GN 02250: Waiver Provisions for Title II and Title XVIII Overpayments
TN 19 (02-15)
A. How to determine which amount to consider when the beneficiary requests waiver
An overpaid beneficiary may request a waiver of overpayment recovery at any time. An overpaid beneficiary may also request a waiver after we have partially or completely recovered the overpayment or denied a prior waiver request. We must make a determination whether to consider waiver for the original overpayment amount or the remaining balance.
NOTE: For cases where we have recovered all or part of the overpayment via tax refund offset (TRO), see GN 02201.030 and GN 02201.033.
1. Outstanding overpayment balance
In most situations, a beneficiary will request a waiver when there is an outstanding overpayment balance (e.g. before we have collected all of the overpaid monies). If there is a question as to whether the beneficiary is seeking waiver of just the outstanding balance, or whether the beneficiary is seeking waiver of the entire overpayment amount, clarify the issue.
Example: Daniel Mason was overpaid $5,000. We recovered $2,000 of the overpayment through full benefit withholding. The overpayment balance is now $3,000. He files a waiver request stating the overpayment was not his fault and he now cannot afford to repay the overpayment. We will make a waiver determination based on the $3,000 overpayment balance.
Example: Daniel Mason was overpaid $5,000. We recovered $2,000 of the overpayment through full benefit withholding. The overpayment balance is now $3,000. He files a waiver request stating the overpayment was not his fault and he cannot afford to repay the $5,000 overpayment. We will make a waiver determination based on the entire $5,000 overpayment.
2. Waiver requested after we have fully recovered the overpayment
If the beneficiary requests a waiver after we have recovered the entire overpayment (via benefit withholding, installment payments, refund, tax refund offset (TRO), etc.), make a determination based on the entire overpayment amount.
Example: Emma Williams was overpaid $600. We recovered the entire overpayment through full benefit withholding for March and April. She files a waiver request in May stating the overpayment was not her fault and she is unable to meet her living expenses. She used a credit card to offset what we withheld to pay her rent and utilities. We will make a waiver determination based on the entire $600 overpayment.
3. Overpaid beneficiary went into debt
In order to consider whether collection of the overpayment will defeat the purpose of the program, the overpaid beneficiary must show that debt was incurred to repay the overpayment, or, that all current income (including benefit payments) is needed to meet living expenses and is unable to repay the overpayment. For more information regarding defeat the purpose, see GN 02250.100.
Example: Daniel Mason was overpaid $5,000. He repaid the entire overpayment through full benefit withholding. He files for waiver stating the overpayment was not his fault, and he is unable to meet his living expenses. In addition, he alleges he lost his home. We will make a waiver determination based on the entire $5,000 overpayment.
B. Refund submitted and waiver is pending
While the waiver request is pending, if the beneficiary refunds the overpayment (either in full or in part), consider the entire amount of the overpayment when making your determination. This includes the amount of the refund. Process the waiver request as normal by following the instructions in GN 02250.000
C. Refund submitted after we have already approved the waiver
If the beneficiary submits a refund after approval of the waiver request, review the prior waiver determination to determine the basis for the approval.
1. Waiver was approved based on against equity and good conscience
If we have approved the waiver because recovery is against equity and good conscience, take the following action with the submitted refund:
Return the refund to the beneficiary; and
Document the remarks screen in the Debt Management System (DMS).
2. Waiver was approved based on defeat the purpose of the Act
Determine whether accepting the offered refund would still defeat the purpose of the act
a. Collecting the refund would still defeat the purpose of the Act.
If the beneficiary:
Borrowed the refund money, or,
Deprived himself or herself of funds needed for ordinary and necessary living expenses, see GN 02250.120.
return the funds to the beneficiary and document DMS Remarks.
b. Collecting the refund now would not defeat the purpose of the Act.
Take the following actions if development shows that recovery does not defeat the purpose of the Act:
Reopen the waiver determination following the instructions in GN 02250.385;
Hold a personal conference, see GN 02270.000;
Revise the determination based on the facts;
Attach a statement to the initial waiver determination documenting the change; and
Notify the beneficiary accordingly following the instructions in GN 02250.370.
NOTE: If we are unable to reopen the waiver determination based on administrative finality, return the refund to the beneficiary and document the action via DMS Remarks.
D. References
GN 04001.001 Reopenings – General Statement
GN 04001.010 When and Why SSA Reopens – Policy Principle
GN 02201.033 Handling Postoffset/Postcertification Inquiries
GN 02201.034 Processing a Waiver Request
GN 02250.115 Application of Defeat the Purpose Provisions
GN 02250.150 Against Equity and Good Conscience
GN 02403.006 Processing Remittances Received in the Field Office (FO)