Compliance Geek,
I think you've just got the wrong labels on the players. In the example given, the title would be: John Doe by XYZ Mental Health, Representative Payee.
XYZ Mental Health is opening the account and its appointed personnel would sign any documents. John Doe, the person under the disability, would not sign anything.
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In this world you must be oh so smart or oh so pleasant. Well, for years I was smart. I recommend pleasant.