TN 34 (07-07)

A. Policy

1. Authority for cross-program recovery

Section 1147 of the Social Security Act describes the authority to collect overpayments through “cross-program recovery.”

The Social Security Protection Act of 2004 expanded the authority for cross-program recovery under section 1147 of the Act. This includes recovering a Title II overpayment from an SSI underpayment.

2. Criteria for cross-program recovery

a. When to impose cross-program recovery

In order to impose cross-program recovery against an SSI underpayment otherwise due:

• We must have notified the person about the Title II overpayment and decided to collect it.

• It does not matter if the person is already repaying the Title II overpayment by monthly Title II benefit adjustment or by monthly installment refunds. Impose cross-program recovery against the SSI underpayment.

b. When not to impose cross-program recovery

Do not impose cross-program recovery if:

• The person has a pending waiver or reconsideration request regarding this overpayment.

  NOTE: Although cross-program recovery is not imposed when a waiver or reconsideration request is pending, cross-program recovery is imposed when an appeal is pending at the hearing level, appeals council level, etc. See GN 02201.019B., “Waiver of Recovery-Procedure,” GN 02201.025B.2., “Overpayment- Reconsideration-Procedure-FO-Stop Recovery,” and GN 02201.027A., “Overpayment-Hearing-Policy.” These sections explain the effect of a request for waiver, or reconsideration, or a reconsideration of a waiver denial, on overpayment recovery.

• SSA receives a bankruptcy petition that names the Title II debtor.

3. Sequence of reductions

Consistent with the instructions in SI 02101.002, “SSI Underpayment Due-Individual Alive” and SI 02101.003, “SSI Underpayment Due-Individual Deceased-General”:

a. When direct payment of a representative fee is involved, the priority of reduction is:

• Interim assistance reimbursement (IAR);

• Direct payment of representative fee;

• Recovery of SSI overpayment;

• Recovery of Title II overpayment (cross-program recovery).

b. When direct payment of a representative fee is not involved, the priority of reduction is:

• Recovery of SSI overpayment;

• Recovery of Title II overpayment (cross-program recovery);

• Interim assistance reimbursement (IAR).

B. Procedure

1. Notices

An SSI notice is issued that explains that a Title II overpayment is being recovered from an SSI underpayment. The notice tells the person:

• He/she still has a Title II debt;

• The amount of the debt;

• The amount of the SSI benefit reduction;

• The amount of the SSI benefit left, if any, after the reduction is taken;

• That he/she can request review and provide evidence showing that the debt is no longer owed or the amount of the debt is different than that stated in the notice; and

• He/she can request waiver of recovery of the Title II overpayment.

POMS SI 02220.022C., “Exhibit-Notice Language”, shows the system-generated paragraphs.

2. Installment requests

Do not accept installment agreements when cross-program recovery is available.

3. Person requests reconsideration of the fact or amount of the original debt (overpayment determination)

Some debtors may still request reconsideration of the overpayment determination. The notice about the cross-program recovery gives the debtor the opportunity to request a review and to present evidence that he/she does not owe the debt or owes an amount that is different than the amount stated in the notice. The evidence can be a cancelled check, remittance receipt from SSA, an acceptable document showing the debt was waived or other valid document.

IMPORTANT: The determination on the debtor's request for review is a reconsideration determination. Therefore, the notice that SSA sends to the debtor must include language explaining the right to a hearing before an administrative law judge.

Accept form SSA-561 (Request for Reconsideration) or equivalent when the debtor asks for reconsideration of the fact or amount of the original overpayment.

a. Debtor requests reconsideration within the time limit

In most cases involving cross-program recovery, the time period for requesting reconsideration has already expired. If, however, the debtor requests reconsideration within 60 days of the date of the initial overpayment notice, take the following actions:

• Tell the debtor SSA will review the information in our records and any evidence submitted by the debtor and provide a written determination after the review; and

• Input the reconsideration request to ROAR (See MSOM DMS 006.019); and

• Refund any money withheld due to cross-program recovery on or after receipt of the signed request; and

• Adjudicate the request for reconsideration per instructions in GN 03102.000, “Reconsideration-Title II and Entitlement Under Title XVIII.” For additional instructions on processing reconsideration approvals and denials, see GN 02201.025, “Overpayment-Reconsideration.”

b. Debtor requests reconsideration beyond the time limit

If a debtor requests reconsideration of the fact or amount of the original overpayment after the 60-day time limit has expired, develop good cause for late filing (See GN 03101.020, “Good Cause for Extending the Time Limit to File an Appeal”). If a good cause determination cannot be made immediately, take the following actions when the debtor requests reconsideration beyond the time limit:

• Tell the debtor SSA will stop the cross-program recovery and refund any money that was withheld due to cross-program recovery on or after receipt of the signed request; and

• Input the reconsideration request to ROAR (See MSOM DMS 006.019); and

• Refund any money withheld due to cross-program recovery on or after receipt of the signed request; and

• If Good Cause is Established

Adjudicate the request for reconsideration per instructions in GN 03102.000 “Reconsideration-Title II and Entitlement Under Title XVIII.” For additional instructions on processing reconsideration approvals and denials see the following.

