TN 19 (01-17)

A. Policy for overpayment waiver requests

Technicians must make all SSI overpayment waiver decisions through the Modernized Supplemental Security Income Claims System (MSSICS) via Direct Supplemental Security Record (SSR) Update. For waiver inputs, see MSOM BUSSR 004.009, Waiver (UOWV). The following are basic waiver policies.

1. When we will waive an overpayment

We waive the recovery of an overpayment only if the liable recipient is without fault in causing the overpayment, and recovery or adjustment would:

• Defeat the purpose of Title XVI of the Act; or

• Be against equity and good conscience; or

• Impede effective or efficient administration of Title XVI of the Act because of the amount involved.

2. Effect of waiver approval

• The effect of an approved waiver is to relieve the overpaid recipient, his or her estate, or his or her spouse (and the spouse’s estate) of the obligation to repay the overpayment.

• We will only reopen an approved waiver if we later determine that the overpayment was the result of fraud.

3. When a liable person may request a waiver

• An SSI recipient (or his or her representative) may request a waiver at any time.

• An SSI recipient (or representative) may make a second or subsequent waiver request even if we denied the prior request and the due process period has expired.

• A recipient may request a waiver after we have started recovery, or even after we have completely recovered the overpayment.

• If the liable party makes a second or subsequent waiver request on an overpayment, but provides no new or material facts or evidence, we may deny the request without making a new determination, based on res judicata. For instructions on res judicata for SSI overpayments, see SI 02260.008.

• If the total overpayment is $1,000.01 or more, the debtor must request a waiver in writing, over the recipient’s signature (or that of his or her representative payee, legal counsel, or other appointed representative).

• If the original overpayment, not the balance, is $1,000.00 or less, the recipient, representative payee, or other authorized representative may make a verbal waiver request. Technicians may not initiate waiver processing unless the debtor (or representative) requests a waiver.

• Even if the written request does not contain all the information required on Form SSA-632-BK (Request for Waiver of Overpayment or Overpayment Recovery or Change in Repayment Rate), we acknowledge it as a request for waiver.

• The date of the waiver request is the date the field office (FO) receives the written request.

For basic waiver policy, see SI 02260.001. For administrative waiver policy, see SI 02260.030. Technicians must document the date of the verbal waiver request on the DROC screen in MSSICS, or, for non-MSSICS cases, on a SSA-5002 faxed into NDRed.

4. Effect of waiver request

A request for waiver stops recovery or adjustment effective with the month we receive the written waiver request. We do not resume recovery or adjustment until we make the waiver determination and the appeal period has expired.

5. Actions following a waiver request

If you cannot approve the waiver within 10 days of the request:

• Stop recovery or adjustment; and

• Refund, the amount recovered for the month of the waiver request and any subsequent month.

B. Waiver procedures

1. Written waiver request

In order to process a request for a waiver when the original overpayment amount is $1,000.01 or more, the request must be in writing and over the recipient’s signature (or that of the representative payee, legal counsel or other appointed representative). Even if incomplete, we acknowledge this document as a waiver request.

For administrative waiver instructions, see SI 02260.030.

The waiver request date is the date the FO receives the written request.

2. Actions following a waiver request

1. If you cannot make the waiver determination within 10 days of the waiver request date you must:

   • Stop all recovery or adjustment actions.

   • Refund the amount recovered in the month the recipient filed the request for waiver and any subsequent months. (Use the A-OTP process to refund the recovered amount(s).) For instructions on the A-OTP process, see SM 01901.005 and MSOM BUSSR 004.007 through MSOM BUSSR 004.009 and MSOM BUSSR 003.022.

2. Fax all pertinent evidence the recipient provided, or that you obtained while developing the waiver into the electronic file using the NDRed process. Include Form SSA-632, paystubs, etc.

3. Do not refund any funds we collected for months(s) before the month the FO received the waiver request.

4. Do not refund payments withheld if we have made another collect decision (i.e., different period of overpayment) or the recipient has an unresolved overpayment.

3. Initial waiver development

1. Develop only for the person(s) who is or are liable for making repayment.

   For a discussion of liability when the recipient has a representative payee, see SI 02201.020 through SI 02201.023 and SI 02201.025.

   NOTE: Effective 12/04/2008, a representative payee (or his or her estate) is solely liable for repaying SSI payments the representative payee received on behalf of a deceased recipient for month(s) after the month of the recipient’s death. See SI 02201.005.

2. If the disposition is to administratively waive the overpayment, follow the documentation requirements in SI 02260.030C.5. (listing the requester’s name and relationship to the overpaid recipient, the overpayment amount, overpayment period, overpayment sequence number, the documents and records the technician used to make the waiver determination, and the date and method by which we received the waiver request [e.g., via telephone or in-office visit].

3. For other waiver approvals and proposed waiver denials, document the case file with your determination using the DROC screen for MSSICS cases or the NDRED process for non-MSSICS cases. Provide details on the basis for your decision of the following factors:

   • Determination regarding fault or without fault per SI 02260.010 and SI 02260.015; and

   • Determination regarding ability to repay-whether the debtor meets or doesn’t meet the requirements of:

     • Defeat the purpose per SI 02260.020; or

     • Against equity and good conscience per SI 02260.025; or

     • If resources exceed the limit per SI 02260.035; and

   • Fax all pertinent evidence (provided by the debtor or obtained while developing the waiver) into the electronic file using the NDRED process, including form SSA-632, pay stubs, etc.

