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VB 00205.165: Establishing Good Cause For Payment to a Beneficiary in the United States For More Than 1 Full Calendar Month

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  • Effective Dates: 06/25/2014 - Present
  • Effective Dates: 04/15/2018 - Present
  • TN 1 (11-01)
  • VB 00205.165 Establishing Good Cause For Payment to a Beneficiary in the United States For More Than 1 Full Calendar Month
  • A. Introduction
  • A beneficiary who has been in the United States for more than 1 full calendar month can continue to be considered a foreign resident and to be paid SVB if certain conditions exist, as explained in VB 00205.160C.
  • B. Policy
  • 1. Beneficiary Remains in United States Due to Circumstances Beyond His/Her Control
  • To establish good cause for the continuance of his/her foreign resident status and the continued payment of SVB while present in the United States, a beneficiary who states that he/she made a good faith effort to return to his/her home abroad but was prevented from doing so by circumstances beyond his/her control must submit the following:
  • * Evidence of the good faith effort he/she made to return to his/her home abroad before 1 full calendar month had elapsed;
  • * Evidence of the circumstances/event that prevented him/her from returning to his/her home abroad within the 1 full calendar month period; and
  • * His/her signed statement showing what efforts he/she had made to return to his/her home abroad and the date he/she intended to return, what happened to prevent this and when he/she plans to return to that home.
  • If the beneficiary is unable to give this statement (e.g., he is hospitalized and his condition prevents making any statement), the statement may be obtained from a relative or other person assisting in this request. The name, address and relationship of this individual to the beneficiary must be obtained. NOTE: in these instances representative payee development may be necessary.
  • See VB 00205.165D. for a discussion of the kinds of evidence which can be submitted.
  • 2. Beneficiary Remains in United States to Appeal SSA Determination
  • To establish good cause for the continuance of foreign resident status and the continued payment of SVB, an individual who has been in the United States for more than 1 full calendar month in order to be present for an appeal in connection with his/her claim filed under an SSA-administered program must submit the following:
  • * Evidence identifying the proceeding in which the beneficiary is involved and the date(s) he/she is scheduled to attend (or if this is not set, the date(s) of the public portion of the proceeding is to be held); and
  • * His/her signed statement showing the proceeding he/she is/will be attending, when he/she believes his/her participation in it will be concluded and when he/she plans to return to his/her home abroad.
  • C. Process—Beneficiary in the United States Claims Good Cause for Staying in the United States for more than 1 Full Calendar Month
  • 1. FO Action
  • If an SVB beneficiary contacts an FO and indicates that he/she must stay in the United States for more than 1 full calendar month because he/she is unable to return to his/her home abroad, the FO will develop for good cause. The FO will assist him/her in making the statement described in VB 00205.165B. It will make photocopies of the evidence needed and forward these and the beneficiary's statement to the appropriate CPS. The FO will tell the beneficiary to notify SSA promptly if the situation changes and/or if he/she decides to return to his/her home abroad.
  • 2. CPS Action
  • The CPS will determine whether good cause exists for the beneficiary's failure/inability to return to his/her home abroad within the 1 full calendar month limit. It will notify the beneficiary (at his/her address in the United States) of its determination and suspend/resume/continue SVB payments, if appropriate.
  • 3. Follow-up Action
  • a. Follow-up With SVB Beneficiary
  • If the beneficiary's statement includes the date he/she expects to return to his/her home abroad, the FO will contact the beneficiary at his/her U.S. address 2 weeks after that date.
  • If the beneficiary is unable to provide the date for his/her return to his/her home abroad, the FO will contact the beneficiary no more than 60 days later at his/her U.S. address. The contact may be made at an earlier time if the circumstances of the case warrant it.
  • b. Contact With SVB Beneficiary
  • If the beneficiary has returned to his/her home abroad, the date he/she returned is obtained. Absent information to the contrary, this information is accepted at face value. The SVB file is documented to show this and from whom the information was obtained. No further action needs to be taken other than to update the Intranet site to show the date the beneficiary returned to his/her home abroad.
  • If the beneficiary is still in the United States, information is secured as to why he/she is still in the United States and what plans he/she has for returning to his/her return abroad. Evidence (as explained in VB 00205.165D.2 or VB 00205.165D.3) of the continued existence of the condition/event that has prevented the beneficiary's return to his home abroad is obtained. If the evidence establishes that good cause continues, another contact is made as explained in VB 00205.165 C.3.a.
