GN 02250: Waiver Provisions for Title II and Title XVIII Overpayments
TN 13 (08-96)
A. Policy - Application Of Administrative Finality
The rules governing reopening of an initial determination under the rules of administrative finality (GN 04001.010 through GN 04001.090) apply to initial waiver determinations. Thus, an initial waiver determination which has become final and is later found to have been incorrect when made may be reopened and revised under the rules of administrative finality.
B. Procedure
If the initial determination was a waiver denial, the PC has jurisdiction to reopen and revise to an approval.
If the initial determination was a waiver approval, the folder and new evidence is sent to the FO to hold (or reconvene) a personal conference.
C. Policy - Change In Circumstances
An initial waiver determination which was correct when made and is no longer open cannot be reopened under the rules of administrative finality based on a subsequent change in circumstances. Although reopening is not possible, a second (or subsequent) waiver determination may be made.
Findings of fault and equity are based on the person's situation prior to the overpayment determination; those circumstances remain constant. Absent new and material evidence, a second waiver determination is not required based on the principle of res judicata (GN 04040.010). However, findings of defeat the purpose are based on the person's current financial situation.
Changes in the person's financial situation can occur at any time and can affect the defeat the purpose finding and the waiver determination. A determination is effective when it is established that defeat the purpose criteria are met. Generally, unless a person can establish he has gone into debt to repay, waiver will be effective with the date of the new request for waiver.