GN 00503: Payee Notices and Appeal Rights
TN 7 (01-06)
The Social Security Act requires SSA to provide advance notice to any legally competent individual before appointing a representative payee. Once a determination of incapability is established and a payee has been selected, advance notice of the proposed payee appointment must be afforded the beneficiary, or the person who can act for the beneficiary per GN 00503.100E., prior to certification of benefits to the proposed payee. (See GN 00501.015 for notice responsibility.)
The decision to appoint a representative payee (the capability determination) and the selection of the payee are both initial determinations and therefore carry appeal rights (see GN 00503.110 for Appeal Rights). Advising the beneficiary (or the person who can act for him) of his/her due process and appeal rights using the advance notice is a legal requirement. Do not send the current payee an advance notice unless he/she is one of the individuals described in GN 00503.100E. Instead, a final notice as described in GN 00503.130 must be sent to the former payee when the change is made.
EXCEPTION: Advance notice is not required for beneficiaries living in foreign countries (see GN 00503.130 and GN 00505.044). Also, in certain situations, an advance notice is not sent to a parent (See GN 00503.100E.2.).
NOTE: Contacting the current payee to obtain input on a proposed change of payee action is a procedural requirement, as described in GN 00504.100B.1. Sending the advance notice and contacting the current payee are two different requirements and should not be confused.
REMINDER: As an initial determination, the law requires that SSA provide the beneficiary with advance notification of the payee decision prior to certification of benefits to the proposed payee. Receiving a signed statement (e.g., SSA-4164) along with the SSA-11, Request to Be Selected as Payee, does not satisfy the advance notice requirement because a payee has not yet been selected. See GN 00503.100B.1. for instructions on when the SSA-4164 may be used.
1. When to Provide Advance Notice
Advance notice must be provided when:
a payee appointment will be made, whether an initial appointment or a change of payee (including title II beneficiaries who are technically entitled);
a child will continue to have a payee after the child attains age 18;
benefits are resumed to the same payee after nonpayment of 6 or more months (as described in GN 00504.160);
a beneficiary has the same payee when reentitled after correct termination of benefits (as described in GN 00504.180).
Give the beneficiary advance notice once incapability is established and a proposed payee has been selected. When disability is involved, advance notice should not be provided until the DDS has made a favorable decision.
2. Contents of Notice
The contents of the advance notice must inform the beneficiary that SSA has determined that a payee is needed, the name of the proposed payee, and the beneficiary's right to appeal. The notice will also advise the beneficiary that if no protest is received within 10 days of the receipt of the notice, payment will be made to the payee as stated in the notice. It also explains the 60-day reconsideration period. (The notice language is shown in NL 00703.763 - NL 00703.769.)
NOTE: Since no payee application is needed when a child's payee will continue after the child attains age 18 (situation b. above), the advance notice has to be prepared manually.
CAUTION: Since no advance notice is sent to beneficiaries living in foreign countries, the final notice in those cases must include a full explanation of appeal rights.
3. SSA-4164 (Advance Notification of Representative Payment)
The SSA-4164 provides the beneficiary (or legal guardian/representative who can act for the beneficiary) with advance notification of representative payment. When the SSA-4164 is used as the advance notification, a signed copy must be given to the beneficiary and a signed one must be retained by SSA, either in an electronic folder (if possible) or in the claims file.
B. When to Use the SSA-4164
Use the SSA-4164 when the beneficiary is in the local office, agrees to the appointment and the interviewer has determined that the payee applicant is the best payee choice. This will usually occur where a very stable beneficiary/payee relationship (e.g., parent/adult-child, husband/wife) exists. In such a case, it is not necessary to mail an advance notice. Upon demand, the Electronic Representative Payment System (eRPS) will generate two copies of the SSA-4164; a signed copy must be given to the beneficiary and a signed one must be retained by SSA, either in an electronic folder (if possible) or in the claims file.
Retain a copy of the SSA-4164 until 5 years after benefits are terminated. ALERT: The completion of this form does NOT eliminate the need for a thorough investigation of the payee applicant's suitability. It should be used only after entitlement is established, the required payee investigation is conducted and the payee selection made. However, it will eliminate the need to delay processing until the expiration of the appeal period.
The DO receives a medical allowance from the DDS on an SSI claim. As requested, the beneficiary comes into the DO to update income and resource information. The beneficiary is accompanied by his/her mother who had filed to be his/her payee. The beneficiary indicates that he/she wants his/her mother to be payee and that she helps with his/her daily needs. It would be appropriate to explain the advance notice requirements to the beneficiary, have him/her sign an SSA-4164 and give a copy to the beneficiary. A signed one must be retained by SSA, either in the electronic folder (if possible) or in the claims file.
A parent is a natural or adoptive parent.
2. Person Standing In Place of a Parent
A person standing in place of a parent is a person who is fulfilling parental duties in the absence of a natural or adoptive parent.
