QUESTION PRESENTED
               You asked us for guidance in determining whether Title II benefits should be suspended
                  when individuals are under civil commitment at St. Peter Regional Treatment Center
                  pursuant to a court order finding the individual to be mentally ill and dangerous.
                  As explained below, we advise that, if an individual is committed as mentally ill
                  and dangerous with no criminal involvement, Title II benefits should not be suspended.
                  But if an individual is charged with a criminal offense and is found either (1) incompetent
                  to stand trial due to mental illness or deficiency, or (2) not guilty by reason of
                  mental illness or deficiency, Title II benefits should be suspended once the individual
                  has been under civil commitment at public expense for more than 30 continuous days.
               
               LAW
               I. Social Security Law and Policy
               Pursuant to Public Law 106-170 (effective April 1, 2000), Section 202(x)(1) of the
                  Social Security Act (Act), as amended, provides in pertinent part:
               
               (A) Notwithstanding any other provision of this subchapter, no monthly benefits shall
                  be paid under this section or under section 423 of this title to any individual for
                  any month ending with or during or beginning with or during a period of more than
                  30 days throughout all of which such individual--
               
               . . .
               (ii) is confined by court order in an institution at public expense in connection
                  with--
               
               (I) a verdict or finding that the individual is guilty but insane, with respect to
                  a criminal offense,
               
               (II) a verdict or finding that the individual is not guilty of such an offense by
                  reason of insanity,
               
               (III) a finding that such individual is incompetent to stand trial under an allegation
                  of such an offense, or
               
               (IV) a similar verdict or finding with respect to such an offense based on similar
                  factors (such as a mental disease, a mental defect, or mental incompetence)[.]
               
               . . .
               (B)(ii) For purposes of clauses (ii) and (iii) of subparagraph (A), an individual
                  confined in an institution as described in such clause (ii) shall be treated as remaining
                  so confined until--
               
               (I) he or she is released from the care and supervision of such institution, and
               (II) such institution ceases to meet the individual’s basic living needs.
               Section 402(b) of Pub. L. 106-170 eliminated the requirement that an individual’s
                  confinement stem from a crime which is punishable by imprisonment for more than one
                  year (i.e., a felony) and replaced it with the requirement that the individual be confined for
                  30 days before SSA will suspend Title II benefits.
               
               The POMS provisions concerning individuals confined as described in Section 202(x)(1)(A)(ii)
                  state that Title II benefits are suspended when:
               
               
                  - 
                     
                        1.  
                           A court issues a verdict, finding, or ruling declaring the beneficiary: 
                              - 
                                 
                                    A.  
                                       guilty but insane with respect to a criminal offense; 
 
 
- 
                                 
                                    B.  
                                       not guilty of a criminal offense by reason of insanity; 
 
 
- 
                                 
                                    C.  
                                       incompetent to stand trial under an allegation of a criminal offense; or 
 
 
- 
                                 
                                    D.  
                                       determined to have a similar verdict or finding with respect to a criminal offense
                                          based on similar factors (such as mental disease, mental defect, or mental incompetence);
                                        
 
 
 and 
 
 
- 
                     
                        2.  
                           The institution officially confines the beneficiary at public expense for more than
                              30 continuous days.
                            
 
 
POMS GN 02607.040C, GN 02607.310A.1.a. [1] Benefits must be suspended until the institution officially releases the beneficiary
                  from confinement and the institution ceases to provide for his basic living needs. See id.
               
               For purposes of determining sanity, the court looks at the defendant’s mental condition
                  at the time of the alleged crime, whereas for purposes of determining competence to
                  stand trial, the court looks at the defendant’s mental condition at the time of the
                  court-ordered mental health examination (i.e., pre-trial). See POMS GN
                  
                  02607.320A.1. A person found incompetent to stand trial is never convicted of a criminal offense.
                  See POMS GN 02607.001B.8; GN 02607.320A.1.
               
               II. Minnesota Law
               Minnesota law provides for the civil commitment of individuals who are legally found
                  to be “mentally ill and dangerous to the public” (MID). A person who is MID is defined
                  as a person:
               
               (1) who is mentally ill [2] ; and
               
               (2) who as a result of that mental illness presents a clear danger to the safety of
                  others as demonstrated by the facts that (i) the person has engaged in an overt act
                  causing or attempting to cause serious physical harm to another and (ii) there is
                  a substantial likelihood that the person will engage in acts capable of inflicting
                  serious physical harm on another.
               
