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SI 02220.005: Documenting the Supplemental Security Income (SSI) Overpayment

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  • Effective Dates: 01/30/2017 - Present
  • Effective Dates: 02/06/2018 - Present
  • TN 41 (01-17)
  • SI 02220.005 Documenting the Supplemental Security Income (SSI) Overpayment
  • A. Background of documenting SSI overpayments
  • * When we pay an SSI recipient more than the amount that he or she is due for a month or more, the recipient is overpaid. We must notify the recipient (and his or her representative payee) of the overpayment. We must then dispose of the overpayment by making one or more of the following overpayment disposition decisions:
  • * Recover the overpayment,
  • * Waive the overpayment; or
  • * Make a determination that the overpayment did not exist, and is erroneous or uncollectible. For information on what constitutes an overpayment, see SI 02201.005.
  • * The overpayment disposition decision reflects how we dispose of an overpayment.
  • * Regardless of the amount of the overpayment, we must document all overpayment disposition decisions on the Supplemental Security Record (SSR).
  • * Technicians must document the rationale for all non-collect overpayment disposition decisions in the case file. For a complete list of non-collect overpayment disposition decisions, see SI 02220.005C.3.a. Additionally, technicians must obtain management review and concurrence on non-collect decisions for overpayments of $2,000.01 or more.
  • * Managers must document their review and concurrence with non-collect decisions on overpayments of $2,000.01 or more.
  • B. Types of overpayment documentation
  • 1. Field office (FO) SSR documentation
  • * Regardless of the overpayment amount, we must first determine all months for which the recipient was overpaid (the overpayment period). For overpayment period information, see SI 02201.005C.4. and SM 01311.035D. Document the final disposition of each overpayment sequence on the SSR you are taking action on, including any notice, collection, transfer, or appeal decision, by posting it through Direct SSR Update.
  • * For original overpayments of $2,000.00 or less, the FO technician (Claims Specialist (CS)/Customer Service Representative (CSR) or higher) selects the applicable overpayment disposition decision on the overpayment decision (UOPD) screen in Direct SSR Update.
  • * The following table lists all possible overpayment decisions found on the UOPD screen (MSOM BUSSR 004.008) with corresponding policy instructions.
  • Overpayment Decision
  • SM
  • SI
  • 1=WAIVER
  • SM 01311.422
  • SM 01311.423
  • SM 01311.424
  • SI 02260.000
  • 2=APPEAL
  • SM 01311.423
  • SM 01311.424
  • SI 02220.001
  • 3=RECOVER BY CHECK ADJUSTMENT
  • SM 01311.120
  • SM 01311.125
  • SI 02220.001
  • 4=UNWILLING TO REPAY
  • SM 01311.200
  • SM 01311.205
  • SI 02220.050
  • 5=UNABLE TO REPAY
  • SM 01311.200
  • SM 01311.205
  • SI 02220.050
  • 6=UNCOLLECTIBLE
  • SM 01311.280
  • SM 01311.285
  • SI 02220.053
  • 7=ERRONEOUS
  • SM 01311.280
  • SM 01311.285
  •  SI 02301.315
  • 8=UNABLE TO LOCATE/OUT OF COUNTRY
  • SM 01311.200
  • SM 01311.205
  • SI 02220.051 or SI 02220.050
  • 9=OVERPAYMENT TO BRING FORWARD
  • SM 01311.350
  • SI 02220.011
  • 10=RECOVER BY INSTALLMENTS
  • SM 01311.235
  • SM 01311.240
  • SI 02220.025
  • 11=COMPROMISE SETTLEMENT
  • SM 01311.290
  • SM 01311.295
  • SI 02220.030
  • 12=INCORRECT OVERPAYMENT
  • SM 01311.340
  • SM 01311.345
  • SI 02201.010 or SI 02201.020
  • 13=RECOVER FROM TITLE II BENEFITS
  • SM 01311.255
  • SM 01311.261
  • SI 02220.020
  • 14=REFERRAL TO DOJ (CIVIL SUIT)
  • SM 01311.220
  • SI 02220.035
  • 15=REFERRAL TO OIG
  • SM 01311.220
  • SI 02220.036
  • 16=REFERRAL TO TREASURY
  • SM 01311.220
  • SI 02220.040
  • 17=BANKRUPTCY
  • SM 01311.220
  • SI 02220.040
  • * If the debtor resides outside the US
  • * If the debtor resides in a foreign country, post a DM TAC (SM 01311.200) to indicate that we are unable to locate the debtor, or the debtor is out of the country.
