SI 02305: Redeterminations of Eligibility and/or Payment Amount
TN 33 (09-97)
A. Introduction
It is important that rep payees act in the best interest of recipients for whom they are receiving SSI payments.
Quality assurance data indicate that there has been more questionable suitability in cases where the rep payee is not a relative of the recipient and lives somewhere other than the recipient's household.
B. Policy
During an RZ, if the rep payee is not a relative and does not reside in the same household as the recipient, development of payee suitability is usually required.
A face-to-face interview is usually required with the recipient and the rep payee.
However, separate face-to-face interviews may be appropriate when the SSI recipient and the rep payee live in different geographic areas. Even though a second FO's assistance may be required, face-to-face interviews are especially important in these cases.
NOTE: Residence in different geographic areas may indicate a need for change of payee.
The face-to-face interview requirement may be waived when the interview would be clearly unproductive.
EXAMPLE: The recipient is comatose, or the interview would impose undue personal hardship on either the recipient or payee (due to hospitalization, work, travel a great distance to interview, etc.).
Other methods including telephone interviews with the party unable to come in, third party verification, etc., may be used to determine the payee's continued suitability.
C. Procedure
Use this procedure to develop rep payee suitability:
Review the Representative Payee (REPY) segment of the pre-RZ SSID. These cases are identified on Post Entitlement Operational Data Store (PE ODS) with an action code of “O.” See MSOM MISCINPUTS 002.002 for a list of action codes.
Develop rep payee suitability if the Type of Payee (T) code is “OTH” and the Custody (CU) code is “SEL”.
Schedule an appointment using an SSA-L3074-U2 or SSA-L3075-U2. Both the rep payee and the SSI recipient should be present, if possible.
Refer to the chart below for processing instructions and questions to ask during the RZ interview to help you determine payee suitability:
| Step | Action |
|---|---|
| 1 | Ask the payee and the recipient whether the recipient is able to manage his /her own funds. Determine if the payee is “managing” the funds or acting as a “conduit.” |
| EXAMPLE: Does the payee give most or all funds to the recipient? | |
| If yes, develop direct payment unless statutorily precluded per GN 00502.020. | |
| If no, go to step 2. | |
| 2 | Ask the rep payee whether the recipient's funds are maintained separately from his/her own funds and how the funds are held. |
| If funds are commingled, consider whether improper use or misuse may be involved, and develop per GN 00504.110 and GN 00604.010. Go to step 3. | |
| If funds are not commingled, go to step 3. | |
| 3 | Ask about: |
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| NOTE: The responses to these questions may provide indicators of the payee's performance in meeting the recipient's needs. | |
| If the visits are infrequent and/or the payee has inadequate knowledge of the recipient's needs, consider whether lack of care and concern on the payee's part is an issue. | |
| 4 | Develop for a change of payee or direct payment, if appropriate per GN 00504.110, GN 00502.010 through GN 00502.110. |
| If there is someone who has more frequent contact with the recipient, he/ she may be a good candidate for rep payee. | |
| 5 | If visits are frequent and/or the payee has adequate knowledge of the recipient's needs, do not develop rep payee suitability any further. |
| 6 | If misuse of funds is indicated during any part of the interview, develop per GN 00604.020 and GN 00604.030. |
| 7 | Document the following on an SSA-5002: |
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