PROGRAM OPERATIONS MANUAL SYSTEMPart DI – Disability InsuranceChapter 265 – Initial Case ProcessingSubchapter 35 – Notice InstructionsTransmittal No. 7, 01/23/2024
The Office of Disability Policy created this section to delineate the parties that must receive communication throughout the claims process by clearly defining the recipients and providing table guidance.
Summary of Changes
DI 26535.042 Recipients of Correspondence and Notices
This new section provides comprehensive information regarding recipients of correspondence and notices when multiple parties are involved. (i.e. appointed representatives, legal guardians.). The table addresses such situations.
This section provides definitions of individuals and entities with whom we correspond and send notices. In addition, this section outlines who must receive correspondence when multiple parties are authorized to act on behalf of a claimant or are designated to assist a claimant.
An individual claiming a right under the Title II or Title XVI benefits program. The terms applicant, beneficiary, and recipient may be used interchangeably when referring to the individual claiming a right to benefits.
An individual who submits a claim for benefits on behalf of themselves, or on behalf of another person.
For more information on proper applicants, see GN 00204.003.
An individual the claimant appoints to represent them in their business before the Social Security Administration (SSA) (i.e., to act on the claimant's behalf and pursue the claimant's interests).
For more information on representation of claimants, see DI 31001.001.
An individual who is declared incompetent by a court and for whom a legal guardian has been appointed. While the appointment of a legal guardian does not necessarily mean the individual is legally incompetent, a guardian has a duty to act on behalf of the individual for whom they are appointed.
For more information on a legally incompetent adult, see GN 00204.003.
An individual or entity responsible for managing Social Security benefits or payments of a beneficiary or recipient who is determined incapable of managing or directing the management of their own benefits.
A representative payee does not have the same rights as a legal guardian unless they are also the legal guardian. We may only disclose information to current representative payees that the individual needs to perform the duties of representative payee (e.g., to receive and disburse or conserve the beneficiary’s Social Security benefits). For additional information about disclosure and modified notices to payees, see GN 03316.120 and NL 00603.025A.2.
A payee must receive correspondence so they may act on behalf of the beneficiary, when necessary, on matters relating to the beneficiary’s claim.
For more information on payee responsibilities and duties, see GN 00502.114.
An individual appointed by a state court to manage the affairs of an individual who is not able to do so. However, the appointment of a legal guardian or conservator does not necessarily mean the person is legally incompetent.
For more information on the role of the legal guardian or conservator, see GN
In some instances, other individuals or entities, as defined in DI 26535.041A in this section, who have a duty or responsibility to act on behalf of a claimant or beneficiary must receive all correspondence or notices that the claimant also receives to fulfill the duty they have to the claimant.
An adult claimant, including individuals who have attained age 18 in an age-18 redetermination case, is the primary recipient of correspondence and notices.
If the claim involves
Applicant who is NOT a claimant, Payee, or AR
The Payee receives a modified copy of the notice. For more information, see NL
For claimants under age 18 and adult claimants with a legal guardian, the primary recipient of notices and correspondence is the parent or legal guardian.
Child claimants and adult claimants with a legal guardian