TN 33 (09-23)

GN 02613.025 Good Cause Provisions

NOTE: Refer to the chart for the action required.

Court Case

Action

Martinez Settlement

On April 1, 2009, SSA changed its policy of not paying fleeing felons. Follow the instructions below only for felony warrants with offense codes 4901, 4902, or 4999. Follow the Martinez settlement instructions in GN 02613.860GN 02613.885 for all other felony warrant codes.

Clark Court Order

On May 9, 2011, SSA changed its policy and no longer suspends or denies benefits or payments based solely on a probation or parole violation warrant (i.e., warrants with offense codes 5011, 5012, 8101, 8102, or 9999 or “Blank” and an offense charge symbol of “probation or parole violation”). Follow the Clark Court Order instructions in GN 02615.100GN 02615.190 for all probation or parole violation warrants.

We will make additional changes to this section, as necessary, in the future.

A. Introduction

Effective January 2005, the SSPA of 2004 provides a mandatory “good cause” exception authorizing the Commissioner to continue to pay an individual’s benefit, and/or repaying any previously withheld benefit under certain specified circumstances. The SSPA also gives the Commissioner the discretionary authority to find good cause for not suspending an individual’s (i.e., probationer’s or parolee’s) benefit and/or repay any previously withheld benefits based on mitigating circumstances if the individual establishes that the offense underlying the warrant and imposition of the probation or parole (as well as the violation of probation or parole) was both nonviolent and not drug-related.

SSA will evaluate the reasons why a beneficiary did not satisfy their warrant. This includes analysis of the incoming warrant information, verification of the warrant information by the Office of the Inspector General (OIG), a review of the information provided by the beneficiary, and a review of the beneficiary’s Social Security records. This evaluation will determine whether there is good cause to continue payments. First we look for mandatory good cause. If that is not found we look for good cause based on mitigating circumstances (i.e., discretionary good cause) where the beneficiary, generally, requests SSA to consider a good cause reason for not satisfying their warrant and provides evidence to substantiate their claim for good cause.

NOTE: The fugitive felon good cause provisions described in this section apply to both Title II and Title XVI benefits. Good cause does not extend to the rep payee provisions. Refer to GN 00502.133.

B. Policy

1. Mandatory good cause

SSA will not suspend an individual’s benefits if either:

a. Court of competent jurisdiction

A court of competent jurisdiction has:

  • Found the individual not guilty of the criminal offense or probation/parole violation; or

  • Dismissed the charges relating to the criminal offense or probation/parole violation on the unsatisfied warrant; or

  • Vacated the warrant for arrest of the individual for the criminal offense or probation/parole violation; or

  • Issued any similar exonerating order (i.e., a judicial order excusing the individual from alleged fault or guilt) or taken similar exonerating action (e.g., the criminal offense on which the warrant is based is either no longer considered a crime punishable by death or confinement of more than one year or no longer enforced; i.e., felony).

Or

b. Individual erroneously implicated

The individual was erroneously implicated in connection with the criminal offense or a probation or parole violation based on identity fraud.

NOTE: See GN 02613.150C.1. for cases where the EVS Code is “A” and the beneficiary states that they do not have an outstanding warrant.

2. Discretionary good cause

If good cause cannot be found based on mandatory criteria, the beneficiary will be given the opportunity to establish good cause based on mitigating circumstances. Good cause based on mitigating circumstances will be found if all the factors in either Option A or all of the factors in Option B are met. If the required factors are not present on the warrant or are conclusively available in SSA records, SSA cannot establish good cause unless the beneficiary provides the necessary evidence.

a. Option A

Find good cause if:

  • The criminal offense or probation/parole violation on which the beneficiary was charged or convicted was non-violent and not drug related. For a probation/parole violation the original offense was also non-violent and not drug related; and

  • The beneficiary was not convicted of any subsequent felony crimes since the warrant was issued; and

  • The law enforcement agency that issued the warrant reports that it will not extradite the fugitive or is unwilling to act on the warrant.

b. Option B

Find good cause if:

  • The criminal offense or probation/parole violation on which the beneficiary was charged or convicted was non-violent and not drug related For a probation/parole violation the original offense was also non-violent and not drug related; and

  • The beneficiary was not convicted of any subsequent felony crimes since the date the warrant was issued; and

  • The warrant is/was the only existing warrant and was issued 10 or more years prior to the date the Fugitive Felon Match processed the current warrant information; and

  • The beneficiary lacks the mental capacity to resolve a warrant as evidenced by one of the disability diagnostic codes listed in GN 02613.910; or, is incapable of managing payments; or is legally incompetent; or Social Security has appointed a representative payee to handle their payments; or is residing in a long-term care facility, such as a nursing home or mental treatment/care facility.

