TN 32 (08-23)

GN 00504.260 Representative Payee Requests Waiver of Benefits (Title II)

A. Policy

1. General

A payee's request to waive a beneficiary's right to title II benefits must be submitted in writing. Policy guides shown in GN 02409.001 will also apply when the request is made by a payee. The request is honored if found to be in the beneficiary's best interests. The ARC, CDPS (or CDIPS) is responsible for making the formal determination.

CAUTION: These instructions apply to waiver requests on title II benefits only. Before considering waiver of benefits in initial claims, be sure that the request is received from the proper applicant, and close-out procedures have been properly followed. If there is any question of the advisability of the request, consider appointing another payee for the beneficiary. For information on withdrawal of title II benefits, see GN 00206.005 and GN 00206.010. For information on voluntary termination of title XVI benefits, see SI 02301.230.

2. When to Honor Request for Waiver

The ARC, CDPS (or CDIPS) will honor a request for waiver if the payee:

  • fully understands the consequences of the request, and

  • convincingly explains how the request, if approved, will secure some advantage to or further the interests of the beneficiary.

B. Procedure

1. Documentation Requirements

  1. a. 

    Obtain the following information, as appropriate, for folder documentation:

    • The name of the requester, their relationship to the beneficiary; if they have custody of the beneficiary, and/or the amount of money which they contribute toward the cost of the beneficiary's care, maintenance, and other day-to-day needs.

    • Information about the beneficiary's current living situation, what their needs are, how needs are being met, if the beneficiary's living arrangements may change in the foreseeable future, and other pertinent information.

    • The reason for the request; e.g., religious beliefs or an adoptive parent's wish for the child not to know natural parents' identity, etc.

    • The names, addresses, and relationships of other persons interested in the beneficiary's well-being, including the name of the facility (or person) with custody of the beneficiary.

    • The name and address of the beneficiary's legal guardian, spouse, and natural or adoptive parent of minor child. Each of these should be considered as potential payees.

    • A statement to the effect that they understand that if the waiver is honored, they may request that it be revoked at any time in the future; however, the revocation may have limited retroactivity.

      If a withdrawal is approved, a subsequent application is needed and will have limited retroactivity.

  2. b. 

    Document the file with the date the waiver request is to be effective and secure a signed statement that the payee understands that it will apply to all future benefits due the beneficiary unless it is later revoked. (There are no provisions that authorize a partial waiver of benefit payments with the exception of waiving all of the payment except the SMI premium.)

2. Verification Requirements

If the reason for waiving benefits is for financial benefits (e.g., eligibility for Medicaid benefits), verify the expected outcome of waiving the benefits with the appropriate source and document on an RC.

NOTE: Since a waiver of benefits by a payee may be retroactively revoked (unlike one by a capable beneficiary), we must ensure the decision is based on accurate information.

3. Requester Does Not Have Custody of the Beneficiary

  1. a. 

    If the requester does not have custody of the beneficiary, contact the beneficiary's custodian and ascertain:

    • Beneficiary's living situation and needs.

    • Who is providing funds for care.

    • Who is demonstrating concern for the beneficiary's well-being.

    • Degree of concern shown by the person filing the waiver request.

  2. b. 

    If there is a legal guardian, contact them and:

    • Advise of the waiver request.

    • Give the legal guardian an opportunity to file to be payee or to protest the waiver.

    • Request a signed explanation, if the legal guardian does not wish to file.

    • Summarize on an RC that the legal guardian will not file to be payee, if the legal guardian refuses to furnish a signed statement.

  3. c. 

    Contact the spouse or natural or adoptive parent of a minor child if they contribute to the beneficiary's support or demonstrates strong concern. Inform them of the waiver request and give them an opportunity to file to be payee or to protest the waiver.

4. Waiver Not in Beneficiary's Best Interests

Develop for a qualified payee if the FO investigation shows that the beneficiary's needs are not being adequately provided for and benefits are needed to improve or maintain day-to-day needs. Follow the procedures in GN 00504.100B.1. as part of the development. When appropriate, refer the matter to a public social agency (see GN 00504.300).

5. Processing a Waiver Request

Send the waiver request with results of the FO investigation, recommendation, and rationale to the PC.

NOTE: The PC will associate the material with the claims folder and forward to the ARC, CDPS (or CDIPS) for a decision. Document the decision on the Report of Contact Details screen in the eRPS (MS INTRANETERPS 016.002).

Do not suspend unless the requester is the payee, has requested suspension or is refusing to accept future checks and direct payment to beneficiary is prohibited. (Follow guidelines in GN 00504.105.)

NOTE: The PC will ask the FO to develop for a qualified payee if the request is denied and if the FO has not already done so.

C. Reference

Conditions under which benefits may be waived, GN 02409.001 through GN 02409.030.

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GN 00504.260 - Representative Payee Requests Waiver of Benefits (Title II) - 08/11/2023
Batch run: 08/11/2023