Whether a claimant, who is found incompetent to stand trial and committed to a mental-health
institution by a guardian pursuant to Missouri Revised Statutes § 552.020.11(6), is
eligible for benefits reinstatement due to a change in her commitment status from
criminal to civil under Chapter 475 and section 632.120.
We conclude that a change in commitment status does not permit benefits reinstatement
when, as in this case, the claimant remains confined by court order in an institution
at public expense.
C~'s (the claimant’s) disability insurance benefits under Title II were suspended
effective October 2006, after the Circuit Court of the City of St. Louis determined
she was “incompetent to proceed” in relation to her criminal charges and committed
her to Fulton State Hospital (FSH). On November XX, 2007, the Circuit Court of the
City of St. Louis Probate Division (Probate Division) entered Judgment finding that
the claimant was totally incapacitated due to a mental or physical condition and was
unable to care for herself. Because of her total incapacity, the Public Administrator
for the City of St. Louis, was appointed as her guardian under Missouri Revised Statutes
Chapter 475 (Probate code). The Probate Division found that the claimant’s condition
required placement in a supervised living situation to be selected by her guardian.
It also ordered the guardian to file an annual report to apprise it of the claimant’s
status. On January XX, 2008, the Circuit Court of the City of St. Louis entered a
Judgment and Order to Dismiss Charges. In its order, the Court found that the claimant
lacked the mental fitness to proceed in the criminal matter and there was no substantial
probability that she would be mentally fit to proceed in the future. Therefore, the
Court dismissed the criminal charges without prejudice pursuant to section 552.020.11(6)
of the Missouri Revised Statutes. The Court also took judicial notice of the Probate
Division’s finding that the claimant was incapacitated. According to hand-written
notations on the January 2008 Order, the claimant’s commitment at FSH changed from
“Incompetent to Proceed” to Voluntary by Guardian effective January XX, 2008. The
claimant remained at FSH until April XX, 2011, when she was transferred to St. Louis
Psychiatric Rehabilitation Center (SLPRC). Both FSH and SLPRC are operated by the
Missouri Department of Mental Health. See https://dmh.mo.gov/mentalillness/mohealthhomes.html . SLPRC provides “long-term inpatient psychiatric treatment and psychosocial rehabilitation
services to adults . . . who are recovering from a severe and persistent mental illness
for which they were criminally committed.” https://dmh.mo.gov/slprc/ .On April 29, 2011, the Reimbursement Officer for SLPRC, requested that the agency
reinstate the claimant’s Title II benefits based on the claimant’s change in status
to “Voluntary by Guardian.” Attached documentation noted the following potential payers
for the claimant’s care: MST (likely Missouri State Treasurer), Insurance Plan, Medicare,
Medicaid, Food Stamps, and SSA. The documentation also noted that the claimant’s current
care fell under the Missouri Department of Mental Health’s Comprehensive Psychiatric
Services (CPS) Division. See https://dmh.mo.gov/docs/acronyms.pdf.. We assume that the agency did not reinstate benefits in response to this request.
In a Judgment dated June XX, 2016, the Probate Division identified the claimant as
its ward. It ordered that costs associated with the claimant’s probate matter be paid
by the City of St. Louis. On April XX, 2017, the Public Administrator for the City
of St. Louis, was substituted for as the claimant’s guardian.
Section 202(x)(1)(A)(ii)(III) of the Social Security Act (Act), 42 U.S.C. § 402(x)(1)(A)(ii)(III),
prohibits payment of Title II benefits to an individual who “is confined by court
order in an institution at public expense in connection with– . . . a finding that
[the] individual is incompetent to stand trial under an allegation of [a criminal]
offense.” An individual remains confined until “(I) he or she is released from the
care and supervision of such institution, and (II) such institution ceases to meet
the individual’s basic living needs.” 42 U.S.C. § 402(x)(1)(B)(ii)(I and II). The
purpose of section 402( x) is to “deny benefits to those persons whose needs are being
provided at public expense due to their confinement.” Wilkins v. Callahan, 127 F.3d 1260, 1262 (10th Cir. 1997).
Missouri law sets forth the procedure for committing individuals to state facilities
when they have been deemed incompetent to stand trial. See
Mo. Rev. Stat. § 552.020.11(6). When an individual lacks the mental fitness to proceed
in a criminal matter and is unlikely to be competent to proceed in the future, then
the court shall dismiss the criminal charges only if the accused is involuntarily
detained under Chapter 632 or deemed incapacitated under Chapter 475 and committed
to a mental-health facility by a guardian pursuant to section 632.120. See Mo. Rev. Stat. § 552.020.11(6); State v. Moore, 952 S.W.2d 812, 814 (Mo. Ct. App. 1997) (discussing subsection (6)).
Program Operations Manual System (POMS) GN 02607.330 outlines agency policy for individuals determined Incompetent to Stand Trial (IST)
by courts. If after a court drops criminal charges and the claimant’s commitment becomes
“civil” or “voluntary” instead of criminal, the claimant’s benefits remain suspended
until the institution “officially releases” the beneficiary and ceases to provide him or her with basic living needs. See POMS GN 02607.330.A.
Since 2006, the claimant has been confined to state institutions. In addition, all available evidence indicates that the claimant’s basic living needs
are provided by the state institution at the public expense. See POMS GN 02607.850.A.1.b (basic living needs means the institution provides the inmate with food, clothing,
and shelter) . Although the claimant’s commitment status was changed from criminal to incapacitated
under Chapter 475, a change in commitment status does not permit resumption of benefits
unless the institution releases the beneficiary and ceases to provide for her basic
§ 402(x)(1)(B)(ii); POMS GN 02607.330.A. Because the claimant remains incapacitated and confined to a public institution
and held at the public expense, her Title II benefits should remain in suspense.
Based on the information you have given us, we believe you would be justified in concluding
that the claimant’s benefits should remain in suspense.