SSR 62-46. VALIDITY OF APPLICATION -- SELECTION OF PERSON TO RECEIVE PAYMENTS

The legal guardian of a mentally ill worker, adjudicated an incompetent and confined in a State hospital, filed application in September 1961 for disability insurance benefits on the worker's behalf. The worker was released from the hospital a month later, and was capable of managing any benefits which might be payable. Held, the application filed by the worker's guardian was effective to establish his entitlement to benefits, and benefit payment could be made to the worker despite his legal incompetency.

In March 1961, a worker, W, age 56, was found by a court to be incompetent and was committed to a State mental hospital, suffering from a mental condition which had made him unable to work since November 1958. In September 1961, his sister, who had been appointed his legal guardian, executed and filed an application on his behalf for a period of disability under section 216(i) of the Act, and for disability insurance benefits under section 223. A month later W was released from the hospital on a "trial visit" basis, and applied to have benefits paid to himself. Evidence obtained from the hospital and other sources established that W was still under a disability when released, and had been under such disability since November 1958, and that he had disability insured status.

It was subsequently determined that W had been mentally incompetent throughout the period of his confinement, being unable by reason of insanity to manage his business affairs. the judicial adjudication of legal incompetency was still in full force and effect. However, though W was still unable to engage in any substantial gainful activity, at the time he requested payments be made to him he was looking after some of this personal affairs and was capable of managing any benefits which might be payable. In fact, the psychiatrist familiar with his condition recommended the benefit payments be made to W and stated that the responsibility of handling his funds would have therapeutic value and would help in his rehabilitation.

Sections 216(i) and 223 of the Act provide that a disabled worker must file application in order to establish a period of disability and/or become entitled to disability insurance benefits. Under section 223(b), by filing an application in one month the worker can be entitled to such benefits for each of the preceding 12 months, if (as in this case) all other entitlement requirements were met in such months and the worker is still under a disability at the time application is filed.

The first issue presented in this case is whether the worker has filed application, as required by the law and regulations, through the application filed on his behalf by his legal guardian in September 1961. if that application establishes his entitlement at all, it will establish entitlement to benefits beginning September 1960. If the application was ineffective, W cannot be entitled to a benefit for September 1960.

Regulations No. 4, ยง 404.603 provides:

The Administration determines who is the proper party to execute an application for benefits in accordance with the following rules:
(a) If the claimant has attained the age of 18, is mentally competent, and is physically able to execute the application, the application shall be executed by him.

* * * * * *

(d) If the claimant (regardless of his age) has a legally appointed guardian, committee, or other representative, the application may be executed by such guardian, committee, or representative. * * *

Since W was mentally incompetent when the application in question was filed, under the regulations quoted above his legal guardian could properly execute and file an application on his behalf, and the application when filed established his entitlement to benefits beginning September 1960.

The second issue presented by this case is whether W's benefits should be paid to him, or to his sister as his legal guardian, or to some other person found to be suitable and willing to carry out the responsibility of managing W's benefits in his best interest.

When it appears to the Secretary that the interest of an applicant entitled to a payment would be served thereby, certification of payment may be made, regardless of the legal competency or incompetency of the individual entitled thereto, either for direct payment to such applicant, or for his use and benefit to a relative or some other person.

Under this section (and ยง 404.1601, Regulations No. 4), the Administration may make a payment directly to W even though he is legally incompetent (i.e., a legal guardian has been appointed for him) if it appears that such direct payment would be in his best interest. Consideration of all the facts and the current professional evaluation show that he was capable of managing his own funds, and that such responsibility would have therapeutic value and would help in his rehabilitation and serve his interest.

It was therefore held that W is entitled to disability insurance benefits effective September 1960 on the basis of the application executed and filed on his behalf by his legal guardian. Moreover, the benefits will be paid directly to W, rather than to his legal guardian.


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