NOTE: For discretionary good cause to apply, all conditions under either Option A or Option B have to be met. Also, for good cause to apply under Option A or Option B a statement from the beneficiary regarding any subsequent felony convictions is required.

3. When good cause may be requested and established

NOTE: When the beneficiary wishes to establish mandatory (See GN 02613.025B.3.a. for information on mandatory good cause) or discretionary good cause (See GN 02613.025B.3.b. for information on discretionary good cause) for not satisfying their outstanding warrant take a statement from the beneficiary requesting good cause. See GN 02613.030B for instructions on the good cause statement.

a. Mandatory good cause

Beneficiaries may request mandatory good cause at any time. The time for making this request is not limited by Administrative Finality.

NOTE: Plea bargains--If an individual is charged with a felony crime and then pleads guilty to a misdemeanor, the felony charge is considered dismissed or null and void. Because a plea agreement dismisses the felony charge relating to the criminal offense, mandatory good cause applies. See GN 02613.025B.4. for additional information on establishing evidence for plea bargains/plea agreements.

b. Discretionary good cause

Beneficiaries may request discretionary good cause up to 12 months from the date of the Advance Notice of Suspension notifying them of the planned fugitive suspension or within 12 months after the beneficiary receives their initial award notice or within 12 months after the beneficiary receives their initial determination notice of fugitive felon or probation or parole violator suspension (i.e., continuing fugitive felon or probation or parole violator suspension notice or the closed-period of fugitive felon or probation or parole violator suspension notice).

c. Good cause establishment periods

After a beneficiary contacts an SSA office to request good cause for not satisfying their outstanding warrant, they have 90 days to provide the good cause evidence or information to SSA. If, at the end of the 90-day period, the beneficiary has not submitted the necessary evidence, good cause will be denied. See GN 02613.450 for additional instructions on protests and establishing good cause.

If the beneficiary protests and requests to establish good cause during the due process period (after they received advance notice of proposed suspension), then, SSA will continue paying the beneficiary their Title II benefits for up to 90 days so the beneficiary can provide the good cause evidence. If, at the end of the 90-day period, the beneficiary has not submitted the necessary evidence, good cause will not be found.

A beneficiary has 12 months to request good cause from the date they received notification from SSA that they have an outstanding warrant and that their benefits would be suspended. The 12 month period begins from the date on the notice of the advance notice of benefit suspension or the date on the Title II initial award notice or the date on the initial determination notice of fugitive felon or probation or parole violator suspension/overpayment notice or the date on the notice of closed period suspension/overpayment.

If the beneficiary contacts SSA during the 12 month period (after the due process period has expired) and wishes to establish good cause, then SSA will not reinstate Title II benefits. SSA will allow the beneficiary 90 days to provide SSA with good cause evidence. If at the end of the 90-day period the beneficiary has not submitted the necessary evidence, good cause will be denied. See GN 02613.450 for additional instructions on protests and establishing good cause.

4. Proof of good cause

The beneficiary must provide evidence to support a claim of good cause for not satisfying a warrant. FOs should not be developing to obtain any of the information needed for a good cause determination. For facts that are not already documented in SSA records, the beneficiary must provide evidence to support a claim of good cause for not satisfying a warrant. If the preferred good cause documentation to support a beneficiary’s allegation of good cause are not readily available or the agency holding the information will not provide the information in the required format, SSA will accept alternative methods of good cause documentation from the warrant issuing agency, probation or parole agency or the court of jurisdiction for the warrant. The evidence must meet the following requirements:

a. Preferred method of good cause documentation

Information about the beneficiary or warrant is on the letterhead of the court, appropriate law enforcement agency or probation/parole agency that issued the warrant or court document; and the person signing the document has knowledge that the facts presented in the letter are correct and have been verified by the issuing agent.

b. Alternate methods of documenting good cause

  • Fax from the warrant issuing agency or the court of jurisdiction for the warrant or probation or parole agency. The fax must provide pertinent information regarding the beneficiary and the warrant. It must also contain the name of the person providing the information and their job position for the warrant issuing agency, probation or parole agency or the court of jurisdiction for the warrant and the date the information was provided to SSA.

  • Report of Contact (RC), SSA-5002, or a RPCOC screen in MCS completed by an SSA technician based on a telephone call SSA received from the warrant issuing agency, probation or parole agency or court of jurisdiction for the warrant regarding the warrant or the beneficiary’s attending physician or the administrator of the long-term care facility where the beneficiary resided. The RC or RPOC must provide pertinent information regarding the beneficiary and the warrant. It must also contain the name of the person providing the information and their job position for the warrant issuing agency, probation or parole agency or the court of jurisdiction for the warrant and the date the information was provided to SSA.

c. Evidence required to establish good cause

Good Cause Criteria

Evidence of Preferred Good Cause

a. The court found the individual not guilty of the crimes or dismissed the criminal charges or vacated the warrant.

