TN 8 (07-11)

A. Policy on appeal rights

The decision to appoint a representative payee (the capability determination), and the payee selection are initial determinations, subject to the formal appeals process with certain exceptions. For a list of decisions which are not determinations see GN 00503.110B in this section.

1. Specific issues which carry appeal rights

Below are initial determinations, subject to the formal appeals process.

• Appointment of a payee for a beneficiary under age 18 who is no longer under parental control through a court order (an emancipated child);

• Payment of benefits to a payee for a legally competent adult;

• Selection of a specific individual as a payee;

• Payment of accrued or conserved funds to the beneficiary in installments instead of a lump sum;

• Negligence in misuse cases; and

• Selection of someone other than the parent of a minor child as payee.

  For exceptions on sending an advance notice to a parent, see GN 00503.100E.2.b. For more information on when not to send an advance notice if the proposed payee is a parent, see GN 00503.100E.2.c.

2. Who may appeal an initial determination

The following can appeal an initial determination:

• a legally competent adult beneficiary;

• a legal guardian of a legally incompetent beneficiary;

• a legal guardian of a minor child;

  EXCEPTION: Statutory guardians do not have appeal rights.

  For information on additional development/considerations when there is a guardian, see GN 00502.139;

• an emancipated minor;

• a custodial or non-custodial parent of a minor child;

  EXCEPTION: If the court removes a child from the parent’s custody and the court has permanently terminated parental rights, a court-appointed guardian or custodian rather than the parent is the only person who can appeal on behalf of the child.

  For information on when to use good judgment, see GN 00503.100E.2.d. For information on additional exceptions, see GN 00503.100E.2.

• a person standing in place of a parent for a minor child;

• an authorized representative appointed by the beneficiary or legal guardian; or

• a voluntary conservator.

B. List of decisions which are not initial determinations

Not all of the decisions made regarding payees are initial determinations. The following are not initial determinations and are not subject to the formal appeals process:

• Decision that a minor whom the court finds still to be under parental control needs a payee;

• Payment of a large conserved or accrued benefit to a representative payee in installments;

• Determination of misuse;

• The applicant cannot appeal the determination not to appoint a payee applicant; (When appointing someone other than the parent of a minor child as a payee, see GN 00503.110A.1.);

• Determination that a representative payee is required for a legally incompetent beneficiary; and

• Suspension of benefits pending the appointment of a representative payee.

NOTE: A beneficiary may appeal the determination that he or she is legally incompetent. However, we must pay the beneficiary through a representative payee unless we change the decision.

C. References

• GN 00504.160, Required Contacts Before Issuing Payments Following a Period of Suspension or Nonpayment

• GN 00603.070, Payment of Large Amounts of Accumulated or Conserved Benefits – Title II Only

• GN 00503.150, Notice of Suspension for Payee Development