Download SSI-Overpayments-September-2020-Full-Updated-Document-Packet.pdf
What is Supplemental Security Income (“SSI”)? 1
What is an overpayement?. 1
What causes an overpayement?. 1
How can I prevent an overpayment?. 2
What will SSA do if they think I was overpaid?. 3
What can I do to fight the overpayment? 4
What is a Reconsideration?. 4
What is a Waiver?. 6
How do I ask for a Waiver? 8
What do I do if SSA denies my Reconsideration and/or Waiver Requests? 8
How do I appeal a Reconsideration Denial Determination? 9
How do I appeal a Waiver Denial Determination? 9
What if I lose at the hearing? 10
What happens if I do nothing or lose all of my appeals? 10
SSI Overpayment Checklist 11
SSI Overpayment Appeals Flowchart 12
Income List for SSI Beneficiaries 13
Resources List for SSI Beneficiaries 14
Additional Information: 15
Attached Social Security Administration Forms Index 16
Sample SSI Overpayment Notice 17
SSA-561-U2: “Request for Reconsideration” 25
SSA-632-BK: Request for Waiver of Overpayment Recovery 29
SSA-634: “Request for Change in Overpayment Recovery Rate” 43
Ha-501-U5: “Request for Hearing by Administrative Law Judge” 51
HA-520-U5 “Request for Review of Hearing Decision/Order” 53
SSA-1696-U4: “Appointment of Representative” 55
SSA-3288: “Consent for Release of Information” 62

What is Supplemental Security Income (“SSI”)?

SSI is a monthly cash benefit for adults who are age 65 or older or who are blind and disabled and have limited income and resources. Children with disabilities may also qualify for SSL ¹

What is an Overpayment?

An overpayment happens when the Social Security Administration (“SSA”) sends you more money than you are supposed to receive. ² The overpayment amount is the difference between the amount you received and the amount of SSI money you are entitled to receive.³

When SSA thinks there has been an overpayment, they will try to get the money back. You do not always have to return the extra money.

What causes an Overpayment?

Common causes of overpayments are:

Changes in your income or When your income increases, or the value of your resources increases, this canaffect how much SSI money you should receive.⁴ See pages 13-14 for an explanation of these terms.
SSAmade a mistake calculating your monthly

¹ 20 C.F.R. § 416.202.
² 20 C.F.R. § 416.537.
³ 20 C.F.R. § 416.538. See also, 42 U.S.C. 1383(b)(l)(A).
⁴ See Program Operations Manual System (“POMS”) – the detailed manual used by the local SSA offices which is available on SSA’s website w.w.w.ssa.gov – § SI 01415.037(B); POMS§ SI Ol l 10.003(A)(2) for income and resource limits in box above.

Changes in where youlive, how many people live with you, or your household’s total

Changes inyour marital

Ifgetting SSI based on disability, your health improves but SSA continues to pay

Changesin the amount you receive from other benefit programs, such as Social Security or Veterans

Fleeing to avoid persecution for a crime which is a felony or to avoidcustody or confinement for a felony conviction or violating a condition or probation or ⁵

You enter a nursing home, hospital or mental health care facility for onemonth or ⁶

How can I prevent an Overpayment?

It is a good idea to keep track of your monthly SSI checks to make sure the amount you receive is what you think you are owed.

Reportall changes in your income, health, living situation or marital status right away to

⁵ 20 C.F.R. § 4 l 6.202(f).
⁶ 20 C.F.R. § 416.211, 212.

Watchfor any unexpected changes in your SSI

Ifyou are working, keep records of your monthly wages and report any changes to your local SSA office right

Income and Resources that are not counted when determining the correctamount of your SSI check are listed on pages 13-14 of this manual. Also refer to these lists if you have income or resources that exceed the SSI limits and you need to spend down the excess

What will SSA do if they think I was overpaid?

SSA will first send you a letter called “Notice of Overpayment” that tells you that you were overpaid and what your rights are.

