Adding to what Valveman has already explained, constant leakage to atm will occur if/when the bellows has failed and the PSV outlet is connected to a flare header or some other closed system. Whatever system that is, it will have a higher pressure than atm, thus there's a driving force for leakage (backflow) from the outlet side through the failed bellows to the atm. The whole purpose of this particular design is to ensure that the set pressure remains relatively constant, despite the failure of the bellows. You may ask, why doesn't the balance piston prevent this leakage. The answer is that this is not a sealed (leak-tight) balance piston. The balance piston is closely fitted to the valve stem but there's no o-ring that seals off leakage like there is in small balanced piston PSVs (PSVs with just a balance piston and no bellows).
That's how this valve is intended to work. You may also ask, when would you want to use such a valve? It's for applications in which one prioritizes the importance of holding the set pressure constant, despite the failure of the bellows. Obviously, this means that one is willing to tolerate the continuous leakage (through the cracked bellows) from the outlet system to the atm. I think there are few applications in which this is a tolerable circumstance. So, understand that trade-off and recognize that this design isn't for broad application. It's seldom tolerable to allow a constant leakage to the atm. Also, recognize that it makes no sense to use this valve in an application where the discharge is routed directly to the atm.