When direct payment is prohibited based on legal evidence, you do not need to develop
If you suspect or receive a lead that the beneficiary has a mental or physical condition
that prevents him or her from managing or directing someone else to manage benefits,
you must make a capability determination.
Consider the following when assessing the need for capability development:
Does the individual have difficulty answering questions, getting the evidence or information
necessary to pursue the claim, or understanding explanations and reporting instructions?
If yes, do you think this difficulty indicates the beneficiary cannot manage or direct
the management of benefits?
Do not assume you need capability development solely based on the disability diagnosis.
Develop capability only if there is an indication that the beneficiary cannot manage
or direct the management of his or her benefits.
CAUTION: Do not delay or suspend benefits while developing capability, unless noted in the
exceptions to immediate payment, per GN 00504.105 Direct payment to Incapable Beneficiaries When Further Payee Development is Needed.