Almost all representative payee applications are processed via the eRPS. Once a payee selection has been made in the eRPS, the appropriate advance notice can be triggered from the eRPS. When a regular advance notice is requested (MS INTRANETERPS 012.008), the eRPS will automatically determine who is sent the advance notice and will produce the advance notice, which is mailed from CO. eRPS can only send one advance notice for each title (i.e., title II and title XVI). If more than one is required (e.g., you decide both parents should get advance notice), it must be done manually using DPS. Also in certain situations described below, eRPS cannot detect that an advance notice is needed; therefore a manual notice must be prepared.
When a SSA-4164 is requested (option 3 off the RPRR) to satisfy advance notice requirements, two copies will be generated immediately in the FO.
NOTE: Be sensitive to situations where sending the advance notice to the beneficiary may seem irrational (e.g., beneficiary is in a coma or in advanced stages of Alzheimer’s disease); explain to the prospective payee that this is a legal requirement and Congress enacted this provision to provide a safeguard against a potentially adverse action. The law does not permit SSA to decide whether a person is capable of fully comprehending the due process notice. As levels of comprehension are frequently different between individuals with seemingly similar circumstances, a universal notification policy provides the greatest protection for all individuals.
1. Beneficiary is an Adult or Legally Emancipated Child
If the beneficiary is an adult or legally emancipated child, send advance notice to the:
beneficiary, if legally competent; or
legal guardian or legal representative, if the beneficiary is legally incompetent and the legal guardian or legal representative is not the proposed payee.
CLARIFICATION: Do not send advance notice to statutory guardians or legal guardians of competent adults. However, always send a copy of an advance notice to the authorized representative. (See GN 00502.139.)
REMEMBER: A beneficiary age 18 or older is considered an adult, even though entitled to a child's benefit.
NOTE: Advance notices to legally emancipated child beneficiaries must be prepared manually.
2. Beneficiary is a Child
If the beneficiary is a child, under age 18 and not legally emancipated, the need for an advance notice depends on many factors.
a. Send Advance Notice to Legal Guardian or Authorized Representative
Send an advance notice to the legal guardian or legal representative, if he/she is not the proposed payee.
b. Send Advance Notice to Parent Unless
Send an advance notice to the parent UNLESS the parent:
is the proposed payee,
is legally incompetent,
is under age 15,
has relinquished parental rights or has had them permanently terminated by a court (see GN 00503.100E.2.d.), or
cannot be notified (whereabouts unknown).
c. Do Not Send Advance Notice if Proposed Payee is a Parent
In most situations, if the proposed payee is a parent, do not send advance notice to the other parent who:
lives in the same household with the parent who will be named payee, or
is the non-custodial parent and the parent with custody will be named payee. (See GN 00503.100E.2.e.)
d. Use Good Judgment
Use good judgment in determining whether a parent (or parents) should receive an advance notice. For children removed from parental custody, review court orders carefully to determine if the parental rights are permanently terminated, rather than temporarily taken away. (Do not assume that the parent(s) has no rights because the child is in foster care.) Determine if the State is the legal guardian when a child is in foster care.
Examples of language on court orders that may indicate that the parent's rights have been permanently terminated are: "permanent placement;" "parental rights have ceased;" and "no further contact by parents."
NOTE: If the court order is unclear about parental rights or guardianship, contact the court for clarification. If further assistance is needed, contact the regional office.
If parental rights are not permanently terminated and one of the exceptions described in GN 00503.100E.2.b. above does not exist, send the parent an advance notice. If there is a legal guardian, eRPS cannot send the notice to the parent. Prepare a manual notice using DPS.
e. Situations Where Other Parent Should Also Receive Advance Notice
Although you are required to send the notice to only one of the parents if someone other than a parent is the proposed payee, there may be situations where you feel the other parent should also receive advance notice. For example, the parents have joint custody of the child. An advance notice to the non-selected parent may be appropriate if the parent with whom the child lives is the proposed payee.
CAUTION: eRPS cannot send the notice in the situation described in e. above. These situations are very sensitive, so exercise caution in handling them.
f. No Parent and Person Standing in Place of a Parent Not Proposed Payee
If there is no parent, and there is a person standing in place of a parent who is not the proposed payee, use your judgment in determining whether advance notice is needed. (This will be a manual notice.)
3. Diary for Protest
The eRPS automatically sets a diary for the protest period for advance notice. If a manual advance notice is needed, diary the case for 15 days to allow sufficient time for a protest to be filed.
4. Beneficiary Contacts FO Before Protest Period Expires
If the beneficiary contacts the FO and states that he/she has received the advance notice, understands his/her rights and agrees to the payee selection, you need not wait until the 15-day diary period expires to effectuate the selection. Document the file on the Report of Contact Details screen or a Report of Contact that the beneficiary has agreed to selection and effectuate the selection decision. Receipt the advance notice issue established in eRPS.
NL 00703.769 and MS INTRANETERPS 012.008 – Advance notice language for addressees other than beneficiary
SM 01010.055 – SM 01010.057 - Early input of SSI initial claims
GN 00504.160 – Development needed when benefits have been interrupted
GN 00503.110 – Appeal rights
GN 00503.120 – Processing protests to advance notice
GN 03101.070 – Appeals – Actions Which Are Initial Determinations
GN 03101.080 – Appeals – Actions Which Are Not Initial Determinations