TN 50 (03-19)

GN 00605.001 Overview of Annual Representative Payee Accounting


Social Security Act § 205(j)(3) and 1631(a)(2)(C);
Regulations 20 CFR § 404.2035, 404.2065, 416.635 and 416.665
Public Law- PL 115-165

A. Introduction

Representative payee policy for reporting on the use of benefits is the same for Title II and Title XVI. However, there are some differences between processes and procedures within each program. Concurrent Title II and Title XVI cases are selected and processed as title XVI cases for accounting purposes (e.g., the case is selected based on the Supplemental Security Record, field offices (FOs) must develop continued eligibility when conserved funds equal or exceed $2,000).

The term “beneficiary” is used generically, in this subchapter, to refer to both Title II beneficiaries and Title XVI recipients. Title II and Title XVI (or SSI) designations are used where differences exist.

The instructions in this chapter apply to the entire audience unless otherwise specified. This means that if an instruction does not designate field office (FO), processing center (PC), claims representative (CR), etc., it applies to anyone who is involved in or is responsible for performing the work.

B. Policy

1. General

Social Security law and regulations require representative payees (payee) to use the benefits they receive for the current needs of the beneficiary and in their best interests. They are responsible for keeping records and reporting on the use of benefits. Certain payees must complete a paper Representative Payee Report, (SSA-623-OCR-SM, SSA-6230-OCR-SM, SSA-6234-OCR-SM) or an online report using the internet Representative Payee Accounting (iRPA) annually. Public Law 115-116 amended the Social Security Act to exempt certain payees from the annual accounting requirement. (See GN 00605.015 for information on payees who are exempt from the annual accounting requirement.) However, we may request any payee to complete an accounting report anytime we receive information that raises a question about the payee’s use of monthly benefits or conserved funds.

The accounting report is used to monitor how the payee spent or saved the benefits on behalf of the beneficiary, identify situations where representative payment may no longer be appropriate, or determine if the payee is no longer suitable. We send an accounting report to all payees who are required to complete the report if any benefits were paid during the 12-month report period. We do not send an accounting report to payees exempt from the accounting requirements under GN 00605.015 or to State mental institutions participating in the Onsite Review Program.

Additionally, we may select any payee for an educational visit and payee review. For more information, see GN 00605.635 Representative Payee Reviews and Educational Visits Conducted by the Protection and Advocacy Agencies.

NOTE: Payees with dedicated accounts are excluded from the annual accounting selection criteria. FO's are responsible for monitoring how these payees used the title XVI benefits and dedicated account funds by sending them a Representative Payee Report of Benefits and Dedicated Account, SSA-6233-BK, to complete. (See GN 00605.200 for more information regarding monitoring dedicated accounts.)

2. When to complete Representative Payee Evaluation Report, SSA-624-F5

FOs are required to conduct a face-to-face interview when:

  • the payee's responses on the accounting report indicate improper use of benefits,

  • there is a change in custody,

  • the payee fails to complete the initial and second request SSA-623-OCR-SM, SSA-6230-OCR-SM, or SSA-6234-OCR-SM, or

  • the payee fails to complete an online report (iRPA) to SSA.

In addition to the payee, the beneficiary and custodian (if other than the payee) are also interviewed to confirm information provided by the payee and to ensure the beneficiary's current needs are being met. The FOs complete a Representative Payee Evaluation Report, SSA-624-F5, to document the interviews, their evaluation and action taken as appropriate. (See GN 00605.085 for processing non-responder alerts and GN 00605.100 for the SSA-624-F5.)

3. When to consider a change of payee

If the payee does not respond after repeated attempts by the FO to obtain the required accounting report, FOs are required to consider a change of payee (see GN 00605.090). When the FO determines that the current payee is no longer suitable and a change of payee is necessary, it develops for a successor payee. If a new payee is not readily available, the beneficiary may be paid directly (unless direct payment is prohibited) while the FO continues payee development. If the FO determines that direct payment would cause substantial harm to the beneficiary, direct payment can be delayed for a maximum of 30 days (see GN 00504.105).

4. Increased monitoring of payee performance

In addition to monitoring payee performance through the annual accounting process, SSA is required to conduct site visits and random reviews to all payees. Effective with FY 2019, the Protection and Advocacy agencies (P&A) in each state will conduct, for SSA, all representative payee reviews and educational visits. Other features of the program include a 6-month visit to newly appointed fee-for-service payees; annual certification that fee-for-service payees meet the requirements to charge a fee for their services; and “quick response checks” when the FO receives complaints from vendors over nonreceipt of payment, etc. These initiatives were put into place to protect beneficiaries from misuse of benefits by organizational and other volume payees and to help ensure payees are carrying out their duties and responsibilities in compliance with representative payment policies and procedures.

C. Definitions

The following terms are associated with the processing of the accounting reports as described in this subchapter:

  • Actionable – SSA-623-OCR-SM, SSA-6230-OCR-SM, or SSA-6234-OCR-SM accounting reports that require PC or FO development due to unacceptable responses, relevant remarks, relationship and payee coding discrepancies, etc. The Wilkes-Barre Direct Operations Center (WBDOC) Screening Process (see GN 00605.040) refers to these cases as “exceptions.”

  • Approved – SSA-623-OCR-SM, SSA-6230-OCR-SM, and SSA-6234-OCR-SM accounting reports processed to completion (e.g., system control was cleared, unacceptable response was resolved, conserved funds were input via the Electronic Representative Payee System (eRPS)).

  • Prongfile – Undeliverable SSA-623-OCR-SM, SSA-6230-OCR-SM, or SSA-6234-OCR-SM accounting reports and non-responder alerts which are “No Action Necessary” because the payment status code is T1/T01 (death) or S8/S08 (payee development).

D. References

  • Accounting Requirement Exemption for Certain Payees, GN 00605.015

  • Onsite Review Program of State Mental Institutions, GN 00605.500

  • Suspensions For Payee Development, GN 00504.100

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GN 00605.001 - Overview of Annual Representative Payee Accounting - 05/15/2013
Batch run: 03/13/2019