TN 49 (02-06)
SI 00810.120 Income Determinations Involving Agents
This section deals with the actions of agents who conduct financial transactions on behalf of others, and the income policies that apply to such transactions.
An SSI beneficiary may be an agent for another person or have an agent acting on his or her behalf. When an agent takes part in a financial transaction that generates countable income, SSA must determine if the income is chargeable to the agent or to the SSI beneficiary by evaluating whether the agent acted on his or her own behalf or on behalf of the person he or she represented.
NOTE: References to an “SSI beneficiary” in this section include the SSI claimant and all individuals whose income and resources are subject to deeming.
An “agent” is a person or organization acting on behalf of another person or organization. The term “agent” applies to all individuals who act in a formal or informal fiduciary capacity, regardless of his or her titles (e.g., representative payees, guardians, conservators, etc.).
Income is any item an individual receives in cash or in-kind that can be used to meet his or her food or shelter needs (See SI 00810.005 – What is Income?).
C. Policy - SSI Beneficiary is an Agent
1. General Income Counting Rules
Monies an SSI beneficiary receives in his or her capacity as an agent on another’s behalf are not income to him or her.
Monies an SSI beneficiary receives for use on his or her own behalf are evaluated using regular income rules (See SI 00810.001).
2. Deposits to a Bank Account an Agent Held for Another Person
a. Account Correctly Titled
Deposits to the account are not income to the SSI beneficiary who is acting as an agent for another, if the title or designation of the bank account held for the other person reflects the agency relationship (See GN 00603.010, GN 02402.050 and GN 02402.055 for correct account titling).
b. Account Incorrectly Titled
Deposits to an incorrectly titled account are income to the SSI beneficiary acting as an agent for another, unless he or she deposits the money into the account for another person and disburses or intends to disburse the money from the account on the other person’s behalf (See SI 01120.020 for instructions concerning the treatment of resources when an agent is involved.)
3. Fees Received by an Agent
Agents are sometimes authorized to keep part of the funds he or she receives on behalf of another. An SSI beneficiary acting as an agent is charged with unearned income when he or she receives fees, commissions, or contributions for services he or she rendered.
4. Benefits Misused by an Agent
If an agent who is an SSI beneficiary misuses another’s funds, the misused funds are unearned income to the agent in the month received unless the agent makes restitution.
If an agent who is an SSI beneficiary makes restitution for the funds he or she misused, he or she is not charged with unearned income.
5. Receipt and Use of Funds from an Absent Household Member
Frequently an individual leaves home (e.g., is confined to a Title XIX facility) and all or part of his or her income is turned over to someone maintaining the home. When funds are turned over to an SSI beneficiary, the guidelines below apply for determining if the beneficiary is acting as an agent.
a. When the SSI Beneficiary is Assumed to be Acting as an Agent
Absent evidence to the contrary (See SI 00810.120C.5.b.), assume the SSI beneficiary is acting as an agent if he or she alleges the funds received are being:
used to maintain the home for the absent household member; or
used on behalf of the absent household member in some other manner (e.g., paying the absent individual’s life insurance premiums).
b. When the Absent Spouse is in a Medicaid Facility
If an SSI beneficiary, who is living at home has an absent spouse living in a Medicaid facility, the assumption in SI 00810.120C.5.a. may not apply. Further development is required to determine if the SSI beneficiary is acting as an agent for the absent spouse.
The assumption in SI 00810.120C.5.a. does not apply, if the State has determined that a certain amount of the institutionalized spouse’s income should be “assigned” to the at-home SSI beneficiary and the “assigned” amount is actually made available as cash income to the at-home SSI beneficiary for his or her own use. The cash income made available is unearned income to the SSI beneficiary. (States may use other terms for this income, such as “diverted income” or “protective maintenance income.”) In this situation, the SSI beneficiary is not acting as an agent because the money has been assigned to meet his or her own needs.
The assumption in SI 00810.120C.5.a. does apply, if the State does not assign a portion of the institutionalized spouse’s income to the at-home SSI beneficiary.
NOTE: The amount of money that an SSI beneficiary uses on behalf of the absent spouse is not cash income to the SSI beneficiary. However, the money may be outside in-kind support and maintenance (ISM) from the absent spouse when the at-home SSI beneficiary uses the money to pay the household operating expenses (See SI 00835.350).
REMINDER: If one member of an eligible couple is temporarily absent due to confinement in a Title XIX facility (See SI 00835.043), follow instructions in SI 02005.050 to determine SSI eligibility and payment.
c. Funds Received from an Absent Household Member
If any portion of funds received from an absent household member is for the SSI beneficiary’s personal use, the amount of cash income diverted to personal use is unearned income to the SSI beneficiary.
If another member of the SSI beneficiary’s household receives funds from the absent household member (See SI 00835.450).
D. Policy - SSI Beneficiary Has an Agent
1. General Income Counting Rules
Treat monies received by an agent acting on behalf of an SSI beneficiary as if the beneficiary received the monies directly. These monies are charged as income to the beneficiary when received by the agent, following the income-counting rules in SI 00810.010.
