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GN 02201.021: Field Office (FO) Actions Title II Overpayment Waiver Request

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  • Effective Dates: 07/08/2016 - Present
  • Effective Dates: 04/25/2018 - Present
  • TN 32 (03-15)
  • GN 02201.021 Field Office (FO) Actions Title II Overpayment Waiver Request
  • A. Stopping recovery
  • Stop recovery using the following instructions:
  • * Stop recovery (if applicable) as of the month we receive the waiver request.
  • * Input the initial waiver protest reason (if the request is in writing) or informal waiver protest reason (if the request is oral) using the Protest/Stop Recovery Request (FO) (DRPF) screen in the debt management system (DMS) (see MS DMS 006.019).
  • * Annotate DMS Remarks to document your actions.
  • * Follow the instructions below for your specific case.
  • B. Waiver processing instructions
  • These are general waiver processing instructions. For more detailed waiver instructions, see GN 02250.001 through GN 02250.425. For more information about personal conferences, see GN 02270.003 through GN 02270.015. If the beneficiary is not requesting a waiver decision and only wants reconsideration of the fact or the amount of the overpayment, agrees to repay the overpayment, or makes a compromise offer for repayment, see GN 02270.007 for miscellaneous waiver policy instruction.
  • 1. Approval overpayment amount is $1,000 or less
  • Follow the $1,000 administrative waiver tolerance instructions in GN 02250.350.
  • 2. Approval overpayment amount is more than $1,000
  • When approving a waiver request where the overpayment amount is more than $1000, take the following actions:
  • * Prepare form SSA-635, Waiver Determination following the instructions in GN 02250.315.
  • * Prepare a notice using the Document Processing System (DPS) following the instructions in GN 02250.370 Waiver Notice.
  • * Determine if peer or management review is applicable following the title II waiver decisionmaker instructions in GN 02250.301.
  • * Input the waiver approval decision to ROAR using the Waiver Disposition (DRWD) screen in DMS (see MS DMS 006.004).
  • * Annotate DMS Remarks to document your actions.
  • * Release the notice.
  • 3. Denial recommendation before personal conference
  • We must provide the beneficiary an opportunity for a personal conference before we can deny the waiver request. Take the following actions:
  • * Input the denial using the DRWD screen in DMS (see MS DMS 006.004).
  • * Annotate DMS Remarks to document why you cannot approve the waiver.
  • * Annotate DMS Remarks to document why you cannot approve the waiver, see GN 02250.315C.
  • * Request the folder (if applicable) following the instructions in GN 02270.003.
  • * Schedule the folder review and personal conference following the instructions in GN 02270.005.E.
  • * Follow the additional instructions for conducting the personal conference, problems with the personal conference, and the personal conference decision in GN 02270.007 through GN 02270.015.
  • 4. Prior waiver denial based on fault is on ROAR for the same overpayment
  • If there is a prior waiver denial on ROAR and we denied the waiver because the beneficiary was at fault in causing the overpayment, take the following actions:
  • * Do not make the waiver determination.
  • * Send the waiver request to the PSC for review in consideration of res judicata.
  • * Annotate DMS Remarks to document your actions.
  • For more information regarding res judicata, see GN 04040.010 and GN 02201.034C.
  • C. Waiver request on the Master Beneficiary Record (MBR) or ROAR and no record of SSA-632-BK
  • A beneficiary may request a waiver either orally or in writing. Therefore, it is possible that we annotated the beneficiary’s record with an informal waiver request and the beneficiary did not submit Form SSA-632-BK, Request for Waiver of Overpayment Recovery or Change in Repayment Rate, or the equivalent. Therefore, you must follow-up by contacting the beneficiary to see if he or she still wishes to pursue waiver and obtain the necessary documentation for fault, income, expenses, etc. At this point, we should have already stopped recovery using the informal waiver protest per the instructions in GN 02201.021A in this section.
  • 1. Contact the beneficiary by telephone
  • Use the following steps when contacting by telephone:
  • * If the beneficiary wants to pursue waiver, obtain a completed SSA-632-BK (or equivalent) and process per GN 02201.021B.2 in this section.
  • * If the beneficiary does not want to pursue waiver, obtain a statement from him or her to this effect and resume recovery via DMS. Use the Establish Offset (Debtor) (DROA) screen for current pay or deferred case (see MS DMS 006.015). Use the Record Installment Agreement (DRIN) screen for suspense or terminated case (see MS DMS 006.014).
  • * Annotate DMS Remarks to document your actions.
  • * If the beneficiary wants to request reconsideration instead, obtain an SSA-561-U2, Request for Reconsideration, and input the request via the Protest/Stop Recovery Request (FO) (DRPF) screen in DMS (see MS DMS 006.019).
  • * Annotate DMS Remarks to document your actions.
  • NOTE: It might be necessary for the FO manager to manually clear the pending informal waiver.
  • 2. If the FO is unable to contact the beneficiary by telephone
  • If you are unable to contact the beneficiary by telephone, take the following actions:
  • * If the beneficiary does not respond to your phone call attempts, send a 30 day close-out letter.
  • * If the beneficiary does not contact the FO within 30 days, resume recovery via the DROA or DRIN screen in DMS.
  • * Annotate DMS remarks.
  • NOTE: The close-out letter should explain that our records indicate the beneficiary expressed interest in filing for waiver of recovery of the overpayment and that we have tried unsuccessfully to contact him or her. Advise the beneficiary that if he or she does not contact us within 30 days with information required to complete and process the waiver request, we will assume he or she does not want to request waiver and recovery will resume.
  • D. Waiver and reconsideration requested
  • The overpaid beneficiary may request reconsideration (appeal) of the overpayment and waiver of recovery at the same time. A formal determination or dismissal of the reconsideration is always necessary prior to making a determination on the waiver request. For more information regarding the request for reconsideration, see GN 02201.025.
  • * Complete any necessary development.
  • * Fax the material into the Non-Disability Repository for Evidentiary Documents (NDRed) and Paperless with a SSA-409, Postadjudicative Routing coversheet explaining this is a combined waiver and reconsideration request.
  • * Annotate DMS Remarks.
  • After processing the reconsideration portion, the PSC will forward the waiver request back to the FO to process if there is a remaining overpayment balance (see GN 02201.025B.4).
  • NOTE: The Office of International Operations (OIO) will process the waiver request along with the reconsideration request. They do not need to forward the waiver to the FO.
  • E. Medicare waiver requests
  • Send the completed SSA-632-BK to the PSC following the instructions in HI 02201.015.
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