| 1 | Yes | No Action. | 
                        
                           
                           |  | No | Review the electronic Representative Payee System (eRPS) and Supplemental Security
                                 Record (SSR) to see if the latest beneficiary address is on SSA records. If it is,
                                 prepare a SSA-5002 (Report of Contact) and document that a face-to-face interview
                                 is not necessary. (The need for a payee change was considered when the custody change
                                 was input to the SSR and eRPS.) Also review the payee coding on the Master Beneficiary
                                 Record (MBR), SSR and eRPS and correct as appropriate.
                               Only develop for an SSA-624(Representative Payee Evaluation Report) when the latest beneficiary
                                 address is not shown on the SSR and eRPS or the payee submitted an unacceptable response which cannot be resolved.
                               | 
                        
                           
                           | Blank | DIRCON for a response. | 
                        
                           
                           | 2A | Yes | No action. | 
                        
                           
                           | No | Field Office (FO) will conduct face-to-face interviews and complete an SSA-624 if
                                 an appropriate explanation cannot be obtained via DIRCON.
                               | 
                        
                           
                           | Blank | DIRCON for a response. | 
                        
                           
                           | 2B | Yes | Verify that payee is authorized to collect a fee; review the data tags at the top
                                 of the SSA-6234 to verify that the amount collected is appropriate (GN 00605.061):
                               Fee For Services (FFS) indicates whether the payee is authorized to collect a payee fee. If this field
                                 does not contain a “Y” and the payee reports collecting a fee, eRPS ZIPL must be checked
                                 (see GN 00605.074B.2. If fee authorization cannot be verified by reviewing eRPS, the FO must resolve the
                                 fee issue.
                               Guardianship Status (GS) indicates whether a payee has been appointed legal guardian. A “Y” in this field
                                 indicates that the payee is the beneficiary’s legal guardian. A legal guardian may
                                 collect a fee as indicated by the court. (GN 00602.040; GN 00605.074B.4.b.)
                               Maximum Fee Amount (MFA) shows the maximum total fee which may be collected by the payee throughout the reporting
                                 period. If the payee reports a fee withholding which exceeds the MFA development per
                                 GN 00605.074B.3. through GN 00605.074B.5. Drug Addiction/Alcoholism (DAA) indicates whether there is DAA involvement which may affect the amount of fee
                                 a payee may collect as explained in GN 00506.200.
                               If the payee reports withholding a fee for payee services and the data tags on the
                                 report form do not indicate that the payee is authorized to collect a fee, the reviewer
                                 should query eRPS (MS 07414.008) to determine if the payee has been authorized to
                                 collect a fee. Any inconsistencies must be resolved by the FO with a face-to-face
                                 interview with the payee.
                               
                                 
                                    NOTE: If it is discovered that a payee has collected an unauthorized fee for services,
                                       an investigation and determination must be made to document whether misuse had occurred.
                                     | 
                        
                           
                           | No | No Action | 
                        
                           
                           | Blank | DIRCON for a response. | 
                        
                           
                           | 2C | Any amount | Add the amounts in questions 2B, 2C, 2D and 2E. If the total is less than 90% of the
                                 Total Accountable Amount (TAA) and the payee cannot resolve the difference, the FO will conduct a face-to-face interview
                                 and complete an SSA-624.
                               If the payee indicates “ALL” (or the TAA) as a response to more than one question
                                 and the payee cannot resolve the difference, the FO will conduct a face-to-face interview
                                 and complete an SSA-624.
                               | 
                        
                           
                           | 2D | Same as 2C. Exception: If the beneficiary resides in an institution and the amount in 2D is $360 or more,
                                 or an amount equal to the TAA if smaller
                               | Same as 2C.   No Action | 
                        
                           
                           | Blank | DIRCON for a response. | 
                        
                           
                           | EXCEPTION: If the beneficiary resides in an institution, and the amount in 2D is $360 or more,
                                 or an amount equal to the TAA if smaller
                               or an amount less than $360 or the TAA if smaller | No action | 
                        
                           
                           | If the payee cannot explain how they provide for the beneficiary's personal needs
                                 or how personal needs are met, the FO should review personal needs spending with the
                                 payee or consider a change of payee if appropriate.
                               | 
                        
                           
                           | 2E   | Same as 2C . | Same as 2C. | 
                        
                           
                           | EXCEPTION: An amount equal to or greater than 3 x Federal Benefit Rate (FBR)
                               | Title II – No Action
                                 Title XVI or Concurrent – FO will develop according to GN 00603.001 if the payee must be contacted for another reason. SI 01110.000 | 
                        
                           
                           | or   $2000 or more                     An amount <20% of TAA and TAA is >$25,000
                               or An amount <20% of Conserved Funds (CF) and CF is >$5,000
                               or An amount >$10,000 for Title II only cases. | Title II – No action
                                 Title XVI or Concurrent – FO will receive an alert from WBDOC when conserved funds equal $2000 or more and
                                 must develop continuing Supplemental Security Income (SSI) eligibility. The PSC receives
                                 the unacceptable forms because of other unacceptable or blank responses
                                 FO should DIRCON for explanation of expenditures   FO should DIRCON for explanation of rapid CF spend down   FO should DIRCON for explanation of possible excessive CF; ensure needs are being
                                 met
                               | 
                        
                           
                           | Any amount and Conserved Fund (CF) data entry is $5000 or more
                               | If the amount in 2E is less than 25% of the TAA and you contact the payee to resolve another issue, determine if the payee is spending
                                 funds appropriately.
                               | 
                        
                           
                           |   3 | REMINDER: Apply these instructions only if the amount in question 2E exceeds $500.
                               |   | 
                        
                           
                           |   3A | Checking/Savings Account | Review title of account in item 3B. GN 02402.055; GN 00603.010.
                               | 
                        
                           
                           | U. S. Savings Bonds | Review method of titling in item 3B. GN 00603.030 | 
                        
                           
                           | Certificates of Deposit | Review method of titling in item 3B. GN 00605.068H.; GN 00603.030 | 
                        
                           
                           | Collective Savings/Checking Account | Review the PF (Precedent File) data tag at the top of the SSA-6234 to determine if
                                 precedent file information for the payee is on record. A “Y” indicates information
                                 is on record and no action is needed.
                               If the PF tag is blank and the payee indicates more than $500 (in question 2E) held
                                 in a collective account, review the collective account information in eRPS and resolve
                                 the discrepancy.
                               MS 07418.000 | 
                        
                           
                           | Other | Evaluate type of account in item 4A. Also, review title of account in item 3B or 4B.
                                 (GN 00605.068G and GN 00605.068)
                               | 
                        
                           
                           | Blank | DIRCON for a response. | 
                        
                           
                           | 3B | Any response except “Other” | No action, if 3A is acceptable. | 
                        
                           
                           | Other | Evaluate title of account in item 4B. (GN 00605.068H)
                               | 
                        
                           
                           | Blank | DIRCON for a response. | 
                        
                           
                           |  4A | Stocks or mutual funds | Follow instructions in GN 00603.040 | 
                        
                           
                           | Blank and 3A is “Other”
                               | DIRCON for a response. | 
                        
                           
                           | 4B | Any response other than those specified inGN 00603.010 and GN 00603.020
 | Develop according to GN 00605.068H.     | 
                        
                           
                           | Blank and item 3B is “Other”
                               | DIRCON for a response. | 
                        
                           
                           | 5 | Blank or signed by someone other than the payee | Develop per GN 00605.069 for a completed, signed payee report
                               |