Capability refers to a beneficiary’s ability to manage or direct the management of their Social Security benefits. Follow this general principle regarding capability issues for adult beneficiaries:
Presume that a legally competent adult beneficiary is capable of managing, or directing someone else to manage, the benefits to which they are entitled, unless there are indicators or evidence to the contrary.
For information when there is not a presumption of capability, see GN 00502.001C. When you suspect a beneficiary may not be capable, you must make a capability determination. When developing capability, a beneficiary, who exercises direct involvement, control, and choice in identifying, accessing, and managing services to meet their personal and other needs, is capable, and you must pay them directly. Make a finding of incapability only when it is clearly in the best interest of the beneficiary to do so, based on convincing evidence (legal, lay, and medical), using sound and reasoned judgment. The determination that a beneficiary is incapable of managing or directing someone else to manage their benefits is one of the most important determinations you will make. This determination may deprive an individual of fiscal independence and self-determination regarding how benefits are spent. You must follow the instructions in GN 00502.001 through GN 00502.075 when making capability determinations. If you determine a beneficiary is incapable, you must identify and appoint a suitable representative payee. For information on representative payee payment, see GN 00502.001B. After the initial capability determination, you must remain alert to indications of a change in the beneficiary’s condition or circumstances that might require a new capability determination.
To the extent possible, offer the beneficiary an early opportunity to participate in the selection process. The beneficiary may be a key source in the search for a suitable payee. The beneficiary may be able to provide you with information regarding individuals who currently assist them in day-to-day living, as well as those they trust to handle financial affairs. The Social Security Act also allows for advance designation of payees, per GN 00502.085A. For information on advance designation and instructions on how you must consider advance designees, see GN 00502.085.
Find an able, caring payee for any beneficiary whom you determine as incapable, considering the beneficiary’s best interests.
Before changing a current payee, contact the current payee, per GN 00504.100.Attention to payee issues should not end once SSA appoints a payee or determines that a payee is not required. You must remain alert to indications of a change in the payee or beneficiary’s circumstances that may require a new capability determination or payee appointment (this may include changes in direct payment or payee payment).
NOTE : You must document your capability determination per GN 00502.065.
SSA prohibits the following types of beneficiaries from receiving direct payments, and presumption of capability does not apply. These beneficiaries do not need capability determinations and must receive benefits through a payee:
Adult beneficiaries who are judged legally incompetent, follow the instructions in GN 00502.023; andChildren under age 15 (unless they have been legally emancipated). (For direct payment to children, 15 to 17, follow the instructions in GN 00502.070).
For beneficiaries not listed under these prohibitions, you must make a capability determination, based on convincing evidence as noted in GN 00502.001A in this section, to resolve any question regarding a beneficiary’s ability to manage or direct the management of benefits.
The following table contains instructions on capability, selection of payee, and other issues covered in other subchapters that deal with specific payee issues: