TN 2 (11-06)

NL 00755.300 Good Cause Language

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 March 18, 2011, upon remand from the Second Circuit, the District Court for the Southern District of New York certified a nationwide class in Clark v. Astrue that includes all individuals whose benefits or payments we suspended or denied after October 29, 2006. Given the pending litigation, including continuing litigation about the class certification, at this time we are not suspending or denying payments based solely on a report of a probation or parole violation warrant. Follow the instructions in EM-11032, dated May 9, 2011 for processing cases with probation or parole violation warrants with offense codes: 5011, 5012, 8101, 8102, or 9999 or “Blank” and an offense charge symbol of “probation or parole violation.”

We will make additional changes to this section, as necessary, in the future.

A. Procedure - Explaining Mandatory and Discretionary Good Cause (FO and PSC/OCO-ODO Instructions)

Good Cause Paragraphs to Use on Notices

UTI #

Explaining Mandatory and Discretionary Good Cause on the Appropriate Beneficiary Notice

Procedural Reference(s)

Mandatory Good Cause Paragraph UTI# FUG052

Discretionary Good Cause Paragraph UTI# FUG031

Good Cause Paragraphs for an Initial Award Plus Suspension Paragraph

NL 00755.100C.

GN 02613.025

NL 00755.900C.1.

Mandatory Good Cause Paragraph UTI# FUG030

Discretionary Good Cause Paragraph UTI# FUG031

Good Cause Paragraphs for the Advance Notice of Proposed Suspension

NL 00755.200A.2.b.

GN 02613.025

NL 00755.900C.2.

Mandatory Good Cause Paragraph UTI# FUG052

Discretionary Good Cause Paragraph UTI # FUG053

Good Cause Paragraphs for Suspension Notice

NL 00755.400

GN 02613.025

NL 00755.900C.3.

Mandatory Good Cause Paragraph UTI# FUG054

Discretionary Good Cause Paragraph UTI # FUG055

Good Cause Paragraphs for Closed Periods of Suspension

and for

Closed Periods of Suspension and Notices Overpayment

NL 00755.500

GN 02613.025

NL 00755.900C.4.

B. Procedure - Paragraphs That Explain What Evidence or Proof Is Necessary To Qualify For Good Cause

1. Paragraphs to Add to Beneficiary Notices to Explain What Evidence or Proof is Necessary to Prove Good Cause

Use the caption(s) and paragraphs in the following chart when SSA has examined the beneficiary’s case file and he/she can meet or cannot meet one or more of the good cause reasons, but additional evidence or information is needed from the beneficiary before SSA can make a good cause determination. (See GN 02613.025 for the good cause procedures. See NL 00755.900C.5. for the language used in the good cause paragraphs and captions that explain what evidence is necessary to prove good cause.)

IF:

the action is for an Initial Award Plus Suspension Notice

THEN:

Use:

caption UTI# MESCO2 before the already established good cause paragraph

Add:

already established good cause paragraph UTI# PAY157

Select:

one or more of the appropriate paragraph(s) to use with PAY157 that provides the good cause reason(s) that the beneficiary has already established based on evidence or records in the beneficiary’s file

FUG032

FUG033

FUG034

FUG035

FUG036

FUG037

FUG038

FUG039

Add:

UTI# PAY158 to notify the beneficiary what evidence or information is still needed to establish good cause.

Select:

one or more of the additional paragraphs from the list below to explain what additional evidence is needed to establish good cause for the beneficiary:

FUG042

FUG040

FUG041

FUG043

FUG044

FUG045

FUG046

IF:

the action is to send the Advance Notice of Proposed Suspension Notice

THEN:

Use:

Caption UTI# MESCO2 before the already established good cause paragraph

Add:

already established good cause paragraph UTI# PAY157

Select :

one or more of the appropriate paragraph(s) to with PAY157 that provides the good cause reason(s) that the beneficiary has already established based on evidence or records in the beneficiary’s file.

FUG032

FUG033

FUG034

FUG035

FUG036

FUG037

FUG038

FUG039

Add:

UTI# PAY158 to notify the beneficiary what evidence or information is still needed to establish good cause

Select:

one or more of the additional paragraph(s) from the list below to explain what additional evidence is needed to establish good cause:

FUG042

FUG040

FUG041

FUG043

FUG044

FUG045

FUG046

2. Paragraphs That Should Not Be Included in Specific Fugitive Felon Notices to the Beneficiary

IF:

Good Cause Paragraphs for Suspension Notices and Suspension Plus Overpayment Notices

and for

Closed Periods of Suspension and Closed Period of Suspension Plus Overpayment Notices

THEN:

Do not add PAY157 or PAY158 and their accompanying fugitive felon paragraphs to the suspension or closed period of suspension notice. At this point in time, an initial determination has been made to suspend monthly payments to the beneficiary because he/she has an outstanding warrant for more than 30 continuous days and the beneficiary could not establish good cause for not satisfying the warrant.

NOTE: Additional information regarding preparation of good cause approval notices and paragraphs is found in NL 00755.320C. Additional information regarding preparation of good cause denial notices and paragraphs is found in NL 00755.330.

C. Procedure - Good Cause Approval and Denial Paragraphs

See NL 00755.900C. for the language (i.e., paragraphs and captions) used to explain good cause to the beneficiary in fugitive felon notices.

See NL 00755.900F. for the language (i.e., paragraphs and captions) used to approve or deny good cause requests received from beneficiaries.

D. Procedure –Procedural References for Locating Notices Involving Good Cause

Type of Notice Involving Good Cause

Procedural Location

Initial Award Notice Plus Suspension for Fugitive Felon/Probation Parole Violator Suspension

NL 00755.100C.

Advance Notice of Proposed Suspension

NL 00755.200A.2.b.

Explaining Mandatory and Discretionary Good Cause To the Beneficiary

NL 00755.300A.

Good Cause Approval Paragraphs and Resumption Notices

NL 00755.320

Good Cause Denial Paragraphs and Notices

NL 00755.330

Fugitive Felon/Probation or Parole Violators Reinstatement Paragraphs and Notices

NL 00755.600

Fugitive Felon/Probation or Parole Violator Beneficiary Inadvertently Suspended Paragraphs

NL 00755.700


To Link to this section - Use this URL:
http://policy.ssa.gov/poms.nsf/lnx/0900755300
NL 00755.300 - Good Cause Language - 08/22/2011
Batch run: 08/22/2011
Rev:08/22/2011