  • D. Kinds of Evidence
  • 1. Evidence of the Beneficiary's Good Faith Effort to Return to His/Her Home Abroad
  • This can include, but is not limited to:
  • * A plane ticket showing a date of return within the 1 full calendar month period
  • * Notification from a travel agency, airline etc. confirming the beneficiary's reservation to return to his/her home abroad on a date within the 1 full calendar month period
  • * Confirmation (or other official notice) of the cancellation of his/her ticket to return on a date within the 1 full calendar month period
  • 2. Evidence of Circumstances Preventing Beneficiary's Return to His/Her Home Abroad
  • This can include, but is not limited to a:
  • * Newspaper article or other publication describing the event (transportation strike, disaster, etc)
  • * Statement from the doctor treating the beneficiary
  • * Certificate, obituary, etc. showing death of family member
  • 3. Evidence of Presence to Appear at SSA Appeals Proceeding
  • This can include but is not limited to:
  • * An SSA letter to beneficiary advising him/her of where and when the proceeding will be held
  • * A letter from beneficiary's attorney or other representative advising him/her where the proceeding will be held and when he/she is scheduled to appear
  • E. Process—Beneficiary Outside the United States Claims Good Cause for Staying in the United States for more than 1 Full Calendar Month
  • 1. General
  • It may be necessary to develop good cause for a beneficiary, who stayed in the United States for more than 1 full calendar month, after the beneficiary has returned to his/her home abroad. Generally this occurs when a beneficiary did not report a visit to the United States and SSA learned after the beneficiary returned to his/her home abroad that he/she was in the United States for more than 1 full calendar month.
  • If the beneficiary is in the Philippines, the Foreign Service Post in Manila will contact the beneficiary and obtain the necessary evidence (as explained in VB 00205.165E.3.) and forward this material to the appropriate CPS for a determination on whetherthe Foreign Service Post good cause exists.
  • If the beneficiary is in the Philippines, the Federal Benefits Unit in Manila will contact the beneficiary and obtain the necessary evidence (as explained in VB 00205.165E.3.) and forward this material to the appropriate CPS for a determination on whether good cause exists.
  • If the beneficiary is not in the Philippines, the FO or FSP servicing his/her address outside the United States will undertake this development.
  • NOTE: If a beneficiary returns to his/her home abroad within 1 full calendar month after the cessation of the good-cause extension, SSA considers him/her to be a foreign resident. If he/she stays in the United States for more than 1 full calendar month after the cessation of the good-cause extension, SSA assumes the he/she has lost or abandoned his/her foreign resident status, as explained in VB 00205.160A.
  • 2. Beneficiary States He/She Was Unable to Return to His/Her Home Abroad Within 1 Full Calendar Month Due to Circumstances Beyond His/Her Control
  • In such cases, the beneficiary must submit a signed statement explaining what occurred and documentary evidence showing:
  • * The date he/she left his/her home abroad, if the trip to the United States was not previously reported to SSA. (This can be a plane ticket, passport, etc. showing the date of departure for the United States.) and
  • * His/her good faith effort to return to his/her home abroad within 1 full calendar month (as described in VB 00205.165D.1.) and
  • * The circumstances/event that prevented his/her return within the 1 full calendar month (as explained in VB 00205.165D.2.) and
  • * The termination of the circumstances/event (i.e., evidence similar to that listed in VB 00205.165D.2.) and
  • * The date he/she returned to his/her home abroad. (This can be a plane ticket, passport, etc. showing the date he/she returned to the country in which he/she resides.)
  • 3. Beneficiary States He/She Was Unable to Return to His/Her Home Abroad With 1 Full Calendar Month Because He/She Was Personally Appearing at His/Her Appeal of an SSA Determination
  • In such cases, the beneficiary must submit a signed statement explaining what occurred and documentary evidence showing:
  • * The date he/she left his/her home abroad, if the trip to the United States was not previously reported to SSA. (This can be a plane ticket, passport, etc. showing the date of departure for the United States.) and
  • * The proceeding (e.g., ALJ hearing) involved and his/her attendance or the dates of the public portion of the proceeding. (This can be the decision rendered in the appeal showing his/her presence, evidence listed in VB 00205.165D.3., etc.) If the beneficiary states that his/her presence was required beyond this time, evidence of that must be submitted.
  • * The date he/she returned to his/her home abroad. (This can be a plane ticket, passport, etc. showing the date he/she returned to the country in which he/she resides.
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