Mandatory Good Cause

  • A copy of the court docket indicating the beneficiary was found not guilty of the criminal charges or a copy of the court decision showing that they were found not guilty of the criminal charges.

  • A copy of the court docket indicating charges were dismissed or another official court or law enforcement agency document stating that it dismissed the criminal charges.

  • A copy of the court docket or another official warrant issuing agency document indicating the warrant in question was vacated.

  • Documentation on PUPS specifically stating that the charges were dropped or that the individual was acquitted, where the PUPS record can be positively associated with this specific warrant.

NOTE: Plea bargains--If an individual is charged with a felony crime and then pleads guilty to a misdemeanor, the felony charge is considered dismissed or null and void. Because a plea agreement dismisses the felony charge relating to the criminal offense, mandatory good cause applies.

FOs will need evidence to verify this sort of plea bargain arrangement. The following documents can be used to verify the dismissal of the charges through a plea bargain: a court order, a plea agreement, and, at the federal level, a Judgment & Commitment Order ("J&C"). One or more of these documents should include the charge to which the individual is pleading as well as the disposition of the original charges in the underlying indictment. However, these documents may not fully state whether the crime to which the individual is pleading is a felony or a misdemeanor. Moreover, although the court order should reflect that the individual was convicted of the misdemeanor, not the felony, and that the felony indictment has been dismissed, this may not be uniform throughout all jurisdictions. Documents that do not fully identify the crime to which the individual is pleading or whether the felony indictment has been dismissed may require some further development by the FO to the court. Unfortunately, because each judge and each jurisdiction may state the disposition of the case differently, it is not possible to provide the exact language that the SSA FO should look for in these documents.

b. The law enforcement agency that issued the warrant reported that someone else used the beneficiary’s identity fraudulently.

Mandatory Good Cause

An official document from the court or the warrant issuing agency stating that the warrant was erroneously issued in the beneficiary’s name.

NOTE: See GN 02613.150C.1. for cases where the EVS Code is “A” and the beneficiary states that they do not have an outstanding warrant.

c. The criminal charges on the warrant are non-violent and not drug related.

Discretionary Good Cause - Option A and Option B

An official copy of the arrest warrant. The warrant must include the criminal charges on which the individual is wanted. Evaluate the charges using the chart in GN 02613.900.

 

Other documents, including but are not limited to, a docket, a conviction notice, or a plea agreement.

 

The NCIC code on the FFSCF on the FFWQ screen.

 

PUPS records can only be used if the remarks specifically state the type of offense and the PUPS record can be definitely associated with the warrant.

 

NOTE: See below for special considerations for probation or parole violators.

For probation/parole violators only.

 

d. The original criminal charge on which the beneficiary was convicted and granted probation or parole, was nonviolent and not drug related.

Discretionary Good Cause – Option A and Option B--For probation/parole violators only.

 

Court documents describing the trial proceedings and the criminal charges on which they were originally convicted. Examine the criminal charge(s) on the documents and classify the crime by the categories on the chart in GN 02613.900 or via instructions in GN 02613.175 if the crime classification is known.

 

Probation or parole summons or the investigation report that was prepared by the probation or parole officer when the charges for the violation were issued for the warrant.

 

PUPS records can only be used if the remarks specifically document the type of crime and the PUPS record can be definitely associated with the original offense or the violation.

 

NOTE: SSA must only determine if the underlying offense for a probation or parole violator is violent or drug related, not if the crime is a felony or a misdemeanor.

e. Was the beneficiary convicted of another felony since the warrant was issued?

Discretionary Good Cause – Option A and Option B

A statement over the penalty clause on the SSA-795 as to whether they have been convicted of or pled guilty to any such crimes since the date of the warrant.

NOTE: PUPS records should be reviewed for evidence that there has been a subsequent conviction. The absence of a PUPS record does not, however, mean a subsequent conviction has not occurred. A statement from the beneficiary must be obtained to document that no subsequent convictions have occurred, if the beneficiary is trying to establish good cause.

f. Law enforcement will not extradite the beneficiary or is unwilling to arrest the beneficiary for the warrant.

Discretionary Good Cause – Option A

An official document from the warrant issuing law enforcement agency stating that it will not extradite the individual for the charges on the warrant or that it will not take action on the warrant for their arrest. If this information has already been reported on the FFSCF, FFSQ screen, LEA action result field, this documentation is not needed.

g. The warrant is the only existing warrant and was issued 10 or more years prior to the date of the current warrant.

Discretionary Good Cause – Option B

An official copy of the arrest warrant. The warrant must include the criminal charges on which the individual is wanted. Evaluate the charges using the chart in GN 02613.900.

Other documents, including but are not limited to, a docket, a conviction notice, or a plea agreement.