               Minn. Stat. § 253B.02 subd. 17.
               Any interested party may start the civil commitment process by filing a petition in
                  court.  See id. § 253B.07 subd. 2. After hearing the petition, if the court finds by clear and convincing
                  evidence that the proposed patient is MID, “it shall commit the person to a secure
                  treatment facility or to a treatment facility willing to accept the patient under
                  commitment.” Id. § 253B.18 subd. 1(a).
               
               The civil commitment of a person who is MID may occur as a result of a criminal case.
                  In civil commitment cases with criminal involvement, a criminal defendant has been
                  found either (1) incompetent to stand trial due to mental illness or deficiency, or
                  (2) not guilty by reason of mental illness or deficiency after a trial. See Minn.
                  Stat. § 611.026; Minn. R. Crim. P. 20.
               
               Under Rule 20.01 of the Minnesota Rules of Criminal Procedure, a defendant is incompetent
                  to stand trial if he is incapable of understanding the proceedings or making a defense
                  due to mental illness or deficiency; such defendant shall not plead, be tried, or
                  be sentenced. If the court finds the defendant incompetent due to mental illness or
                  deficiency, either the criminal charge is dismissed or the proceedings are suspended,
                  depending on the circumstances. Minn. R. Crim. P. 20.01 subd. 6(b), 8. In addition,
                  the court must commence a civil commitment proceeding or, if the defendant is already
                  under civil commitment, order the commitment to continue. Minn. R. Crim. P. 20.01
                  subd. 6(b)(1)-(2).
               
               Under Rule 20.02 of the Minnesota Rules of Criminal Procedure, a defendant who goes
                  to trial may assert a defense of not guilty by reason of mental illness or deficiency.
                  If the defendant is found not guilty by reason of mental illness or deficiency, the
                  court must commence a civil commitment proceeding or, if the defendant is already
                  under civil commitment, order the commitment to continue. Minn. R. Crim. P. 20.02
                  subd. 8(1)-(2). The Minnesota statute further provides that, “[i]n any case where
                  the [civil commitment] petition was filed immediately following the acquittal of the
                  proposed patient for a crime against the person [3] pursuant to a verdict of not guilty by reason of mental illness, the verdict constitutes
                  evidence that the proposed patient is a person who is mentally ill and dangerous within
                  the meaning of this section.” Minn. Stat. § 253B.18 subd. 1(a).
               
               DISCUSSION
               The question is whether Title II benefits should be suspended in cases where beneficiaries
                  are under civil commitment at St. Peter Regional Treatment Center (SPRTC) as MID [4] pursuant to Minn. Stat. § 253B.18. The answer depends on whether the commitment is
                  related to a criminal matter. The two different types of situations and their effect
                  on the payment of Title II benefits are outlined below.
               
               I. MID Civil Commitment Without Criminal Involvement
               As indicated above, under the Minnesota civil commitment statute, any interested party
                  may file a petition for commitment. In cases with no criminal involvement, generally
                  either a family member or the treating hospital serves as the petitioner. See Minnesota Judicial Branch, Second District, Civil Commitment, at http://www.mncourts.gov/district/2/ ?page=40 (last visited July 17, 2013); Ramsey County Attorney, Civil Commitment Unit, at http://www.co.ramsey.mn.us/
               
               attorney/civilcommitments.htm (last visited July 17, 2013); see also generally National Alliance on Mental Illness-Minnesota, Understanding the Minnesota Civil Commitment Process, at http://www.namihelps.org/assets/PDFs/civilcommitmentSinglePg102108.pdf (Dec. 19, 2006).
               
               When there is no criminal involvement, there is no “verdict or finding . . . with
                  respect to a criminal offense,” as required for benefit suspension under the Act and
                  POMS. See Section 202(x)(1)(A)(ii) of the Act; POMS GN 02607.310A.1.a. The only court proceedings are civil proceedings to determine whether a person should
                  be committed under Minn. Stat. ch. 253B. At the conclusion of the proceedings, if
                  the court finds by clear and convincing evidence that the proposed patient is MID,
                  it will order the person to be committed to a treating hospital (usually SPRTC). See Minn. Stat. § 253B.18 subd. 1(a); Ramsey County Attorney, supra. Thus, for individuals who are under civil commitment at a mental health institution
                  with no criminal involvement, Title II benefits should not be suspended.
               
