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The Commissioner of Social Security has the authority to make benefit payments to an individual or organization other than the beneficiary when doing so would serve the beneficiary’s interest. When the U.S. Social Security Administration (SSA) determines a beneficiary is incapable of managing or directing the management of his or her benefits, a representative payee is assigned. The decision to appoint a representative payee entails weighing the beneficiary’s personal autonomy and preferences against interventions meant to protect his or her best interests. The consequential nature of this decision implies the need to make such decisions with great care and the best evidence available.
With support from SSA, the Institute of Medicine of the National Academies of Sciences, Engineering, and Medicine convened a committee to evaluate SSA’s capability determination process for adult beneficiaries with disabilities and provide recommendations for improving the accuracy and efficiency of the agency’s policy and procedures for making these determinations. In Informing Social Security’s Process for Financial Capability Determination, the committee presents a conceptual model for financial capability and reviews requisite abilities for managing or directing the management of benefits, methods and measures for assessing financial capability, the use of capacity assessment tools, and effects on the beneficiary of appointing a representative payee.