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 - |
NL 00703.822 and/or |
|
Appoint a payee - initial claim - automated; PC copies notice if processed via MCS/MACADE |
||
|
Pay the beneficiary directly (after having been paid through a payee) - automated |
||
|
Deny request for direct payment or continue same payee -eRPS |
MS INTRANETERPS 012.003 |
|
|
Legally Incompetent Beneficiary, including DACs |
Appoint/change a payee - |
|
|
Appoint a payee - initial claim - manual |
||
|
Deny request for direct payment eRPS |
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 |
||
|
Legal Guardian |
Appoint a payee - legal guardian is not payee/applicant - manual |
|
|
Change from representative payment to direct payment -manual |
||
|
Same method of payment continues - legal guardian is not payee/applicant - manual |
||
|
Former Payee |
Change payee or make direct payment - automated but “R” if DOS is less than 12 months |
|
|
Unsuccessful Applicant ( eRPS will produce non-select notices) |
Any, except as noted below |
MS INTRANETERPS 012.003 |
|
Appoint payee — legal guardian/authorized representative is applicant |
MS INTRANETERPS 012.003 | |
|
Make direct payment — legal guardian is applicant |
MS INTRANETERPS 012.003 | |
|
Continue current payment method — legal guardian is applicant |
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 |
|
|
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 |
|
Change a payee - automated |
||
|
Pay the beneficiary directly (after being paid through a payee) - automated |
||
|
Deny request for direct payment - eRPS |
MS INTRANETERPS 012.003 | |
|
Same payee will continue - eRPS |
MS INTRANETERPS 012.003 | |
|
Legally Incompetent Beneficiary |
Appoint/change a payee -manual |
|
|
Deny request for direct payment - eRPS |
MS INTRANETERPS 012.003 |
|
|
New Payee |
Appoint payee - automated unless legal guardian/authorized representative |
|
|
Change the payee - automated |
||
|
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 |
MS INTRANETERPS |
|
|
Former Payee |
Any - automated (FO) must send SSA-623 if DOS is 12 or less months |
|
|
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 |
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 |
||
|
Deny request for direct payment - manual |
||
|
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 |
|
|
Make direct payment to the child - eRPS |
MS INTRANETERPS 012.003 |
|
|
Retain current method - manual |
||
|
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