SI 02220.010:
SSI Overpayment - Notifying the Individual
Effective Dates: 07/28/2010 - Present- Effective Dates: 01/09/2018 - Present
- TN 28 (06-05)
- SI 02220.010 SSI Overpayment - Notifying the Individual
- A. Policy
- 1. Overpayment Notice Requirements - General
- Each initial notice of overpayment whether computer generated by the AONS or produced manually in an FO will include the following:
- * The cause of the overpayment, the amount of the overpayment and the months it occurred;
- * A monthly list of the amounts that were paid and the amounts that should have been paid;
- * A request for refund of the full amount of the overpayment;
- * A proposed rate of adjustment of 10 percent when the overpaid individual continues to receive SSI payments not subject to the payment limit for FLA-D. The notice states a date (month and year) at least 60 days in the future on which such adjustment will begin;
- * Except for members of the Ellender Case in New York State (see GN 02210.214), a discussion of adjustment of title II benefits when the overpaid individual is not currently receiving SSI payments, but does receive Social Security benefits;
- * A discussion of the right of the individual to request a waiver of overpayment collection and/or a reconsideration of the facts of the overpayment; and
- * An explanation on how to request waiver/reconsideration.
- 2. Initial Notice
- Unless it is excluded from AONS (SM 01310.305), the initial overpayment notice is issued:
- * At least 22 days after the overpayment is detected if a Notice of Planned Action is issued.
- * At the same time the overpayment is detected if the overpayment affects retroactive months only. In this case the SSA-L8100 and the overpayment notice are issued on the same day.
- The initial overpayment notice is also delayed:
- * When the overpayment period (SI 02201.005B.3.) extends into a future month.
- * The overpayment is less than $1.00. Recovery action is not initiated against such overpayments and the individual is never notified (SI 02260.030).
- 3. Delayed Release of Initial Notice
- The FO should not send a manual initial notice of overpayment until:
- * After the end of the Goldberg/Kelly due process period; or
- * A pending initial appeal of the reduction, suspension or termination of payment amount is resolved; or
* Until the 60-day appeal period following the disability cessation notice or notice affirming disability cessation has passed. If an appeal is timely filled, do not issue the overpayment notice nor pursue recovery until all appeals are exhausted. (See GN 02201.009B.7.); or- * Until the 60-day appeal period following the disability cessation notice or notice affirming disability cessation has passed. If an appeal is timely filed, do not issue the overpayment notice nor pursue recovery until all appeals are exhausted. (See GN 02201.009B.7.); or
- * The 61st day following the referral of the case to OIG for possible fraud. (See GN 02201.050AD.3)
- NOTE:AONS notices are not released until after the last excess payment has been made or after the end of the Goldberg/Kelly period (see SM 01310.320 and NL 00803.300).
- 4. Manual Notice Not Sent
- A manual notice is not sent and the overpayment is waived (see SI 02260.030B.) when the overpayment is less than $30.01 unless:
- * The overpayment can be recovered by netting (See SM 01311.160 - SM 01311.170; SI 02220.015; SI 02220.015A.5 - SI 02220.015B); or
- * The overpayment can be added to a prior unresolved overpayment. The individual can be notified of both overpayments in one notice.
- * The case is referred to OIG for possible fraud. Delay the notice until the 61st day following the referral to OIG. (See GN 02201.050AD.3)
- 5. Payment Continuation
- * If a recipient reports an event which will cause his/her payment amount to be reduced, suspended, or terminated he/she has the right to request continuation of the prior payment. Such requests must be within 10 days from receipt of the advance notice (i.e., the SSA-L8155, Notice of Planned Action).
- * If an appeal is timely filed (or filed after the 10-day period but good cause is established), the prior payment will continue until you make the initial appeal decision. Resume recovery after you make a determination on the request for waiver and/or reconsideration (See SI 02220.001A.3.c and SI 02260.001B.3.b).
- NOTE:Appeal rights are described in SI 02301.300 through SI 02301.315.
- B. Procedure
- 1. Three Initial Overpayment Notices
- a. SSA-L8170-U3, Notice of Overpayment-Check Adjustment Proposed
- Use the SSA-L8170-U3, Notice of Overpayment - Check Adjustment Proposed when the recipient is in current pay status and not subject to the payment limit for FLA-D to:
- * Propose recovery of the overpayment at the 10 percent rate.
- * State that if the overpayment is not refunded in full we will withhold 10 percent of the recipient’s total monthly income (countable income plus SSI and State supplementary payment) or the amount of the check, whichever is less.
- b. SSA-L8171-U3, Notice of Overpayment-Refund Possible
- Use the SSA-L8171-U3, Notice of Overpayment -Refund Possible:
- * To request full refund from overpaid individuals who are not currently eligible for payment or are subject to the payment limitation (FLA-D) or in payment status E01.
- * To request full refund of the overpayment when the only alternative is recovery by installments; i.e. the overpaid person does not receive Title II payments. Includes members of the Ellender Case in New York State (see GN 02210.214).
- c. SSA-L8172-U3, Notice of Overpayment-Refund Requested (Cross Program Recovery is Possible)
- Use the SSA-L8172-U3, Notice of Overpayment -Refund Requested (Cross Program Recovery is Possible):
- * For individuals in nonpayment status (see SI 02220.010B.2.b above) who are receiving title II benefits.
- * To request full refund of the overpayment and to offer cross-program adjustment.
- NOTE: Due to court decisions, cross-program recovery cannot be offered to members of the Ellender Case in New York State (see GN 02210.214).
- * Use a SSA-L8171-U3, not a SSA-L8172-U3.
- 2. AONS Notices
- See SM 01310.300 for automated overpayment notices. See NL 00803.300 for notice content and procedure, optimum use, etc.
- 3. Manual Overpayment Notices
- * Generally, do not send a manual notice before the case appears on the monthly overpayment listing. If you do send a manual overpayment notice, make sure that one of the exceptions to AONS processing in SM 01310.305 applies.
- * When fraud is suspected, do not send a notice until the 61st day following the day the case was referred to OIG for possible fraud. (See GN 02201.050AD.3)
- See SI 02220.010A.3 about the timing of the automated notice.
- See NL 00803.110 and SI 02220.010A for the content of the overpayment notice.
- * When posting reported changes that may cause an overpayment follow SM 01311.050. If you want to send a manual notice, suppress the AONS notice unless you are certain that an AONS exclusion will apply.
- 4. Additional Overpayment Forms/Notices
- SSA-L8176-U2, Notice of Overpayment - Representative Payee Cover Sheet.
- Use with the notice of overpayment when initially informing the overpaid individual and payee of the overpayment.
- See NL 00803.150 for instructions on use of the SSA-L8176-U2.
- C. References
- * NL 00803.300, Examples of manual and AONS overpayment notices .
- * GN 02215.260, Examples of common usage overpayment forms and notices (e.g. sample of compromise settlement summaries and notices, DOJ referral, etc.).
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