 

And

A comparison on the date of the warrant and the processing date on the FFSCF database to verify that the 10 year time limit is met.

And

A statement over the penalty clause on the SSA-795 as to whether they have been convicted of or pled guilty to any such crimes since the date of the warrant.

h. The beneficiary is incapable or legally incompetent.

Discretionary Good Cause – Option B

A copy of the court order that appointed a conservator or guardian to handle the beneficiary’s affairs or that declared them legally incompetent. If SSA already has this information or the claimant has a representative payee, the documentation is not needed.

SSA records can be used for this documentation. If SSA records show appointment of a representative payee, no further documentation is required.

i. The beneficiary is residing in a long-term care facility.

Discretionary Good Cause – Option B

 

A statement over the penalty clause on the SSA-795 that the beneficiary is residing in such a facility. If SSA already has this information or the claimant has a representative payee, this documentation is not needed.

If the beneficiary does not provide SSA with proof of good cause when the 90 day tickle/diary matures, process the good cause request statement per GN 02613.030C.

 

NOTE: FOs should not develop to obtain any of the information needed for a good cause determination. For facts that are not already documented in SSA records, the beneficiary must provide evidence to support a claim of good cause for not satisfying a warrant. If the requested documents (i.e., preferred good cause documentation) to support a beneficiary’s allegation of good cause are not readily available or the agency holding the information will not provide the information in the required format, SSA will accept alternative methods of good cause documentation (e.g., faxes or telephone calls) from the warrant issuing agency, probation or parole agency or the court of jurisdiction for the warrant or the beneficiary’s attending physician or the administrator of the long-term care facility where the beneficiary resided as described in GN 02613.025B.4.

C. Procedure

1. Making a good cause decision

  • Annotate a good cause decision based on the warrant information received from the Fugitive Felon Matching Operation via the Fugitive Felon SSA Control File (FFSCF) warrant data base (see FFSCF information explained in GN 02613.100), other information in SSA’s records (see other information explained in GN02613.025B.2.c. and GN 02613.025B.2.d.), and evidence provided by the beneficiary (see beneficiary proof in GN 02613.025B.4.).

  • Prepare a good cause determination per GN 02613.025C.6.

  • If good cause cannot be found based on all available evidence on SSA records and the evidence or information provided by the beneficiary, process the good cause denial per GN 02613.025C.6.b.

2. Evaluation of the fugitive felon warrant query (FFWQ) screen and the fugitive felon warrant status query screen (FFSQ) and other SSA records

SSA’s records may contain information that may readily fulfill some good cause requirements. See GN 02613.025D. for the source of this information and the specific conditions that show the requirements are met. General information about these sources follows.

a. Fugitive felon warrant data query screen (FFWQ) and the fugitive felon warrant status screen (FFSQ) from the fugitive felon SSA control file (FFSCF)

 

FFWQ Screen (See MSOM PRISON 006.010 for descriptions of the field values on the FFWQ Screen.)

  • Warrant Date

  • Warrant Number

  • Warrant Issuing State

  • NCIC Number

  • OCA Number

  • Warrant Issuing Agency

  • Warrant Issuing Agency Phone Number

  • Offense Code

  • Offense Type

  • Offense Charge Symbol

  • EVS code (See also GN 02613.925 for the EVS code values.)

FFSQ Screen (See MSOM PRISON 006.011 for a description of the field values on the FFSQ Screen.)

  • Felon Status

  • Warrant Status

  • OIG Subject Status

  • LEA Action Results

  • OIG Status Subject Date

b. MBR

  • Check the medical diagnosis code if it is a disability claim. See GN 02613.910 for diagnostic codes used for good cause reasons.

  • Check the MBR for a REP PAYEE line to determine if beneficiary has a representative payee. (See GN 02613.025B.2.b. for discretionary good cause reasons.)

  • Verify if beneficiary has a period of prisoner suspension LAF S7 with RFST of “PRISON,” “MENTAL,” or “PREDTR,” for prisoner suspension on the MBR. This period of suspension may be a clue that the beneficiary was previously incarcerated for their underlying crime before they were granted probation/parole. If the LAF S7 period is subsequent to the warrant information, the warrant may no longer be active.

c. PUPS

If the unsatisfied warrant is for a probation or parole violation, check the PUPS record for information on the beneficiary’s original offense, if available. Determine the criminal offense and compare it to the list of offense codes in GN 02613.900. If the offense is listed in one of the categories in GN 02613.900, the offense for the underlying criminal charge is considered violent or drug related. If the offense is not listed in one of the categories listed in GN 02613.900, assume the underlying criminal offense before probation/parole was granted was not violent or not drug related. Check the PUPS record to determine if the warrant date precedes the prisoner suspension period. If so the warrant may have been satisfied when the beneficiary was arrested and confined.

