831 (Disability Determination and Transmittal). For additional information, see MSOM MSSICS 001.003.
REMINDER: The FO must establish a list of third-party contacts (e.g., community organizations, family, or friends) that are able to support the claimant's allegation of mental illness.
B. Policy for a DDS request for FO payee development
Capability issues may arise as a result of the DDS development of medical evidence. In an allowed claim filed by a disabled individual, it may appear to the DDS that representative payee development is necessary; or conversely, that the FO must acquire a representative payee application from the claimant instead of a prospective representative payee. In such a case, if DDS has not transferred the claim back to the FO, the DDS contacts the FO via a message in eView, telephone, fax, or email and records on the DDS Query (DDSQ) a “U” in the CDF field to document the disposition of the unresolved development of the representative payee issue(s). If the FO finds the claimant incapable, the FO must initiate and develop a representative payee for the individual.
NOTE: The DDS alerts the FO (on the Remarks section of the SSA-831) when there is evidence in a Title XVI childhood case that:
the impairment relates to maternal substance abuse,
the child's mother or father suffers from substance abuse, or
the child is being abused.
The FO must then determine if the parent or legal guardian is the proper payee (see DDS Notification of Allegations That Could Cast Doubt on Payee Suitability GN 00502.137).