               EXAMPLE: A probate court ordered Lisa Pringle committed as mentally ill, and she was
                  admitted to SPRTC. On a subsequent MID petition, the court found that Pringle was
                  MID and ordered her committed for an indeterminate period of time. The submitted materials
                  and the history provided in Pringle’s court appeal indicate that she was never charged
                  with any criminal offense, and that Regions Hospital was the petitioner in the MID
                  civil commitment proceeding. See In re Civil Commitment of Pringle, No. C1-02-1635, 2003 WL 174885 (Minn. App. Jan. 28, 2003). Accordingly, Pringle’s
                  benefits should not be suspended.
               
               II. MID Civil Commitment With Criminal Involvement
               As mentioned above, MID civil commitments may occur in connection with criminal cases
                  where the court finds a defendant either (1) incompetent to stand trial due to mental
                  illness or deficiency (Rule 20.01), or (2) not guilty by reason of mental illness
                  or deficiency (Rule 20.02). See also Minn. Stat. § 611.026 and Rule 20. In both instances, if the defendant is not already
                  under civil commitment, the court must commence a civil commitment proceeding.
               
               Where there is criminal involvement, petitions for MID commitment are most often initiated
                  by the County Attorney’s Office, usually immediately after the finding of incompetency
                  or the verdict of not guilty by reason of mental illness or deficiency in the criminal
                  prosecution. See Ramsey County Attorney, supra. In particular, if a person was tried and acquitted of a certain type of crime (i.e., a “crime against the person”) as not guilty by reason of mental illness or deficiency,
                  the verdict constitutes evidence that he is MID. See Minn. Stat. § 253B.18 subd. 1(a).
               
               If a defendant in a criminal case was found either (1) incompetent to stand trial
                  due to mental illness or deficiency, or (2) not guilty by reason of mental illness
                  or deficiency, and he also has been under civil commitment at a mental health institution at public
                  expense for more than 30 continuous days, the requirements for Title II benefit suspension
                  under the Act and POMS have been met. See Section 202(x)(1)(A)(ii)(III)-(IV) of the Act; POMS GN 02607.310A.1.a.
               Benefits should continue to be suspended until the institution officially releases
                  the beneficiary and ceases to provide for his basic living needs. See Section 202(x)(1)(B)(ii) of the Act; POMS GN 02607.040C, GN 02607.310A.1.a & 3, GN 02607.330A.1 & 4. With respect to incompetency cases, the POMS states that, even if the criminal
                  charges are dismissed, that does not affect the beneficiary’s suspension status. POMS
                  GN 02607.330A.1. Such a beneficiary should thus remain in suspension status until the condition above
                  is met.
               
               EXAMPLE: In October 2011, Felix pled guilty to a criminal offense. He was sentenced
                  to a two-year diversion program and five years of probation. In June 2012, the criminal
                  court issued a probation violation order. Around October 2012, the issue of Felix
                  competence to proceed was raised, and the criminal court commenced a competency proceeding
                  pursuant to Rule 20.01. Meanwhile, in December 2012 Felix was charged with three additional
                  criminal offenses; he was held in Anoka County Jail. In February 2013, a psychological
                  evaluation report was submitted to the criminal court in connection with the competency
                  proceeding, and the court found Felix incompetent to proceed. A petition for civil
                  commitment was filed that same day in probate court. In March 2013, the probate court
                  held a commitment hearing, and ordered Felix to be committed as mentally ill. He was
                  transferred from Anoka County Jail to SPRTC.
               
               In this case, because of the criminal court’s finding that he was incompetent to proceed,
                  Felix was never tried on his probation violation or subsequent criminal charges. Instead,
                  he was committed as mentally ill at SPRTC. Felix meets the requirements for Title
                  II benefit suspension. That is, he was found incompetent to stand trial due to mental
                  illness in a criminal case, and he has been under civil commitment for more than 30
                  continuous days, presumably at public expense. Note that, for purposes of benefit
                  suspension, it does not matter if the criminal charges against Felix are later dismissed.
                  His benefits should continue to be suspended until SPRTC officially releases him and
                  ceases to provide for his basic living needs.
               
               CONCLUSION
               For the reasons discussed above, we advise that Title II benefits should be suspended
                  only when a beneficiary has been committed at an institution at public expense for
                  more than 30 continuous days, as a result of a court finding that the beneficiary
                  is incompetent to stand trial due to mental illness or deficiency, or verdict of not
                  guilty by reason of mental illness or deficiency
               
               Donna L. Calvert
               Regional Chief Counsel, Region V
               By: _____________ 
               Cristine Bautista
               Senior Counsel