3. Underlying criminal offense for probation/parole violators

For probation or parole violators, the NCIC offense code on the FFWQ screen on the FFSCF will generally be 5011 or 5012 which simply identifies the case as a probation or parole violation and does not specifically indicate the nature (i.e., nonviolent or not drug related) of the probation or parole violation offense. The type of probation or parole violation on the warrant will have to be determined per GN 02613.175C.

If you cannot determine via the Offense Code and Type on the FFWQ, the PUPS record or other information in the SSA file or information received from OIG, the underlying criminal charge for the crime the beneficiary committed before they were granted probation/parole, SSA cannot make a determination about the nature of this crime (i.e., if the crime is nonviolent or not drug related). The beneficiary must provide evidence from the State, county or foreign country in which the crime was committed as to the classification of the crime (State or foreign criminal code category e.g., simple aggravated assault) nature of the crime (i.e. not violent or not drug related, etc.) in order to meet the burden for establishing good cause based on mitigating circumstances. If the beneficiary cannot obtain proof of the underlying charges for their crime, SSA may make a determination regarding the nature of the crime based on the State criminal code definitions for the crime per GN 02613.175 if the beneficiary can provide information on the classification of the crime.

NOTE: For a probation or parole violator, the discretionary good cause does not require that the original crime be a felony, only that the underlying or original crime was not violent or not drug related.

4. Beneficiary is deceased

Outstanding warrant information for a deceased beneficiary will not be passed to the FFSCF for automated processing; i.e., an OPEN warrant. However, there may be instances where SSA discovers while reviewing the case because of other alert conditions, review of the warrant or inquiry from another individual on behalf of the beneficiary that the beneficiary is deceased. Actions necessary on the deceased beneficiary’s fugitive felon period are indicated below.

Steps

Actions

1

Review the MBR and ensure that the beneficiary is in T1or other terminated status. Evaluate whether good cause may apply to the criminal charges on the deceased beneficiary’s warrant. (See GN 02613.025B. for the good cause provisions.)

2

If:

  • Good Cause applies process per GN 02613.025C.6.a.

  • Good Cause does not apply or SSA cannot make this determination based on SSA records--Suspend benefits using the FFEL screen for the period of fugitive or probation/parole violation suspension before the date of death, if not already accomplished.

3

Complete the Fugitive Felon Warrant Due Process/Good Cause Screen (FFDG), enter a GOOD CAUSE or GOOD CAUSE DENIAL REASON on the FFSCF per MSOM PRISON 006.003.

Update the FFWD screen to show the WARRANT STATUS “Closed” and the DATE WARRANT ENDED as the beneficiary’s date of death on the MBR. Enter REASON WARRANT ENDED as 2 = Dismissed. (See MSOM PRISON 006.006 for instructions on completing the FFWD screen.)

4

Do not send notice to a deceased beneficiary. If overpayment exists and a representative payee was contingently liable, send notice to the payee.

5. Beneficiary resides in a long-term care facility

  • For good cause purposes, deem beneficiaries residing in a long-term care facility to be incapable even if they are their own payee. Develop the need for a payee (see GN 00502.133).

  • If the beneficiary leaves the long-term care facility and still does not have a representative payee, review the good cause determination. Because the beneficiary has been released from the long-term care facility, they may now have the capacity to resolve the warrant, or they may now be capable of managing their own payments or they may become legally competent and not in need of representative payee. SSA may now make a new determination based on whether the beneficiary currently meets the good cause requirements because of the change in their circumstances after leaving the long-term care facility.

6. Documenting the determination

If SSA determines that a beneficiary has good cause for not satisfying their outstanding felon or probation or parole violator warrant, good cause will be effective with the date the warrant was issued, 1/1/2005, or the date of entitlement to Title II benefits, whichever date occurs last.

After evaluating the beneficiary’s good cause statement (See GN 02613.030C for further information regarding the good cause statement) and the accompanying beneficiary provided information and evidence and after reviewing any corroborating evidence or information contained in SSA records, the FFSCF must be updated with the good cause decision. The good cause decision must be annotated to the FFSCF in all cases where the beneficiary requested good cause whether the decision is to establish good cause or to deny good cause. If concurrent entitlement exists, the same good cause determination will apply to both Title XVI and Title II. Only one determination should be prepared.

a. Good cause is found

If SSA determines that a beneficiary does have good cause for not satisfying their outstanding felon or probation or parole violator warrant, good cause will be effective with the date the warrant was issued, 1/1/2005 or the date of entitlement to Title II benefits, whichever date occurs last.

If good cause is found:

  • Update the FFDG Screen (GOOD CAUSE REASON field add a “Y “in the GOOD CAUSE ESTABLISHED field and enter a YES, GOOD CAUSE REASON: AAA, see GN 02613.930A. for good cause reasons) on the FFSCF per MSOM PRISON 006.003.