  • * If the debtor resides in Puerto Rico or the Virgin Islands, post the new residence address.
  • * Post the new address (the system will automatically post the jurisdictional FO code (DIS) to the SSR; and
  • * Transfer the case in MSSICS to the Downtown Manhattan FO, using FO Code “109.”
  • 2. FO case file documentation
  • * Technicians must document non-collect overpayment disposition decisions of any amount on the report of contact (DROC) screen in the Modernized Supplemental Security Income Claims System (MSSICS). List the overpayment:
  • * Amount;
  • * Sequence number;
  • * Sequence date;
  • * Disposition decision; and
  • * Reason for the disposition decision.
  • * For non-MSSICS cases, document the information shown above on form SSA-5002, and fax the SSA-5002 and all related documents into the non-disability repository for evidentiary documents (NDRED). For NDRED information, see GN 00301.322.
  • NOTE: Do not use Form SSA-8108 (SSI Overpayment and Disposition Determination) to document the overpayment disposition because it is obsolete.
  • * For waiver decisions, follow specific waiver documentation requirements in SI 02260.001
  • C. When an overpayment decision requires or does not require management review and concurrence
  • Whether an overpayment decision requires FO management (or higher) review depends on the original overpayment amount. Use the chart in SI 02220.005C.6.c in this section to determine the level of management review required when fraud is not involved.
  • Whether an overpayment decision requires FO management (or higher) review depends on the original overpayment amount. Use the chart in SI 02220.005C.7 in this section to determine the level of management review required when fraud is not involved.
  • 1. Overpayment collect decisions do not require management review
  • * We are required to attempt to recover overpayments to recipients, regardless of the amount. Therefore, overpayment collect decisions do not require management review. Since a decision to deny a waiver is a decision to attempt collection of the overpayment, waiver denial decisions also do not require management approval.
  • * Technicians will document the rationale for collect decisions during a personal conference when the liable person requests a waiver and the technician cannot approve the waiver. See SI 02260.001 for waiver information or SI 02260.006 for personal conference information.
  • * Technicians will document the rationale for collect decisions during a case review or formal/informal conference when the liable person (or his or her representative) requests an appeal and the technician cannot grant the appeal. For information on overpayment appeals, see SI 02220.017.
  • * Collect decisions include:
  • * Recover by check adjustment;
  • * Recover by installments; and
  • * Recover from Title II benefits.
  • For more information on the overpayment recovery process, see SI 02201.005.
  • 2. Non-collect decisions on overpayments of $1,000.00 or less do not require management review and concurrence
  • * If the original overpayment (not the balance after a collect decision) is $1,000.00 or less (and we have determined that the recipient was not at fault in causing the overpayment), and the recipient requests that we waive recovery of the overpayment, the CS, CSR, or TSC-CSR may waive the overpayment administratively and without management review. For FO administrative waiver instructions, see SI 02260.030C.6. For instructions on TSC overpayment processing, see TC 26010.000.
  • * If the original overpayment is $1,000.00 or less and the recipient was at fault in causing the overpayment, a waiver decision is not applicable, however, another non-collect decision (unwilling/unable to repay, uncollectible, or unable to locate/out of country) may apply. Management review is not required.
  • 3. Non-collect decisions on overpayments of $2,000.00 or less do not require management review and concurrence
  • * FO CSs and CSRs may make non-collect decisions on overpayments of $2,000.00 or less without obtaining management review and concurrence. Non-collect decisions include:
  • * Waiver;
  • * Unwilling to repay;
  • * Unable to repay;
  • * Uncollectible;
  • * Erroneous;
  • * Unable to locate/out of country; and
  • * Incorrect overpayment.