The”Notice of Overpayment” must tell you:⁷ o The amount of the
- Why SSA thinksyou were

HowSSA figured the overpayment

Thedates on which the overpayment

Thatyou have a right to file a Waiver and/or a

Thedeadlines for filing all necessary papers to contest the

How much money SSA willtake out of your check each month if you do not file a Waiver or

A sample “Notice of Overpayment”letter is at pages 17-24 of this

⁷ POMS § SI 02201.025

What can I do to fight the Overpayment?

There are two ways to fight the overpayment, Reconsideration and Waiver.

If you think SSA is wrong and you were not overpaid, or the amount oftheoverpayment is incorrect, you can file a “Request for “

If you agree that you were overpaid, but believe you were not at faultand either you cannot afford to pay it back or recovery of the overpayment would not be fair, or the amount of the overpayment is

$1,000.00 or less, you can file a “Request for Waiver of Overpayment Recovery.”

Youcan file both a Reconsideration and a Waiver at the same If you are not sure which one to file, it is best to file for both.

What is a Reconsideration?

A Reconsideration is an appeal telling SSA that you think they made a mistake.

Compareyour records (wage stubs, bank statements, etc.) with SSA’s figures to determine whether the overpayment is

Youmust file a “Request for Reconsideration” within 60 days of the date on your “Notice of Overpayment,” plus 5 days for mailing.⁸ If you miss the deadline, you will need to show SSA you had a good reason for being

late.⁹

If you file it within 30 days, SSA should not start collecting theoverpaymentand should not take money out of your check until an initial determination is ¹⁰ After 30 days, SSA can begin to collect the overpayment. If you file a Reconsideration after 30 days, any collection effort that has already begun should stop until there is a decision on the Reconsideration.¹¹

⁸ 20 C.F.R. § 416.1409(a); POMS § SI 04005.012(A).
⁹ 20 C.F. R. § 416.141 1.
10 POMS § SI 02220.017(A)(4). / SSA Publication No. 02-1009
II Id.

How do I ask for a Reconsideration?

Fill out form SSA-561-U2 “Request for Reconsideration.” You can addextra pages if there is not enough room on the A copy of Form SSA- 561-U2 is at pages 25-28. You can also get one from your local SSA office or from the Social Security website – h ttps ://w ww . s s a . gov /f or m s /s s a –

561 – u 2. p df

Givea detailed explanation of why you think the overpayment is a

Check the box that says”Informal Conference” if you feel it would be helpful to have a face-to-face meeting with a representative at your local SSA office. You can explain why you think SSA made a mistake and you can bring all your documents to show the SSA worker why you were not overpaid. If you don’t want to meet face-to- face, check the “Case Review”

box and someone will review your file. You can still submit additional records to prove your case when you check “Case Review.”

Mail or hand-deliver the Request for Reconsideration form to yourlocal SSA office. If you mail it, send it certified mail so that youwill have proof that it was delivered before the deadline. If you hand- deliver it ask the SSA receptionist for a dated

What is a Waiver?

A Waiver is asking SSA to forgive the overpayment because it was not your fault and you satisfy at least one of the three additional requirements explained below.

Inorder to get a waiver, you must first show SSA that the overpayment was not your ¹²

After you showthat you are not at fault, you must then meet one of three different tests to show there is a good reason you should not

have to pay the money back. The three tests are listed below.
The legal words in quotations marks and underlined are examples of the language to use on your Waiver request if they describe yow·reason(s).

Paying back the money would“create a hardship” for you because you need the money for ordinary living expenses like food and shelter, or because your monthly income is less than the maximum SSI ¹³

¹² 20 C.F.R. § 416.550; 20 C.F.R. § 416.552; POMS § SI 02206.010
¹³ 20 C.F.R. § 416.550; 20 C.F. R. 416.553. See POMS 02206.001 and SI§ 02206.020 for the hardship policy noted in the box above.