  • Update or add any warrant data on the FFWI screen that requires correction or completion, if necessary, per MSOM PRISON 006.004.

  • Use the following steps to annotate the EVID screen on the SHARED Process with the Good Cause Determination explaining the current circumstances and the reason(s) and evidence the beneficiary provides for requesting good cause and SSA’s justification for establishing good cause.

Steps

Actions

Step 1

From the Main SSA Menu (SC00), Select SHARED PROCESSES (#4), then enter the SSN and select ESTABLISH, and EVIDENCE (#1)

Select Program #1

Select Type # 3 (Unless this is a claims action, then select type #2)

Document Submitted as Proof of the Following Event/Issues: Select “Other”

Document Event Date: Enter the Date Good Cause Determination was Made

Step 2

Skip to Document Type: Enter “FF Good Cause Determination”

Step 3

Skip to Comments: Enter: “FF2 Good Cause Determination—Good Cause Applies Based on Mandatory Good Cause/Mitigating Good Cause Circumstances.”

Step 4

Input Your Personal identification information in the following fields:

  • Name

  • Position

  • Office Code

and include the current date in the date field.

NOTE: Go to Step #5. The reason for the good cause decision must be documented to reflect the specific reasons and evidence that was used to find good cause.

Step 5

Skip to the field “Additional Evidence” and Enter “Y.

Provide the specific type of good cause you are granting the beneficiary (i.e., Mandatory good cause or Discretionary good cause). List evidence used to make good cause determination.

Step 6

If benefits are suspended S9, RFST of FUGFEL for the beneficiary and good cause now applies, benefits will be resumed retroactive to the date of suspension. See GN 02613.600. An automated T2 notice will be sent to the beneficiary based on the good cause reason annotated on the FFSCF.

NOTE: If benefits were suspended before an approved good cause determination was made and the beneficiary establishes good cause, benefits will be resumed retroactive to the first month that fugitive felon suspension was applied. Process the resumption of benefits using the FFEL screen per GN 02613.600.

CAUTION: The same good cause determination will apply to Title XVI and Title II if the cases are concurrent. Prepare only one determination.

b. Good cause is not found

If good cause has been requested and the FO cannot determine if good cause applies for the beneficiary because of insufficient evidence or the evidence or information provided by the beneficiary does not meet the standards to allow good cause to apply for the beneficiary; or, the beneficiary failed to supply SSA with evidence of good cause, then good cause is not found. Process the good cause denial as follows:

  • Beneficiary Protested Timely to Suspension, Protest is Shown In the FFEQ Screen--Beneficiary is in Current Pay

Steps

Actions on Records and Evaluation of Information on Records

1

Check the FFWQ screen on the FFSCF and determine who provided SSA with the warrant information. Check the WARRANT INFORMATION SOURCE.

If the WARRANT INFORMATION SOURCE is: LEA Batch or OIG Initiated or FFAP Record, go to step 2.

If the WARRANT INFORMATION SOURCE is: Third Party Report, go to step 5.

2

If T2 benefits are in LAF C and a protest was posted on the FFDG screen (DUE PROCESS MATURITY DATE) and PROTEST DATE are entered on the FFEQ screen, then

Update the FFDG screen in the ENTER PROTEST DISPOSITION field with “2-PROTEST DENIED.”

3

Update the FFDG screen, Good Cause Determination field and enter a “N” in the GOOD CAUSE ESTABLISHED field, enter a GOOD CAUSE DENIAL REASON (see GN 02613.930B. for the GOOD CAUSE DENIAL code reasons) on the FFDG per MSOM PRISON 006.007.

NOTE: Use code “QID” as the denial code if the reason for the good cause denial was based on the beneficiary not timely providing SSA with their good cause information/evidence.

4

After annotating the FFDG screen with the GOOD CAUSE DENIAL REASON and annotating that the PROTEST DENIED field, FFSCF will allow the T2 finder that is pending to continue processing the suspension action for the beneficiary.

NOTE: An automated T2 suspension/overpayment notice will be generated based on the automated or manual suspension input when the T2 suspension action is processed.

5

If T2 benefits are in LAF C and a protest was posted on the FFDG screen (DUE PROCESS MATURITY DATE) and PROTEST DATE are entered on the FFEQ screen, then

Update the FFDG screen in the ENTER PROTEST DISPOSITION field with “2-PROTEST DENIED.”

And

Also annotate the protest to the FFEL screen in POS.

Go to step 6

6

Update the FFDG screen, Good Cause Determination field and enter a “N” in the GOOD CAUSE ESTABLISHED field, enter a GOOD CAUSE DENIAL REASON:AAA (see GN 02613.930B. for the GOOD CAUSE DENIAL code reasons) on the FFDG per MSOM PRISON 006.007.

