PROGRAM OPERATIONS MANUAL SYSTEMPart GN – GeneralChapter 006 – Use and Accountability of BenefitsSubchapter 02 – Use of BenefitsTransmittal No. 16, 03/09/2020
A QAT does not change or introduce new policy or procedure.
Summary of Changes
GN 00602.100 Exchange of Information with the Department of Veterans Affairs—Representative Payee's and Fiduciary's Improper Use or Misuse of Benefits
Subsection B: Removed GN 03316.025 hyperlink since this is now an archived POMS reference.
The VA fiduciary program is similar to SSA's representative payee program. VA fiduciaries (fiduciaries) and representative payees (payees) both manage use of benefits. Both programs have nearly the same definitions of misuse and improper use:
For the VA's definition of misuse, see VA
Both programs define improper use as an unwise expenditure of benefits that is not in the beneficiary's best interest.
When either agency investigates misuse of benefits by someone serving as both payee and fiduciary, the two agencies share information and may cooperate to investigate. This section defines the appropriate communication methods for sharing information about misuse or improper use.
VA staff notify SSA's OIG if they are investigating or find misuse by a VA fiduciary who is also a payee.
SSA must notify the VA if we find improper use by a fiduciary. We must also notify the VA if we are investigating or have found misuse by a payee who is also a fiduciary. Do not notify the VA of misuse allegations dismissed as unfounded.
To aid investigation of misuse of benefits in either program, SSA has the authority to disclose information from program records to the VA. Include the beneficiary SSN in the email to the VA. This is a permissible use of program information that does not require the record holder’s consent. REMEMBER: In any correspondence with the VA concerning improper use or misuse of benefits, it is important to disclose only the information that is relevant and necessary to the investigation. For disclosure policy, see GN
The VA makes initial reports about misuse to SSA's OIG using the OIG Fraud Hotline. OIG refers reports to the FO. Follow the procedure below to exchange information that will aid investigation of these cases.
The FO records the allegation in eRPS Misuse and develops the misuse allegation or addresses the improper use of SSA benefits per GN 00604.001 through GN 00604.075.
The FO claims specialist follows up with the VA about these cases using the Fiduciary Hub email address for the corresponding state found in GN 00602.100E, plus the email of any VA staff already contacted about the case. In emails, disclose only information that is relevant and necessary to the investigation.
If you find that a VA fiduciary is not performing his or her duties in the veteran's best interests, or if you are investigating or have found misuse by a payee who is also a VA fiduciary, report the information to the VA Fiduciary Hub e-mail address and your regional representative payee coordinator. To determine the proper hub address depending on the state, see GN 00602.100E.
IMPORTANT: When you report to the VA, only disclose information that is relevant and necessary to the investigation.
In some situations, it may be appropriate to incorporate paragraphs in GN 00602.090C.1.
The VA directs follow-up correspondence to you and the regional CPS mailbox.
VA Fiduciary Hub address
FL, GA, NC, SC
AL, DC, KY, MS, PR, TN, VA, WV
AR, IA, IL, LA, MN, MO, WI
AK, AZ, CA, CO, HI, ID, MT, NM, NV, OR, UT, WA, WY
If you become aware that a VA staff member is directing a payee's use of SSA benefits, contact the VA staff member directly to resolve the conflict, following guidance in GN
If you cannot resolve the conflict, refer the case to your regional payee coordinator, who will report the issue to the VA central office.