POMS Reference

GN 00503: Payee Notices and Appeal Rights

TN 6 (11-05)

A. Policy

Any time a payee decision is effectuated, the beneficiary or the person who can act for the beneficiary must be given formal notice of the action. This notice does not contain appeal rights if an advance notice was sent to the addressee or if the addressee does not have appeal rights per GN 00503.110A.2.

EXCEPTION: Formal notices to beneficiaries in foreign countries provide appeal rights because we do not send an advance notice.

We send courtesy notices to unsuccessful applicants to advise them of the decision. This notice does not provide any information on who was selected or why, so disclosure policy is not violated.

B. Procedure

Since most payee decisions will be made in the field offices (FO), the FO will be responsible for sending the appropriate notices. Most notices reflected below are contained in the DPS.

Use the following charts to determine what final notice to send to which recipient. (Instructions for advance notices are in GN 00503.100, MS INTRANETERPS 012.008 and NL 00703.763)

The T2R notice system automatically processes most title II postentitlement notices. However, some of these are “I” (incomplete) or “R” (review) notices that require the PC to complete specific information like an address. (See NL 00730.020C.) PCs should prepare and release these notices after receiving the T2R3 output.

Obtain the necessary information by querying the MBR and/or eRPS. Drop file the T2R3 output into the claims folder.

NOTE: SSA-11 packages will no longer be routinely sent to the PC.

Many title XVI notices involving initial appointment and changes of payee (i.e., payee-to-payee) are automated. In addition, the eRPS can be used to generate non-select notices to both adults and children. However, some actions still require manual notices.

In the chart that follows, the “Type of Action” column provides information on whether the notice is systems generated (“automated”), produced by eRPS (ANSN) or must be prepared manually.

    

BENEFICIARY IS AN ADULT — TITLE II

   

Addressee

Type of Action

Notice Reference

Legally Competent Beneficiary, including DACs

Appoint/change a payee -
postentitlement - automated; “R” if has guardian or payee does not have custody

NL 00703.822 and/or
NL 00730.136 including a copy of the notice sent to the new payee.

 

Appoint a payee - initial claim - automated; PC copies notice if processed via MCS/MACADE

NL 00703.822

 

Pay the beneficiary directly (after having been paid through a payee) - automated

NL 00730.136

 

Deny request for direct payment or continue same payee -eRPS

NL 00703.825

MS INTRANETERPS 012.003

Legally Incompetent Beneficiary, including DACs

Appoint/change a payee -
postentitlement - automated but “R” notice

NL 00703.823

NL 00730.136

 

Appoint a payee - initial claim - manual

NL 00703.823

 

Deny request for direct payment eRPS

NL 00703.827

MS INTRANETERPS 012.003

New Payee

Appoint a payee - initial claim - automated

Award notice with payee language from NL 00730.136.

 

Appoint/change the payee - automated but “R” if LAF S7/S9

NL 00730.136

Legal Guardian

Appoint a payee - legal guardian is not payee/applicant - manual

NL 00703.824

 

Change from representative payment to direct payment -manual

NL 00703.828

 

Same method of payment continues - legal guardian is not payee/applicant - manual

NL 00703.826

Former Payee

Change payee or make direct payment - automated but “R” if DOS is less than 12 months

NL 00703.821

Unsuccessful Applicant ( eRPS will produce non-select notices)

Any, except as noted below

NL 00703.821

MS INTRANETERPS 012.003
 

Appoint payee — legal guardian/authorized representative is applicant

NL 00703.824

MS INTRANETERPS 012.003
 

Make direct payment — legal guardian is applicant

NL 00703.828

MS INTRANETERPS 012.003
 

Continue current payment method — legal guardian is applicant

NL 00703.826

MS INTRANETERPS 012.003

Authorized Representative

Appoint a payee - initial claim -addressee is not payee - MCS produces notice if entered on chk/notc screen. PC must copy if processed via MCS/MACADE

NL 00703.822

 

All post adjudicative actions other than when addressee is payee/ applicant - manual

Copy of notice to beneficiary/payee.

   

BENEFICIARY IS AN ADULT - TITLE XVI

 

Addressee

Type of Action

Notice Reference

Legally Competent Adult

Appoint a payee - initial decisions -automated unless legal guardian/authorized representative who is not payee

NL 00703.822 and
NL 00804.185 including a copy of the notice sent to the new payee.

 

Change a payee - automated

NL 00703.822

 

Pay the beneficiary directly (after being paid through a payee) - automated

NL 00730.136
NL 00804.185

 

Deny request for direct payment - eRPS

NL 00703.825

MS INTRANETERPS 012.003
 

Same payee will continue - eRPS

NL 00703.825

MS INTRANETERPS 012.003

Legally Incompetent Beneficiary

Appoint/change a payee -manual

NL 00703.823

 

Deny request for direct payment - eRPS

NL 00703.827

MS INTRANETERPS 012.003

New Payee

Appoint payee - automated unless legal guardian/authorized representative

NL 00804.185

 

Change the payee - automated

NL 00804.185

Legal Guardian

Appoint a payee — legal guardian is not payee

NL 00804.185 (See separate instructions for former payee or unsuccessful applicant if legal guardian must be notified of those actions.)

 

Change from payee to direct pay - eRPS

Same method of payment
continues - legal guardian is not applicant -manual

NL 00703.828
NL 00703.826

MS INTRANETERPS

Former Payee

Any - automated (FO) must send SSA-623 if DOS is 12 or less months

NL 00703.821

Unsuccessful Applicant

Any - eRPS

See title II chart for references.

Authorized Representative

Appoint a payee - addressee is not payee/ applicant - automated

Copy of notice sent to beneficiary/payee.

   

BENEFICIARY IS A CHILD — BOTH TITLES

   

Addressee

Type of Action

Notice Reference

Beneficiary, not legally emancipated

Appoint/change payee

no notice needed

 

Remove the child from direct payment - eRPS

NL 00703.823

MS INTRANETERPS 012.003
 

Change to direct payment - automated except: title II -“R” if guardian or payee does not have custody; title XVI -suppress and send manually if guardian or authorized representative in addition to payee

NL 00730.136

 

Deny request for direct payment - manual

NL 00703.827

Legally Emancipated Minor

Any - manual unless initial appointment of payee or change to direct payment

same as for an adult

New Payee

Any- same as for an adult

same as for an adult

Parent, Person Standing in the Place of a Parent, or Legal Guardian

Appoint a payee -addressee is not the payee - manual unless title XVI and legal guardian is also parent

NL 00703.824

 

Make direct payment to the child - eRPS

NL 00703.828

MS INTRANETERPS 012.003

 

Retain current method - manual

NL 00703.826

Former Payee

Any - same as for an adult

same as for an adult

Unsuccessful Applicant

Any - include “parent, person standing in the place of a parent” with “legal guardian” situations

same as for an adult

Authorized Representative

Any - same as for an adult

same as for an adult

C. Reference

NL 00730.000 - For automated generation of T2R notices