2. Misuse of Benefits by the Agent
If an SSI beneficiary's agent has been charged with misuse of funds and :
restitution has not been made, the amount of funds misused by the agent is not charged as income to the SSI beneficiary.
restitution is made by SSA or the agent directly to the SSI beneficiary, the amount restored is evaluated using regular income rules in SI 00810.010 in the month restitution is received.
The file must clearly show the relationship between an SSI beneficiary and another individual when an agency relationship exists. If the agent is chosen by a court or governmental agency, record any documents verifying the appointment (e.g., guardianship order) on the EVID screen (See GN 00301.288). If no document exists, contact the source of the appointment and record the information in the file (e.g., DROC or EVID screen).
The file must reflect why income was or was not charged to the SSI beneficiary, when financial transactions involving agents take place.
2. Fees Received by an Agent
Verify fees, commissions, or contributions provided to an SSI beneficiary for his or her services rendered as an agent using the guidelines in SI 00830.005. (See SI 00820.100 if there is an employer-employee relationship.)
3. Misuse of Benefits
Develop misuse as required by GN 00604.020 and document the file according to guidelines in GN 00604.030.
Adjust the SSI beneficiary's record, whose benefits were misused, by removing the misused benefits from the income posted to the SSI record.
Adjust the agent’s record, if he or she is an SSI beneficiary, to post unearned income equal to the amount of the misused benefits in the month(s) he or she received the misused benefits.
If SSA or the agent makes restitution for the misused benefits to the SSI beneficiary, charge the SSI beneficiary with unearned income in the month he or she receives the restitution payment.
If the agent is an SSI beneficiary and makes restitution for benefits he or she misused, adjust his or her record to remove the unearned income postings made for the misused benefits that have been restored.
NOTE: The rules of administrative finality must be followed when adjustments are made to the records of SSI beneficiaries (See SI 04070.010).
4. Receipt of Funds from an Absent Household Member
Record the SSI beneficiary's allegation regarding the use of an absent household member's funds using the MSSICS DPST screen, an SSA-795 or in the Remarks section of an SSA-8000 BK or SSA-8203-F6.
If evidence is presented which rebuts the presumption that the SSI beneficiary is acting as an agent (See SI 00810.120C.5.), record the evidence on the EVID or DROC screen or keep a copy of the evidence in file.
1. SSI Beneficiary Acting as Agent
Elizabeth Wolfe, an SSI beneficiary, is representative payee for her ineligible husband, Robert Wolfe, who receives title II benefits of $450/month. (Mr. and Mrs. Wolfe live in the same household.) Mrs. Wolfe is not charged with $450/month unearned income because she is receiving the title II benefit as an agent for her husband. However, $450/month is used in the spouse-to-spouse deeming computation to determine the amount of Mrs. Wolfe's deemed income.
2. State Acting as Agent for SSI Beneficiary and Receiving Funds on Its Own Behalf
Allen Jackson, an aged SSI beneficiary, is placed by the State of Maryland with a provider who is paid by the State. (This is not a foster care situation.) The State acts as representative payee for Mr. Jackson and receives $40/month from Mr. Jackson's relatives as reimbursement for paying the provider. The $40 is not income to Mr. Jackson because the State receives the money on its own behalf.
3. Agent Uses Money for Self and on Another's Behalf
Clara Dalloway, an SSI beneficiary, is legal guardian for her elderly sister. A friend of the family gives Mrs. Dalloway $120 and tells her that a third of it is for her sister. Mrs. Dalloway keeps $80 for herself and uses the rest to buy clothing for her sister. $80 represents unearned income to Mrs. Dalloway in the form of a gift. The $40 which was paid on her sister's behalf is not income to Mrs. Dalloway because she used this money in her capacity as an agent.
4. Monies from an Absent Household Member Used to Maintain Home and for Personal Use
Christine Duncan, an SSI beneficiary, rents an apartment with her cousin who goes into the hospital for an extended stay. Ms. Duncan reports to the FO that her cousin sent $200 to help with the rent and utility bills. Of the $200, Ms. Duncan needed only $175 for the household bills and used the remaining $25 to buy a birthday present for her brother. Because Ms. Duncan was acting as an agent for her cousin, the FO charges her only $25 in income since she made personal use of that portion of the $200. The FO also must determine whether Ms. Duncan received ISM (according to the rules in SI 00835.350) because of her cousin's payment of $175 toward the household bills.
5. SSI Beneficiary's Spouse Goes into a Medicaid Facility
Teddy Hollenbrook, an SSI beneficiary, reports to the FO that his wife, who was living with him, is now in a Medicaid facility. Mr. Hollenbrook states that the State Medicaid agency sends him $100/month from his wife’s funds. The FO calls the State agency and verifies that the State has assigned $100/month of Mrs. Hollenbrook’s income to Mr. Hollenbrook. Because Mr. Hollenbrook has $100/month available to him (assigned by the State), the FO charges him with $100/month in income.
GN 00602.001, Use of Benefits
GN 00604.060, Restitution of Misused Benefits
GN 00604.065, Misuse by Organizational or Volume Individual Payees
GN 00604.070, Misuse by Individual Payees Serving Fewer than 14
GN 02405.100, How to Process Unendorsed Title XVI Returned Checks
SI 04070.010, Title XVI Administrative Finality – General Reopening Policies