  • * Technicians may need to refer a case to another SSA component, such as the administrative law judge (ALJ), or another agency, such as the Department of Justice (DOJ), or the Department of Treasury (Treasury) for a hearing or other decision before making an overpayment decision. Referral “decisions” include:
  • * Appeal;
  • * Referral to DOJ (Civil Suit);
  • * Referral to OIG;
  • * Referral to Treasury; and
  • * Bankruptcy.
  • 4. Non-collect decisions on overpayments of at least $2,000.01 but less than $20,000.00 require management review and concurrence
  • 4. Non-collect decisions on overpayments of $2,000.01 - $20,000.00 require management review and concurrence
  • a. FO manager reviews, provides concurrence, and documents the review and concurrence
  • FO Management (Operations Supervisor (OS), Management Support Specialist (MSS) or manager) must review and concur with all overpayment non-collect disposition decisions on original overpayments of at least $2,000.01 but less than $20,000.00, through a 2-PIN process.
  • FO Management (Operations Supervisor (OS), Management Support Specialist (MSS) or manager) must review and concur with all overpayment non-collect disposition decisions on original overpayments of $2,000.01 - $20,000.00, through a 2-PIN process.
  • b. The 2-PIN process
  • After the technician selects an overpayment disposition decision via the UOPD, the OS, MSS, or manager takes these actions:
  • * Reviews the non-collect decision for technical accuracy and conformance with POMS instructions;
  • * Documents the required management review for MSSICS cases, using the DROC screen. For non-MSSICS cases, document the required management review on form SSA-5002, fax the SSA-5002 and all related documents into the non-disability repository for evidentiary documents (NDRED);
  • * Briefly states that he or she reviewed the proposed overpayment decision for technical accuracy, conformance with POMS instructions, and concurs with the disposition;
  • * Accesses the Direct SSR Update using his or her own PIN; and
  • * Completes the Decision Approval (UODA) screen on the same day as the CS or CSR, and enters his or her disposition decision on the UOPD.
  • c. FO manager reviews but does not provide concurrence
  • If the FO manager does not concur with the disposition decision, he or she returns the case to the CS or CSR for further action.
  • * Exceptions to the 2-PIN process:
  • * Overpayments under Recovery and Collection of Overpayments (RECOOP) system control;
  • * Overpayment disposition decisions made in the Payment Centers (PCs). PCs follow the instructions in GN 02210.217.
  • * Exceptions to management review and concurrence of non-collect decisions on overpayments greater than $2,000.01
  • * Administrative Law Judge (ALJ) waiver determinations on overpayments of $2,000.01 or more are an exception. They do not require management review.
  • * For instructions on accepting compromise settlement offers, see SI 02220.031.
  • d. Non-collect decisions on overpayments of $20,000.00 or greater, but less than $100,000.00 require Regional Office (RO) review and concurrence
  • d. Exceptions to the 2-PIN process:
  • * Overpayments under Recovery and Collection of Overpayments (RECOOP) system control;
  • * Overpayment disposition decisions made in the Payment Centers (PCs). PCs follow the instructions in GN 02210.217.
  • e. Exceptions to management review and concurrence of non-collect decisions on overpayments greater than $2,000.01
  • * Administrative Law Judge (ALJ) waiver determinations on overpayments of $2,000.01 or more are an exception. They do not require management review.
  • * For instructions on accepting compromise settlement offers, see SI 02220.031.
  • 5. Non-collect decisions on overpayments of $20,000.01 - $100,000.00 require Regional Office (RO) review and concurrence
  • * If the FO manager concurs with the technician’s recommendation of a non-collect decision on an overpayment between $20,000.00 and $100,000.00, the manager must refer the recommendation to the Assistant Regional Commissioner for Management and Operations Support (ARC MOS) for review and concurrence.