NOTE: Use code “QID” as the denial code if the reason for the good cause denial was based on the beneficiary not timely providing SSA with their good cause information/evidence.

An automated T2 suspension/overpayment notice will be generated based on the automated or manual suspension input when the POS/FFEL screen is used for the suspension action.

EXAMPLE:

SSA sent an individual an advance notice of proposed suspension on 11/14/05 and the FFSCF posted a DUE PROCESS MATURITY DATE OF 12/19/05.

 

The beneficiary protested their suspension on 11/25/05 and wanted to provide good cause for not satisfying their outstanding warrant.

 

The SSA technician posted a PROTEST DATE OF 11/25/05 to the FFDG screen.

 

The beneficiary re-contacted SSA on 11/29/05 and tried to provide good cause evidence but it was not sufficient to establish good cause.

On 11/30/05, the SSA technician posted on the FFDG screen a PROTEST DISPOSITION 2=PROTEST DENIED and a GOOD CAUSE ESTABLISHED of “N” and a GOOD CAUSE DENIAL REASON OF QCD.

After annotating the FFSCF, FFDG screen with the protest information, the T2 finder will process the suspension action when the DUE PROCESS MATURITY DATE of 12/19/05 occurs.

  • Closed Period of Suspension, Beneficiary is in Current Pay—Fugitive Felon Suspension Applies for the Closed Period of Suspension

Steps

Actions on Records and Evaluation of Information on Records

1

NOTE: In this situation, the beneficiary was not given advance notice of proposed suspension. A PROTEST DATE and ENTER PROTEST DISPOSITION does not apply on the FFDG screen.

If T2 benefits are in current pay and the beneficiary has a closed period of fugitive felon suspension, then

go to Step 2.

 

2

Update the GOOD CAUSE DETERMINATION fields on the FFDG screen enter GOOD CAUSE ESTABLISHED “N”, enter a GOOD CAUSE DENIAL CODE (see GN 02613.930B for the appropriate GOOD CAUSE DENIAL code reasons) on the FFDG screen per MSOM PRISON 006.007.

NOTE: Use code “QID” as the denial code if the reason for the good cause denial was based on the beneficiary not timely providing SSA with their good cause information/evidence.

3

Check to make sure the T2 benefits are in LAF S9 on the MBR and an RFST of FUGFEL is annotated to the benefit line on the MBR for this closed period of suspension.

Send a manual notice to inform the beneficiary of SSA’s initial determination that good cause was not found based on the information/evidence that they provided to SSA to establish good cause must be sent to them. See NL 00755.400 for information that must be included in the notice to the beneficiary.

 

  • Beneficiary Initially Awarded and Benefits Were Suspended Pending Good Cause Development (Claims Situation, See GN 02613.050B.2.)

Or

  • Good Cause Has Not Been Found or Beneficiary Failed to Provide Evidence to Establish Good Cause—Beneficiary is in Suspension Status

See GN 02613.030C for additional instructions on processing cases where the beneficiary failed to provide good cause within 90 days or the good cause request is denied.

Steps

Actions on Records and Evaluation of Information on Records

1

If T2 benefits are in suspension pending good cause evidence being received by SSA from the beneficiary and the diary time has expired for receipt of the evidence or SSA has received good cause evidence but the evidence did not establish good cause for not satisfying the warrant, then

Go to Step 2.

2

Update the FFDG screen GOOD CAUSE DETERMINATION field enter a “N” in the GOOD CAUSE ESTABLISHED field , enter a GOOD CAUSE DENIAL REASON (see GN 02613.930B. for good cause denial codes) per MSOM PRISON 006.007, if not already completed.

NOTE: Use code “QID” as the denial code if the reason for the good cause denial was based on the beneficiary not timely providing SSA with their good cause information/evidence.

3

Check to make sure the T2 benefits are in LAF S9 on the MBR and an RFST of FUGFEL is annotated to the benefit line on the MBR for this suspension.

4

A notice must be sent to the beneficiary notifying them of SSA’s initial determination that good cause was not established. Fugitive felon/probation or parole violator suspension will apply effective with the date of the warrant. See NL 00755.330 for the instructions and information about the notice that must be sent to the beneficiary for a good cause denial situation. See GN 02613.030C.1 for instructions on preparing a close-out notice when evidence is not submitted to SSA to establish good cause.

D. Exhibit - good cause information in SSA records and on the fugitive felon SSA control file (FFSCF)

Use the following chart to find Good Cause information in SSA records (MBR) and on the FFSCF data base:

Good Cause Criteria

Available Information

1. Was the offense non- violent and not drug related?

 

Probation and Parole Violators:

Was the probation or parole violation charge non-violent and not drug related?

