SI 022: Overpayments
TN 12 (04-09)
A. Policy
1. Defeat the purpose of title XVI of the Act
We do not recover title XVI overpayments if the liable overpaid individual is without fault and both of the following conditions are met:
The individual needs substantially all of his or her current income to meet his or her current ordinary and necessary living expenses; and
Recovery would reduce the individual’s total resources below $3,000 for a person without dependents or $5,000 for a person with one dependent. If the individual has more than one dependent, we allow an additional $600 for each additional dependent.
2. Deemed defeat the purpose of title XVI of the Act
If the overpaid individual is eligible for SSI payments, we use an alternative method to determine whether recovery from a liable individual who is without fault would defeat the purpose of title XVI of the Act. The alternative method is called Deemed Defeat the Purpose of title XVI of the Act.
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We determine that “deemed defeat the purpose of title XVI of the Act” exists in continuing eligibility cases if the individual’s current total income does not exceed:
The Federal Benefit Rate (FBR); plus
The $20 general income exclusion; plus
The $65 earned income exclusion; plus
The federally administered State supplementary level.
We use only that portion of the income of the spouse, parent or essential person which is deemed for computation purposes to determine the individual’s income.
3. Possession of incorrect payment
Recovery does not defeat the purpose of title XVI of the Act if the liable individual has in his or her possession any of the incorrectly paid payment(s) or identifiable proceeds from such payments in liquid resources which accumulated during the overpayment period.
B. Procedure for determining defeat the purpose of title XVI of the Act
No development beyond completion of the SSA-632-BK is required if you determine that the requirements of defeat the purpose of title XVI of the Act are met.
Complete the SSA-632. See SI 02260.005.
1. Eligibility continues
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If SSI eligibility continues and current countable monthly income is less than:
The FBR; plus
The $20 general income exclusion; plus
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The $65 earned income exclusion; plus
NOTE: Do not consider other income disregards (i.e., those used for computation purposes).
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The federally administered State supplementary level
Then find defeat the purpose of title XVI of the Act.
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If SSI eligibility continues and the individual’s total countable income is more than the amount in SI 02260.005B.1.a,
Complete the SSA-632-BK through Section I (see SI 02260.005); then
Follow the procedures in SI 02260.020B.2.
2. No current SSI eligibility or deemed defeat the purpose of title XVI of the Act does not apply
If there is no current SSI eligibility or the provisions of deemed defeat the purpose of title XVI of the Act are not applicable, find that recovery would defeat the purpose of title XVI of the Act if:
The individual needs substantially all current income to meet current ordinary and necessary living expenses; and
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Recovery would reduce the total resources (as defined in GN 02250.115 through GN 02250.130) below $3,000 for an individual without dependents or $5,000 for a person with one dependent. Allow an additional $600 for each additional dependent.
Remember: If you determine the requirements for defeat the purpose of title XVI of the Act are not met, you may still waive recovery if you determine that recovery or adjustment would be against equity or good conscience. See SI 02260.025
3. Spouse-to-spouse deeming
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Determine the amount, if any, of deemable income from the ineligible spouse.
NOTE: This is the calculation you would do if you had to calculate type “V” unearned income. See SM 02101.010.
If there is no income to deem to the liable overpaid individual, do not include the spouse’s income in your deemed defeat the purpose of title XVI of the Act determination.
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If the income deemed from the ineligible spouse lowers the eligible individual’s SSI payment:
Calculate the liable overpaid individual’s payment using only his or her own income.
Add the ineligible spouse’s deemed income to the eligible individual’s own income.
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Subtract the $20 general income disregard.
If the result is greater than the individual FBR, the requirements to establish deemed defeat the purpose of title XVI of the Act are not met.
For system instruction on spouse-to-spouse deeming, see SM 02101.010.
4. Development of possession of incorrect payment
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Possession of incorrect payment
Recovery will not defeat the purpose of title XVI of the Act to the extent the liable individual has in his or her possession any of the incorrect payment(s) or proceeds identifiable as from such payments in liquid resources.
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Determining that the liable overpaid individual possesses the overpaid funds or identifiable proceeds from the overpaid funds can be very difficult. Therefore, accept the individual’s allegation that he or she does not possess overpaid funds (or the identifiable proceeds from the overpaid funds), unless it is obvious from the record that the individual does in fact possess all or part of the overpaid funds.
EXAMPLE: A liable individual who was overpaid $1,200 requests waiver of his or her overpayment. The individual provides the FO with his or her bank statements. After examining the statements you determine that $200 of the overpayment is included in the statements. Even if you determine that the individual is without fault, you can not waive $200 of the overpayment because the liable individual retains $200 of the overpayment in his or her bank account.
NOTE: You can not use waiver tolerance to waive the remaining $1,000 of the overpayment because the total overpayment is $1,200. See SI 02260.030C
For additional information on how to determine whether the liable individual has possession of all or part of the overpayment, see GN 02250.105.
C. System instructions
See MSOM BUSSR 004.007 through MSOM BUSSR 004.009 for instructions on how to add your decision that recovery would defeat the purpose of title XVI of the Act on the UOWV MSSICS screen through Direct SSR Update.