  • * If the Processing Center (PC) manager concurs with the non-collect decision, he or she must refer the recommendation to the Assistant Regional Commissioner for Processing Center Operations (ARC PCO).
  • * The RO reviewer (ARC MOS or ARC POS) takes these actions:
  • * Documents his or her review using the DROC screen in the MSSICS development path. For non-MSSICS cases, the reviewer documents the required RO review using the NDRED process;
  • * Briefly states (on behalf of the ARC MOS) that he or she reviewed the proposed overpayment non-collect decision for accuracy, conformance with POMS instructions, and concurs with the disposition decision; and
  • * Uses his or her own PIN to post the overpayment disposition decision.
  • If the RO reviewer does not concur with the non-collect disposition decision, he or she returns the case to the FO for further action.
  • * If the RO reviewer does not concur with the non-collect disposition decision, he or she returns the case to the FO for further action.
  • NOTE: Refer to regional instructions for specific RO review and concurrence procedures.
  • e. Non-collect decisions on overpayments of $100,000.00 or more require referral to the Department of Justice through the ARC MOS
  • 6. Non-collect decisions on overpayments of $100,000.01 or more require referral to the Department of Justice through the ARC MOS
  • * For overpayment non-collect decisions on overpayments of $100,000.00 or more, refer the case to DOJ through the ARC MOS following FO management review and concurrence.
  • * For complete instructions on forwarding cases to DOJ, see SI 02220.035.
  • f. Chart of management review requirements when fraud is not involved
  • 7. Chart of management review requirements when fraud is not involved
  • Overpayment Decision
  • OverpaymentAmount
  • Overpayment Amount
  • Management Review Requirements
  • Collect
  • Any amount
  • Management review is not required
  • (Non-Collect):
  • Waiver (Approved),
  • Unwilling To Repay,
  • Unable To Repay,
  • Uncollectible,
  • Erroneous, Unable to Locate/ Out of Country, Compromise Settlement, Incorrect Overpayment
  • $2,000 or less
  • Management review is not required
  • Waiver (Approved), Unwilling to Repay, Unable to Repay, Uncollectible, Erroneous, Unable to Locate/ Out of Country, Compromise Settlement, Incorrect Overpayment
  • $$2,000.01 or greater, but less than $20,000.00
  • $$2,000.01 - $20,000.00
  • CSR, CS, or higher (recommending). Management review is required. An Operations Supervisor (OS), or Management Support Specialist (MSS), or higher, must review and concur with the disposition decision(s).
  • Waiver (Approved), Unwilling to Repay, Unable to Repay, Uncollectible, Erroneous, Unable to Locate/ Out of Country, Compromise Settlement, Incorrect Overpayment
  • $20,000.00 or greater, but less than $100,000.00
  • $20,000.01 - $100,000.00
  • CSR, CS, or Higher (recommending). Management review is required. An OS, MSS or higher, must review and concur with the disposition decision(s). Mandatory referral to the Assistant Regional Commissioner for Management And Operations Support (ARC, MOS) for referrals from the FOs, or Assistant Regional Commissioner for Processing Center Operations (ARC, PCO) for referrals from the PSCs. ARC MOS and ARC PCO must review and concur with the disposition decision(s).
  • Waiver (Approved), Unwilling to Repay, Unable to Repay, Uncollectible, Erroneous, Unable to Locate/ Out of Country, Compromise Settlement, Incorrect Overpayment
  • $100,000.00 or greater
  • $100,000.01 or more
  • CSR, CS (Recommending). Management review is required. An OS, MSS Or higher must review and concur with the disposition decision(s). Mandatory referral to DOJ Through ARC MOS. See SI 02220.035.
  • D. If you suspect the overpayment was due to fraud
  • D. If you suspect the overpayment was due to fraud
  • * Refer the case to the Office of the Inspector General (OIG). For instructions on referring fraud cases to OIG, see SI 02201.007.
  • * Post a MO TAC. For instructions for referral to another agency, see SM 01311.220.
  • * Take no further action until OIG contacts you.