• If Good Cause is Not Established

Follow the instructions in GN 03101.020, “If Good Cause is Not Established” when good cause is not established. If cross program recovery was stopped, see the following (in SI 02220.022B.3.d.) for instructions on resuming cross-program recovery.

c. Reconsideration approval (initial determination revised or reversed)

• If the amount of the overpayment shown is incorrect, notify the debtor in writing of the correct amount of the debt. (See GN 03102.425 “Reconsideration Notices of Determination” for information about the reconsideration notice of determination);

• If the debt no longer exists (e.g., was waived, repaid, discharged in bankruptcy), notify the person in writing that the debt no longer exists;

• Correct the systems records to show the correct amount of the debt;

• Refund any incorrectly recovered money; and

• If a new debt balance (other than zero) exists after the reconsideration approval, resume cross-program recovery only after 30 days (plus 5 days for mailing) have passed from the date of the reconsideration determination.

d. Reconsideration denial (initial determination affirmed)

• Notify the debtor in writing per instructions in GN 03102.425A., “Reconsideration Notices of Determination-Procedure-Initial Determination Affirmed”;

• Resume cross-program recovery only after 30 days (plus 5 days for mailing) have passed from the date of the reconsideration determination.

e. Debtor requests a hearing or Appeals Council review on the overpayment determination (fact or amount of the original debt)

• If the debtor requests a hearing or Appeals Council review on the fact or amount of the overpayment, handle the request according to instructions for hearings. See GN 02201.027B., “Overpayment-Hearing-Procedure.”

• In any event, do not take action to stop the cross-program recovery nor to refund any money already withheld from the SSI benefit as payment toward the Title II debt.

• Input the hearing request to ROAR.

4. Person requests waiver

The notice that tells the person about the proposed cross-program recovery explains waiver rights. The person may request waiver at any time. If he/she requests waiver, obtain an SSA-632-BK (Request for Waiver of Overpayment Recovery or Change in Repayment Rate) and adjudicate the waiver request per instructions in GN 02250.005, “Fault/Without Fault Findings-Waiver.”

If the decision is to approve waiver of overpayment recovery, refund any incorrectly recovered money.

C. Exhibit - notice language

The cross-program recovery notice, whether for an SSI award or posteligibility, will be system-generated and will include the following paragraphs. (It will also include standard paragraphs with information such as the right to appeal the decision, Medicaid information, who to contact with questions, etc.)

Reduction to Collect Your/Her/His Social Security Overpayment

When you/she/he received Social Security benefits in the past, you/she/he received more than you/she/he should have. Our records show that you still owe/she still owes/he still owes us MONEY FILL. Congress passed a law that permits us to collect Social Security overpayments by withholding from your/her/his SSI payments. We have withheld MONEY FILL from the SSI you were/she was/he was underpaid to collect the MONEY FILL that you owe/she owes/he owes.

Do You Think That You Do/She Does/He Does Not Owe This Money?

You may ask us to review our finding that you still owe/she still owes/he still owes SSI/Social Security/SSI and Social Security money. You may have evidence to show that you/she/he already paid some or all of the money or that we previously waived collection of it. If so, give us this evidence when you ask for review. We will review the evidence you give us and the information we have. We will send you a letter with our decision. If we find that you do/she does/he does not owe us this amount, then we will correct our records.

For more information on requesting review, see "If You Disagree With The Decision" below.

If You Think You/She/He Shouldn't Have To Pay Us Back

You/She/He may not have to pay us back. Sometimes we can waive the collection of an overpayment, which means you/she/he won't have to pay us back. For us to waive the collection of the overpayment, two things have to be true:

• It wasn't your/her/his fault that you/she/he got too much SSI/Social Security/SSI and Social Security money.

  • AND

• Paying us back would mean you/she/he can't pay your/her/his bills for food, clothing, housing, medical care or other necessary expenses, or it would be unfair for some other reason.

If you think these are true about you/her/him, contact any Social Security office. You can ask for waiver at any time by completing the waiver form and returning it to us. The form is called “Request for Waiver of Recovery or Change in Repayment Rate”, Form SSA-632. We will be happy to help you fill out the form. If you request waiver, we may need a statement of your/her/his assets and monthly income and expenses.

We will stop withholding benefits while we consider your waiver request. If we can’t approve your request for waiver, we will contact you to schedule a time for you to review your/her/his folder and a time to have a personal conference. At the conference, you can explain why you think you/she/he shouldn’t have to pay us back.