Paying the money back is“against equity and good “ This means you relied on the money that you got, and you either spent it or gave up something because you expected a certain amount of money in your monthly check.¹⁴

Paying the money backshould be automatically waived because collecting the overpayment would “impede administrative ” This means the amount of overpayment is so small that it would cost SSA more money to try to get it back than it would to just forget about it. ¹⁵

Thereisno deadline for filing a waiver, but if you file it within 30 days, SSA should not start collection the

overpayment and should not take money out of your check until an initial decision is reached. If you do not file a waiver within 30 days, SSA can begin to collect the overpayment. If you file a waiver after 30 days, any collection effort that has already begun should stop until an initial decision is reached.¹⁶
¹⁴ 20 C.F. R. § 416.554; POMS § SI 02206.025
15 20 C.F.R. § 416.555; POMS SI§ 022060.030. See 20 C.F.R. § 416.555; POMS § SI 02260.030(C); POMS GN §
02201.013(D) for the administrative waiver provisions noted in box above. See 20 C.F.R. § 416.556(a) for the provisions on exceeding resource limits by $50 or less noted in the box above.
16 POMS § SI 02220.017 (A)(4); POMS § GN 02201.01 IAI; SSA Publication No. 05010098.
How do I ask for a Waiver?

Filloutform SSA-632-BK “Request for Waiver of Overpayment Recovery” and explain why the overpayment was not your fault. Form SSA-632-BK is at pages 29-42 of this manual. You can also get this form from your local SSA office or from the SSA website www.ssa.gov.

Makesureyou check the boxes that say the overpayment was not your fault and you cannot afford to pay it back (section 4, box 5). Check the other boxes in box (section) 5 if they apply.

Putyour signature,the date, your address and your phone number on page

13.

Mailor hand-deliver the form to your local SSA If you mail it, send it certified mail so that you will have proof that it was delivered before the deadline. If you hand-deliver it, ask the SSA worker for a date receipt.

If you do not want to file a Waiver request or appeal of an overpayment,you may file with the SSA a form SSA-634 “Request For Change in Overpayment Recovery” to request the amount of the monthly collection that SSA collects from your SSI payment(s) until the overpayment is collected in

What do I do if SSA denies my Reconsideration and/or Waiver requests?

If your Reconsideration or Waiver request is denied, you can appeal again to a higher level within 60 days. The types of appeals are explained below.
For an overview of the appeals process, see the flow chart on page 12.

How do I appeal a Reconsideration Denial Determination?

File a “Request for Hearing by Administrative Law Judge” form which will allow you to appear before a judge to argue your case.

Youmust file a “Request for Hearing,” form HA-501-U5, within 60 days of the date on your Reconsideration Determinations, plus five days for mailing.¹⁷ Send it certified mail or hand-deliver it to your local SSA A copy of this form is at pages 51-52.

At this state, SSA can begin to collect the overpayment (usually bywithholding up to 10% of your income from your monthly SSI checks). Requesting a hearing will not stop SSA from recovering the money at this ¹⁸

How do I appeal a Waiver Denial Decision?

To appeal a Waiver Denial Decision, you must:

File a “Request for Reconsideration” of the Waiver Denial Decisionwithin 60 days of the date on your Waiver Denial Decision, plus 5 days for ¹⁹

If you file it within 30 days, SSA should not start collecting the If you file it after 30 days, any collection effort that has begun should stop until a decision is reached.²⁰

Fill out form SSA-561-U2 “Request for Reconsideration” and send itcertified mail or hand-deliver it to your local SSA office. A copy of this form is at pages 25-28 of this manual.

If your “Request for Reconsideration” of the Waiver Decision isdenied, then you ask for a hearing using from HA-501-U-5 “Request for Hearing by Administrative Law Judge,” as discussed in the section above on appealing a Reconsideration

¹⁷ 20 C.F.R. 416.1433(b); POMS § SI 04030.020; SI§ 04005.012.
18 POMS § SI 02220.017(4)(e).
19 20 C.F.R. 416.1409; POMS § SI 04005.012; See also 20 C.F.R. § 416.1402.
20 POMS § SI 02220.017(A)(6); POMS § SI 02220.001 (A)(2).

What if I lose at the hearing?