  • * If the fraud case is under the jurisdiction of DOJ, post a MJ TAC-referral to the DOJ, Program Integrity, or other agency. For a discussion of posting a MJ TAC, see SM 01311.220 and MSOM BUSSR 004.008.
  • E. References
  • * GN 00301.310 The Non-Disability Repository for Evidentiary Documents (NDRed) Application--Overview
  • * GN 02215.235 Suspension or Termination of Collection Action for Title II and Title XVI Debts
  • * MSOM BUSSR 002.001 Direct SSR Update - Overview
  • * MSOM BUSSR 004.001 SSI Overpayment and Underpayment Processing – Overview
  • * MSOM BUSSR 004.008 Overpayment Decisions (UOPD)
  • * MSOM BUSSR 004.020 Decision Approval (UODA)
  • * SI 02201.005 SSI - What is an Overpayment?
  • * SI 02201.007 Supplemental Security Income (SSI) – Overpayment Fraud
  • * SI 02220.001 Recovery Procedures for SSI Overpayments-General
  • * SI 02220.011 Reconciliation of Overpayment Debt in Terminated Records
  • * SI 02220.020 Cross-Program Recovery (CPR) of SSI Overpayments from Monthly Title II Benefits
  • * SI 02220.025 Overpayment – Recovery By Refund
  • * SI 02220.030 SSI Overpayment – Compromise Settlement
  • * SI 02220.031 SSI Overpayment – Processing of Compromise Offers
  • * SI 02220.035 SSI Overpayment – Recovery by Civil Suit
  • * SI 02220.036 SSI Overpayment for Recovery of Court-Ordered Restitution
  • * SI 02220.040 Supplemental Security Income (SSI) – Recovery Through Bankruptcy Proceedings
  • * SI 02220.050 Suspension and Termination of Recovery Efforts from Living Individual
  • * SI 02220.051 SSI Overpayment – FO Efforts to Locate an Overpaid Individual in Nonpayment Status
  • * SI 02220.053 Suspension and Termination of Supplemental Security Income (SSI) Overpayment Recovery Efforts for a Deceased Individual
  • * SI 02260.000 Waiver Provisions for SSI Overpayments
  • * SI 02260.005 Completing the SSA-632BK (Request for Waiver of Overpayment or Overpayment Recovery or Change in Repayment Rate)
  • * SM 01311.120 Recover by Check Adjustment Decision (D TAC) and Manual Notice Date (C01 Payment Status)
  • * SM 01311.125 Establishing and Changing the Recovery Rate for Check Adjustment
  • * SM 01311.200 Suspending Collection Using the DB, DC or DM TACs
  • * SM 01311.205 Deleting or Changing a DB, DC or DM TAC
  • * SM 01311.220 Bankruptcy and Referral to Another Agency – MJ, MO, MS and MT TAC
  • * SM 01311.235 Recovery by Installments – G TAC
  • * SM 01311.240 Deleting the G TAC
  • * SM 01311.255 Manual Cross-Program Recovery of a Title XVI Overpayment from Title II Benefits
  • * SM 01311.261 Deleting the K TAC
  • * SM 01311.280 Uncollectible and Erroneous Overpayment Decisions – N TAC and NT TAC
  • * SM 01311.285 Deleting or Correcting the N TAC or the NT TAC
  • * SM 01311.290 Compromise Settlement – Y TAC
  • * SM 01311.295 Deleting or Correcting the Y TAC
  • * SM 01311.340 Incorrect Overpayment on an Uncorrectable Record – Z TAC
  • * SM 01311.345 Deleting the Z TAC
  • * SM 01311.350 Overpayment to be Collected on Another Record – Q TAC
  • * SM 01311.422 How the System Reacts to a Suspend Billing Code, Waiver Request, and/or Appeal Request
  • * SM 01311.423 How to Add, Delete, or Change a Suspend Billing Code, a Waiver, and/or Appeal Request
  • * SM 01311.424 Examples of How to Add, Change, or Delete a Suspend Billing Code or Waiver Request
  • * VB 02020.005 Collection of Overpayments from Special Veterans Benefits
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