4. Additional actions following an approval of a waiver request

1. Post the approved waiver decision to the SSR using MSSICS Direct SSR Update and the UOWV screen. For instructions, see MSOM BUSSR 004.009.

2. Follow management review guidelines per SI 02220.005 for overpayments of $2,000.01 or more.

3. Refund any funds recovered for the period covered by the approved waiver request. If the system does not automatically issue the refund after the technician inputs the waiver approval, use the A-OTP process to refund the recovered amount. For instructions on the A-OTP process, see SM 01901.005 and MSOM BUSSR 004.003 through MSOM BUSSR 004.009 and MSOM BUSSR 003.022.

4. If the approved waiver covers months in which we adjusted payments to recover the waived overpayment, refund the withheld amount.

5. Do not provide a refund if we have made another collect decision (i.e., different period of overpayment) or the recipient has an unresolved overpayment.

6. If the liable person is a legal guardian or representative payee, send the legal guardian or representative a manual notice of an approved request for waiver (DPS notice, Waiver Approved Letter). For more waiver decision notices, see NL 00803.200, Notice of Waiver Decision-General). For a complete list of circumstances that require a manual notice, see NL 00801.010B.2.

5. Additional actions following a proposed waiver denial

If, you make a preliminary decision to deny the overpayment waiver request, you must:

1. Document your determination using the MSSICS DROC screen, or NDRed process for non-MSSICS cases. Be sure your determination answers the following:

   • Was the liable party at fault in causing the overpayment according to SI 02260.010 and SI 02260.015?

     • If yes, who was at fault and why?

     • If no, why was he or she not at fault?

   • If the recipient or payee was not at fault, refer to the evidence in the file to explain why the recovery did not meet the criteria for either:

     • Impede effective or efficient administration of title XVI of the Act (SI 02260.030);

     • Against equity and good conscience (SI 02260.025);

     • Defeat the purpose of title XVI of the Act (SI 02260.020); or

     • Adverse changes in financial circumstances following a waiver denial (SI 02260.040).

2. Use the DPS Notice of Personal Conference & Folder Review (Waiver/Recon), see NL 00803.210. Do not include the reconsideration paragraphs. The notice must include the following:

   • The reason we cannot approve the waiver (including the basis of finding that the recipient was at fault, defeat the purpose, or recovery is against equity and good conscience).

   • The appropriate statutory and regulatory basis with a reference to either:

   • Section 1631(b)(1) of the Act, waiver of recovery and

   • Section 1621(e) of the Act, responsibility of an alien's sponsor of the Social Security Act.

   • Always cite sections 416.550-416.555 of title 20 CFR Federal Regulations.

   • The date of the personal conference and the date of the folder review. Allow 5 days between the folder review and personal conference, unless the recipient requests the folder review on the same day as the personal conference.

   • Do not address overpayment recovery (i.e., refund request or payment adjustment).

     Do not input a decision on MSSICS Direct SSR Update or send a notice for the proposed waiver denial. Follow SI 02260.006 for personal conference procedures.

C. References

• SI 02201.020 Supplemental Security Income (SSI) Overpayment: Who is Liable (Responsible) for Repayment? Living Overpaid Individual

• SI 02201.023 Supplemental Security Income (SSI) Overpayment: Recovery from a Representative Payee

• SI 02260.006 Personal Conferences

• SI 02260.010 Development of Without Fault for a Supplemental Security Income (SSI) Overpayment Waiver

• SI 02260.015 Establishing Without Fault for a Supplemental Security Income (SSI) Overpayment Waiver

• SI 02260.020 Defeat the Purpose of Title XVI of the Act

• SI 02260.025 SSI Overpayment Recovery is Against Equity and Good Conscience

• SI 02260.030 Impede Effective or Efficient Administration of Title XVI of the Act (Administrative Waiver)

• SI 02260.035 SSI Overpayment Waiver When Recipient’s Countable Resources Exceed the Limit

• SI 02260.040 Adverse Changes in Financial Circumstances Following a Waiver Denial

• SM 01901.005 When to Use One-Time Payments (OTPs)

• MSOM BUSSR 003.022 One-Time Payment (UPOT)

• MSOM BUSSR 004.001 SSI Overpayment and Underpayment Processing – Overview

• MSOM BUSSR 004.003 Sequence Selection (UOSS)

• MSOM BUSSR 004.007 Add Change Delete Overpayment Decisions (UODC)

• MSOM BUSSR 004.009 Waiver (UOWV)

• NL 00801.010 Manually Prepared Notices

• NL 00803.200 Notice of Waiver Decision – General

• NL 00803.205 Notice of Waiver Decision – Waiver Approved

• NL 00803.210 Notice of Waiver Decision – Waiver Denied

• SI 02201.005 Supplemental Security Income (SSI) – What is an Overpayment?