FFWQ Screen

Offense Code: 4-digit code. (See GN 02613.900B.2. for information on offense codes.)

Determine if the 4-digit offense code is specifically listed in GN 02613.900B.2. as either violent, drug related or non-violent or not drug related.

If the 4-digit offense code is not specifically listed in GN 02613.900B.2.b., then check the chart in GN 02613.900B.2.a. to determine if the first 2-digits of the 4–digit offense code are listed as one of the categories on the chart in GN 02613.900B.2.a. If the first 2-digits of the 4-digit offense code are shown on the chart, then assume the crime is violent or drug related.

If the 4-digit offense code is not specifically listed in GN 02613.900B.2.b. as a violent or drug related or nonviolent and not drug related crime and the first 2-digits of the 4-digit offense code are not found in the chart in GN 02613.900B.2.a., then SSA will not assume the crime is nonviolent or not drug related.

If information is still not available to make a decision on the offense code, then continue processing per GN 02613.175B.1.

 

PROBATION AND PAROLE VIOLATORS

The 4-digit offense code for probation and parole violators will often reflects 5011 or 5012. This coding identifies the cases as probation or parole violations but does not provide any information on either the original charge (underlying charge) or the violation unless this information has been provided by OIG.

NOTE: For probation and parole violators to establish good cause, both the original offense and the violation on the current warrant must be nonviolent and not drug related.

2. Probation and Parole Violators only - Was the underlying criminal offense before probation or parole was granted, non- violent and not drug related?

FFWQ Screen

Offense Code: 4-digit code. (See GN 02613.900B.2. for the offense code information.)

NOTE: The offense code reflected on the FFWQ screen will generally only pertain to the probation or parole violation crime, not the underlying criminal charges.

 

MBR:

--History field shows period of LAF S7 and RFST of PRISON, MENTAL, or PREDTR

NOTE: The indication of LAF S7 and RFST of PRISON, MENTAL, OR PREDTR only acts as a clue that a PUPS record should exist for the beneficiary.

 

PUPS

--PUPS records may show a previously corresponding period of confinement for the underlying criminal offense that the probation or parole violator was originally charged on.

 

If the underlying criminal charges are not indicated on the FFWQ or on other SSA records.

NOTE: Probation or parole violators only have to prove that their underlying criminal offense was nonviolent or not drug related, not that the crime was a felony or a misdemeanor.

 

3. Was the beneficiary convicted of any subsequent criminal charges for crimes that carry a penalty of death or imprisonment for more than 1 year?

FFWQ

--Date of Warrant: MM/DD/YYYY (Date LEA issued warrant for the beneficiary’s arrest)

 

MBR

Period of S7 prisoner suspension on MBR. Suspension period starts after date of warrant.

 

PUPS

PUPS record indicates a period of confinement. The confinement date on the PUPS record is after the warrant date. A conviction date is also on PUPS. The conviction date is later than the date of the warrant. The conviction on the PUPS record must indicate the crime was a “felony” type crime. If there is not indication as to the type of crime on the PUPS record, the beneficiary must provide proof of the subsequent type of crime they were convicted on.

4. Will the law enforcement agency (LEA) that issued the violation warrant extradite the beneficiary or is the LEA willing to act on the warrant?

FFSQ

--LEA Action Result: code is LEA WILL NOT EXTRADITE/ACT ON WARRANT

5. Was the unsatisfied warrant issued 10 or more years prior to the SSA Run Date on the OI-5D?

FFWQ

Date of Warrant: MM/DD/YYYY (Date LEA issued warrant for the beneficiary’s arrest)

SSA Run Date: MM/DD/YYYY

6. Does the beneficiary have a mental impairment that would prevent them from resolving the unsatisfied warrant?

MBR

DIG Code (XXXX) or SDIB code (XXXX) on DIB data line on the MBR has one of the codes listed in GN 02613.910

7. Does the beneficiary have a rep payee?

MBR

RPAYEE Data line shows representative payee.

NOTE: The beneficiary is responsible for providing the evidence or information to make a good cause determination. If after evaluating the above factors in conjunction with all information or evidence found in SSA records (e.g., MBR, PUPS or NUMIDENT, etc.) and the warrant information on the FFSCF and the good cause evidence or information that the beneficiary provided to SSA, the SSA technician cannot establish that the beneficiary’s records or evidence is sufficient or reliable to satisfy the good cause requirements, good cause will be denied. See GN 02613.030B and GN 02613.025B.6.b. for additional information regarding the good cause statement and good cause denial respectively.

 


To Link to this section - Use this URL:
http://policy.ssa.gov/poms.nsf/lnx/0202613025
GN 02613.025 - Good Cause Provisions - 09/11/2023
Batch run: 10/29/2024
Rev:09/11/2023