GN 02201.009: Notification of a Title II Overpayment

changes
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~~Effective Dates: 10/26/2017 - Present~~
Effective Dates: 07/25/2018 - Present
TN 29 (04-11)
GN 02201.009 Notification of a Title II Overpayment
Citations:
20 C.F.R. § 404.502a
A. Notifying overpaid individuals
When the overpayment is discovered, communicate the fact, amount, and liability for repayment to the overpaid person as soon as possible. If you discover the overpayment because of an oral communication (telephone call or interview), advise the person about the liability for repayment during the first oral contact. Annotate the debt management system (DMS) remarks with the conversation. Always send written notice using the manual adjustment, credit, and award data entry (MACADE) system, the document processing system (DPS), etc.
B. What the notice must include
The overpayment notice must include the following information.
* The total amount of the overpayment and how and when it occurred, including:
* the monthly amount the person was paid,
* the monthly amount the person should have been paid,
* why a different amount was due, and
* the months involved.
NOTE: You may use a single sentence, instead of a chart, when explaining what was paid versus what was payable if the overpayment period does not include multiple months or multiple money amounts.
If the overpayment resulted from the entitlement of another beneficiary, inform the adversely affected beneficiary of the name, relationship to the number holder (NH), and basis for entitlement of the new beneficiary (see PC Procedures for Handling Adverse Claims GN 01010.325).
* The right to reconsideration of the overpayment determination. Persons may request reconsideration if they disagree with the fact or amount of the overpayment.
* The right to request waiver of recovery and the automatic scheduling of a personal conference if a request for waiver cannot be approved. We may grant a request for waiver if:
* the person was not at fault, and
* repaying the overpayment would mean he or she could not pay necessary living expenses or would otherwise be unfair.
* Language requesting full, immediate refund, unless we can withhold the overpayment from the next month's benefit.
* Proposed adjustment if we do not receive the refund within 30 days and adjustment is available (see GN 02210.010).
* The availability of:
* installment payments, when refund is requested and adjustment is not currently available;
* cross-program recovery, when refund is requested and the person is receiving another SSA payment (e.g., Title XVI); and
* a different rate of withholding, when full withholding is proposed.
NOTE: Unless the overpayment was a result of fraud, as determined by the Office of Inspector General (OIG), or similar fault, as determined by SSA.
* The need to notify the field office (FO) promptly if reconsideration, waiver, a lesser rate of withholding, repayment by installments, or cross-program adjustment is requested.
C. Form SSA-3105 (Important Information About Your Appeal, Waiver Rights, and Repayment Options)
The overpaid person can use Form SSA-3105 to do the following:
* request reconsideration of the overpayment;
* request waiver of the overpayment;
* request an explanation of the overpayment;
* request partial benefit withholding;
* enclose full refund of the overpayment; and
* request installment payments to refund the overpayment.
This form must accompany each initial overpayment notice. The form has a tear-off portion that the overpaid person may complete and return to SSA (either to the program service center (PSC) or to the (FO)) to choose one or more of these options. To view a copy of the SSA-3105, see GN 02201.010.
D. Person has a representative
If the overpaid person has a representative (e.g., an attorney or non-attorney) to act on his or her behalf, send a copy of the overpayment notice to the representative.
For instructions on who is a representative, see GN 03910.020.
For instructions on contacting a representative, see GN 03910.050.
E. Debtor is in a foreign country
There are differences in the preparation and delivery of the overpayment notice when the debtor is located in a foreign country.
Follow instructions in GN 02215.001 - GN 02215.015.
F. Advance notice
The recovery diary date (i.e., the date full refund is due and, if appropriate, the date adjustment will begin) must be at least 30 days after the date of the overpayment notice. This advance notice ensures that we grant the overpaid person a meaningful opportunity either to contest the correctness of an overpayment determination or to establish the criteria for waiver.
NOTE: The automated system, as well as MADCAP, calculates this date automatically depending on the debit run date (see SM 00610.715, Recovery when the Overpaid Person is in LAF C or D).
If the debtor responds within 30 days of the date of the overpayment notice, the FO must take action to ensure that we do not interrupt the benefit payments. If we cannot ensure the 30-day period, the program service center (PSC) must extend any proposed adjustment for a longer period.
G. Exception to advance notice
Advance notice is not required if the overpaid person has already received advance notice with respect to the overpayment.
EXAMPLE: In February 2009, we sent an overpayment notice to an overpaid person who is no longer entitled to benefits. She subsequently became re-entitled to benefits in March 2010. A new advance overpayment notice is not necessary and we initiate immediate overpayment recovery in the current operating month (COM).
In addition, advance notice is not required if:
* an incorrect payment results because a payment(s) is directly deposited into a joint bank account after the beneficiary's death and the surviving joint account owner is not entitled on the deceased’s record for the month before the month of death (see GN 02201.001F, Social Security Act §204(a)(3), and GN 02201.007F); or
* benefits are incorrectly paid for the current year based on a current year work estimate of earnings (see GN 02201.001F.).
NOTE: Even though the 30-day advance notice required by GN 02201.009F in this section is not required in this case, we may still be required to provide notice to the debtor before suspending his or her benefits. For more specific instructions, see GN 03001.005.
If advance notice is not required, adjustment begins effective with the COM. However, if the person appeals or requests waiver, then stop recovery and follow normal instructions, depending on the type of appeal requested.
H. Disability benefit continuation cases
Do not send the initial overpayment notice until the debtor’s medical cessation appeal is exhausted; i.e., when:
* the Administrative Law Judge (ALJ) or the Appeals Council (AC) returns the folder (electronic file) after the 60-day period for requesting judicial review expires; or
* you received the court decision, if judicial review is requested.
I. Failure to give adequate notice
If notification is deficient (e.g., notice was not sent, notice was not received at least 30 days before adjustment action, or notice content is inadequate), send a new notice. Issue any benefits prematurely withheld. In other words, repay any monies that we withheld to recover the overpayment to the person. Update the overpayment balance and due process recovery date another COM plus 2 months.
J. Undeliverable notice
If you receive a returned overpayment notice as undeliverable, follow instructions for skip tracing in GN 02210.213C.

POMS Reference

GN 02201.009: Notification of a Title II Overpayment