If you get a negative decision from the hearing judge, you can request areview by the Appeals ” A copy for Form HA-520-U5, “Request for Review of Hearing Decision/Order” is at pages 53-54 of this manual. Your request must be filed within 60 days, plus 5 days for mailing. ²¹ Contact Bet Tzedek Legal Services or another legal services agency for help with this level of appeal. If you miss the filing deadline, you will have to show the Appeals Council you had a good reason for being late.²²
Afterall appeals are finished within the Social Security Administration, your next option is to file a lawsuit in United States District Court within 60 days of the Appeals Council’s decision, and to continue through the federal court system if further appeals are ²³

What happens if I do nothing or lose all my appeals?

There are several ways that SSA can get the money back from you if you do not either pay it back or appeal the overpayment, or ifyou lose all your appeals.

SSA can reduce your monthly SSI check by no more than 10% of your totalincome per month, unless fraud or similar fault is involved.²⁴ You can, however, negotiate for a much lower SSA may agree to take out as little as $10.00 per month. ²⁵
If you are no longer receiving SSI checks, SSA can:o Negotiate a monthly payment plan ²⁶
- Arrangefor the overpayment to be taken out of your benefit check from other SSA programs, such as Social Security. The 10% limit applies here as well in most ²⁷
- Takethe overpayment debt out of your federal tax refund ²⁸
- Garnishyour current wages by requiring your employer pay a portion of your monthly wages to ²⁹
- Filea lawsuit against ³⁰ This does not happen often.

²¹ 20 C.F.R. § 416.1468(a).
²² 20 C.F.R. § 416.1468(b).
²³ 20 C.F.R. § 416.1481.
²⁴ 20 C.F.R. § 416.571.
²⁵ POMS § SI 02220.017(a)(l), (A)(2).
²⁶ POMS § SI 02220.025.
²⁷ 20 C.F.R. § 416.572(e).
²⁸ 20 C.F.R. § 4 l6.580(b).
²⁹ 20 C.F.R. § 422.403(d).
³⁰ POMS § SI 02220.035.

SSI Overpayment Checklist

Keeptrack of monthly income, resources and changes in your living Keep all correspondence between SSA and you.
Organizeyour records in separate files by
Didyou receive a “Notice of Overpayment”? Check the Notice and make sure it says what it is supposed to say (see page 3 of this manual).
CompareSSA’s figures with your own
Requestfor Reconsideration if you think SSA is wrong:
- Fillout form SSA-561-U2.
- Fileit within 60 days of your “Notice of ” Use certified mail or get a

receipt.
□ If you file it within 30 days, SSA should not try to collect the overpayment until a decision on your request is reached.

Ask fora Waiver if you believe you were not at fault:

Fillout form SSA-632-BK.
TellSSA why the overpayment was not your
TellSSA if you still receive SSI
Explainwhy you need a waiver by using one of three tests:
“createsa hardship,” or
“againstequity and good conscience,” or
“impedesadministrative efficiency” or “administrative ” See pages 6-7 of this manual for an explanation of these terms.
Fileit at your local SSA There is no deadline for a Waiver.
- If you file it within 30 days of your “Notice of Overpayment,” SSA should not try tocollect the overpayment until a decision on your request is Use certified mail or get a receipt.

IfSSA denies your Reconsideration or your Waiver, you must file an appeal within 60 days from when you receive SSA’s decision. Use certified mail or get a
Appealinga Reconsideration denial:

Fill out form HA-501-US “Request for Hearing by Administrative Law Judge” andsubmit to SSA within 60
SSAcan start collecting the

Appealinga Waiver denial:

Fill out form SSA-561-U2 “Request for Reconsideration” and submit to SSA within60 days (30 days to stop SSA from collecting the overpayment until a decision is made).
If the”Request for Reconsideration” is denied, file form HA-501-US “Request for Hearing by Administrative Law Judge” and submit to SSA within 60 days. Collection efforts can

Income List for SSI Beneficiaries

Income is money or support for your living expenses that you receive regularly, including paychecks from your job, pensions, and Social Security. The income limits for SSI vary from state to state. In California an aged or disabled person cannot have more than $931.00 in countable monthly income in 2020. For an aged or disabled couple who are both eligible for SSI, the 2020 maximum countable monthly income is $1564. The rates are higher
if you are blind, live without cooking facilities, or are in a board and care facility. At the beginning of each year there is usually a small cost-of-living increase in the income limits for both individuals and couples.

