POMS Reference

GN 00605: Representative Payee Accountability

TN 26 (07-07)

A. Introduction

This section summarizes instructions in preceding sections about how to evaluate payee responses on the SSA-623-OCR-SM (Representative Payee Report). The instructions apply to the entire audience, unless otherwise specified.

Most payee report forms will be automatically scanned and reviewed in the Wilkes-Barre Direct Operations Center (WBDOC). The following instructions describe the reviewing guidelines used in the scanning process at WBDOC. They should also be used for those reports which cannot be processed automatically at WBDOC and must be processed manually. For general information on the representative payee report forms, see GN 00605.010.

B. Procedure

REMINDER: When using the chart below to review payee responses, use Direct Contact (DIRCON) (telephone or mail) whenever possible to resolve discrepant responses and confirm unacceptable responses.

1. Reviewing the Responses

Follow the chart below which shows possible payee responses on the 09/2001 version of the SSA-623-OCR-SM, and indicates what, if any, action is required based on each response. REMEMBER: Check the REMARKS section of the form for explanations to questionable payee responses. (See GN 00605.065 for a discussion of the questions on the SSA-623-OCR-SM.)

Question

Payee Response

Action Required

1

 

 

Yes

Technicians will follow procedure in GN 00502.133.

No

No action.

Blank

DIRCON to get an answer

2

Yes

No action.

 

 

No

Review the Representative Payment System (RPS) (and Supplemental Security Record (SSR) to see if the latest beneficiary address is on SSA records. If so, prepare a SSA-5002 (Report of Contact) and document that a face-to-face interview is not necessary. (The need for a payee change was considered when the custody change was input to the SSR/RPS.) Also review the payee coding on the Master Beneficiary Record (MBR)/SSR/RPS and correct as appropriate.

Only develop for an SSA-624-F5 (Representative Payee Evaluation Report) when the latest beneficiary address is not shown on the SSR/RPS or the payee submitted an unacceptable response which cannot be resolved.

Blank

DIRCON to get an answer.

3A

 

 

Yes

No action.

No

Field Office (FO) will conduct face-to-face interviews and complete an SSA-624-F5 if an appropriate explanation cannot be obtained via DIRCON.

Blank

DIRCON to get an answer.

3B

Any amount, or blank

Add to amounts in questions 3C and 3D. If the total is less than 90% of the Total Accountable Amount (TAA) and the payee cannot resolve the difference, the FO will conduct a face-to-face interview and complete an SSA-624-F5.

If the payee indicates “ALL” (or the TAA) as a response to more than one question and the payee cannot resolve the difference, the FO will conduct a face-to-face interview and complete an SSA-624-F5.

3C

Same as 3B above.

Same as 3B above.

 

EXCEPTION: If the beneficiary resides in an institution, $360 or more, or an amount equal to the TAA if smaller

or

an amount less than $360 or the TAA if smaller.

No action.

 

or

an amount less than $360 (a zero amount is not acceptable), or the TAA if smaller, and when added to 3D does not equal $360 or more, or the TAA if smaller.

If the payee cannot explain how he/she provides for the beneficiary's personal needs or how personal needs are met, the FO should review personal needs spending with the payee or consider a change of payee if appropriate.

3D

 

Same as 3B above

Same as 3B above.

An amount equal to or greater than 3 x Federal Benefit Rate (FBR)

Title II No action.

Title XVI or Concurrent – FO will develop according to GN 00603.001, if the payee must be contacted for another reason. POMS SI 01110.000

$2000 or more

Title II – No action

Title XVI or Concurrent – FO will receive an alert from WBDOC when conserved funds equal $2000 or more and must develop continuing Supplemental Security Income (SSI) eligibility. The PSC receives the unacceptable forms because of other unacceptable or blank responses.

 

An amount <20% of TAA and TAA is >$25,000

or

An amount <20% of Conserved Funds (CF) and CF is >$5,000

or

An amount >$10,000 for Title II only cases.

FO should DIRCON for explanation of expenditures

FO should DIRCON for explanation of rapid CF spend down

FO should DIRCON for explanation of possible excessive CF; ensure needs are being met.

 

Any amount, and CF data entry is $5000 or more

If the amount in 3D is less than 25% of the TAA and you contact the payee to resolve another issue, determine if the payee is spending excessively.

4

REMINDER: Apply these instructions only if the amount in question 3D exceeds $500.

 

4A

Checking or Savings
Account.

Review title of account in item 4B. (GN 00603.010; GN 02402.055).

 

U.S. Savings Bonds

Review method of titling in item 4B.

(GN 00605.068H; GN 00603.030)

 

Certificates of Deposit

Review method of titling in item 4B.

(GN 00605.068H.; GN 00603.030)

 

Collective Savings/ Checking Account

Review the PF (Precedent File) data tag at the top of the SSA-6234 to determine if precedent file information for the payee is on record. A “Y” indicates information is on record and no action is needed.

If the PF tag is blank and the payee indicates more than $500 (in question 2E) held in a collective account, the collective account precedent file in RAC must be reviewed and the discrepancy must be resolved.

MSOM RAC 002.007

 

Other

Evaluate type of account in question 5A. Also, review title of account in questions 4B or 5B.

(GN 00605.068G and GN 00605.068H)

 

Blank

DIRCON to get an answer.

4B

Any response except “Other”

No action, if 4A or 5A is acceptable.

 

Other

Evaluate title of account in item 5B.

(GN 00605.068H.)

 

Blank

DIRCON to get an answer.

 5A

Stocks or mutual funds.

Develop according to GN 00603.040.

 

Blank and 4A is “Other”

DIRCON to get an answer.

5B

Any response other than those specified in GN 00603.010, GN 00603.020 and GN 00603.030

Develop according to GN 00605.068H.

 

Blank and 4B is “Other”

DIRCON to get an answer.

6

Blank or signed by someone other than the payee

Develop per GN 00605.069 for a completed, signed payee report

2. Processing Concurrent Cases — Separate Payees Discovered

Decision Factor: Under the accounting selection program, if a beneficiary is concurrently entitled to title II and title XVI payments, a single SSA-623-OCR-SM is generated, which enables the payee to account for all payments received on one form. In these cases the form is controlled under the title XVI system, and the SSA-623-OCR-SM is sent to the payee on the SSR.

NOTE: You can identify a concurrent accounting report by the presence of computer printed data in both the Identification (ID) and Beneficiary Identification Code (BIC) fields in the top portion of the form (see GN 00605.061C.).

In rare cases separate payees may have been appointed for each claim. In accordance with GN 00502.183B.4., one payee should be appointed for all benefits to which the beneficiary is entitled, unless there is some compelling reason to appoint separate payees.

Apply these instructions when you discover that the SSR and MBR show that different payees have been appointed:

  • Resolve the issue which causes the exception;

  • Obtain an SSA-623-F6 (Social Security Administration Representative Payee Report) from the title II payee for the accounting period in question; and

  • Develop for the appointment of the same payee for both claims.