SSA excludes many types of income from being counted. The following are the most common exclusions:³¹
General exclusions:

First$20 a month of most income
First$65 of all earnings, and ½ of the rest of monthly

Examples of some (not all) additional income exclusions:

Incometax
Moneyfrom the sale or exchange of an excludable
Weatherizationassistance, such as insulation or storm
Paymentof your bills by someone else paid directly to the supplier, except for payments for your food and
Homeenergy
Moneyfrom loans, but will become countable resources if held into the following month.
Smallamounts of infrequent income, such as
Upto $20 of unearned income in a month if you receive it only once

during a calendar quarter. For example: bank accounts where the
interest is posted quarterly.

Interestearned on excluded burial
Moneysomeone else spends for your medical care or services, including payment made by the Veterans Administration.
Housingassistance provided by the federal government, such as Section
AgentOrange settlement
German,Austrian, and Japanese reparations
Gifts of commercial transportation tickets for travel within the U.S.andto some territories that are not converted by you to cash.
EarnedIncome Tax Credit
Valueof impairment-related work (“IRWEs”).
Valueof work expenses that a blind person incurs in order to

³¹ 20C.F.R. §416.1103;20C.F.R. §416.1124.
Resources List for SSI Beneficiaries.

Resources include, among other things, money in checking or savings accounts³² , personal

property, stocks, bonds, and land you don’t live on. In order to be eligible to receive SSI, the total value of your resources must be limited. For an individual, the limit is $2,000 in 2020. For a couple, the limit is $3,000 in 2020.

SSA excludes many resources when it figures out your total resources. Below are the most common resource exclusions:³³

D Your home, if you both live there and own at least a portion of it.
D Household goods and personal effects.
D Burial spaces for you and your immediate family.
D Burial funds for you and your spouse ($1,500 or less each).
D Term life insurance policies.
D Whole life insurance policies that have a combined face value of $1,500 or less.
D One car, regardless of value, if it is used for transportation for you and/or a member of your family.
D Federal Housing Assistance Payments.

EarnedIncome Tax Credit payments held for more than one

D Cash held nine months or less for repair or replacement of excluded resources that are lost, damaged or stolen.

AgentOrange Settlement payments held more than one

D Payments to victims of Nazi persecution held more than one month.

Japanese-Americanrestitution payments held more than one

D Low-income energy assistance payments held more than one month.
32 See 20 C.F.R. § 416.1208 and POMS § SI 00810 .130 for the joint bank account policy noted in box above .
33 20 C.F.R. § 416.1210
Additional Information:

If you need help with your overpayment case, especially if you were denied a Reconsideration or a Waiver request, contact a local legal services organization at the numbers below.
If you need to contact your local Social Security office, you can call SSA’s toll-free number or go to the SSA website (see below).
Attached Social Security Administration Forms* Forms Page

Sample OverpaymentNotice from SSA 17-24
SSA-561-02: “Request for Reconsideration,” used to contest initialoverpayment decision or to appeal a Waiver decision 25-28
SSA-632-BK:“Request for Waiver of Overpayment Recovery,”

used to request a waiver of overpayment 29-42

SSA-634:“Request for Change in Overpayment Recovery Rate,”

Used to request change in collection recovery rate 43-50

HA-501-US:“Request for Hearing by Administrative Law Judge,” used to appeal a Reconsideration Determination or to appeal a Reconsideration of a Waiver Decision 51-52
HA-520-US“Request for Review of Hearing Decision/Order,”

used to request review of an unfavorable hearing decision 53-54

SSA-1696-04: “Appointment of Representative,” used to select aPerson to represent you when dealing with the This person can

Be a lawyer or a non-lawyer 55-63

SSA-3288:“Consent for Release of Information,” used to tell SSA

To release certain private information to your representative 62-63
*Note: Most of these forms are available on the Social Security website at www.ssa.gov.
Attachment SSI-Overpayments-September-2020-Full-Updated-Document-Packet.pdf

SSI Overpayment Information Packet – September 2020

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