Navigating Overpayment Waiver Requests During the COVID-19 Pandemic, § 404.506

Overpayment waiver process flowchart

The COVID-19 pandemic has had a significant impact on various aspects of our lives, including social security benefits.

In response to the pandemic, the Social Security Administration (SSA) has implemented measures to provide relief for individuals who have received overpayments under Title II of the Social Security Act. This blog post will discuss the waiver process for these overpayments, as well as when and how to request a waiver.

Key Points:

  1. Qualifying Overpayments and Waiver Requests:

During the pandemic period, the SSA may have made overpayments due to the suspension of certain manual workloads in response to the COVID-19 national public health emergency. If you have received a qualifying overpayment during this period, you may request a waiver.

  1. Presumption of No Fault:

If you request a waiver for a qualifying overpayment, the SSA will presume you are without fault in causing the overpayment unless it is determined that the overpayment was the result of fraud or similar fault, or involved misuse of benefits by a representative payee.

  1. Equity and Good Conscience:

If the SSA determines that you are without fault in causing a qualifying overpayment, it will also determine that recovery of the overpayment would be against equity and good conscience. In this context, “against equity and good conscience” refers to a broad concept of fairness that takes into account all of the facts and circumstances of the case.

  1. Auxiliary Beneficiaries:

If a primary beneficiary is found to be at fault for a qualifying overpayment, auxiliary beneficiaries on the primary beneficiary’s record may still be eligible for a waiver of recovery of the qualifying overpayment if they meet the requirements of the waiver process.

  1. Timelines:

The provisions for waiver of qualifying overpayments apply to those identified by December 31, 2020. If you request a waiver within 30 days of receiving a notice of overpayment, no adjustment or recovery action will be taken until after the initial waiver determination is made.

  1. Waiver Request Process:

When requesting a waiver, you will need to provide information and supporting documentation to the SSA to support your contention that you are without fault and that adjustment or recovery would either defeat the purpose of Title II of the Act or be against equity and good conscience. If the waiver cannot be approved after review, you will be notified and given the opportunity to participate in a personal conference.

  1. Personal Conference:

During the personal conference, you will have the opportunity to review the claims file, present your case, submit documents, and question witnesses. The decision-maker will consider all evidence and information presented before making a decision to approve or deny the waiver.

  1. Written Decision:

The SSA will issue a written decision specifying the findings of fact and conclusions in support of the decision to approve or deny the waiver. If the waiver is denied, adjustment or recovery of the overpayment will begin, even if you choose to appeal the decision.

Example: Overpayment Waiver Request Scenario

Imagine Jane, a single mother of two who received Social Security Disability Insurance (SSDI) benefits during the COVID-19 pandemic. Due to the suspension of certain SSA workloads in response to the pandemic, Jane received an overpayment of $2,000 for several months. She was unaware of the overpayment until she received a notice from the SSA.

Upon receiving the notice, Jane realizes that she meets the criteria for a qualifying overpayment and decides to request a waiver. She gathers documentation to show that she was without fault in causing the overpayment and that recovering the overpayment would defeat the purpose of Title II of the Act and be against equity and good conscience. In her case, the recovery of the overpayment would cause her financial hardship, as she has been struggling to pay for her children’s basic needs and healthcare.

Within 30 days of receiving the overpayment notice, Jane submits her waiver request to the SSA along with the supporting documentation. The SSA reviews her request and determines that Jane is without fault and that recovering the overpayment would indeed be against equity and good conscience. They approve her waiver request, and she is no longer required to repay the $2,000 overpayment.

In this example, Jane was proactive in addressing the overpayment issue, understood the waiver process, and provided the necessary documentation to support her request. As a result, she was able to obtain a favorable outcome and avoid the financial burden of repaying the overpayment.

Conclusion: The waiver process for overpayments during the COVID-19 pandemic has been established to provide relief to those who have been affected by the suspension of certain SSA workloads. If you believe you have received a qualifying overpayment, it is essential to understand the waiver process and act accordingly to protect your rights and financial interests.

https://www.ssa.gov/OP_Home/cfr20/404/404-0506.htm

At Hugo Fierro & Michael Perez, we are a committed team of professionals with a comprehensive understanding of the intricacies inherent in Social Security disability claims. We take great pride in utilizing our expertise to provide tailored guidance and support to our clients. Our skilled team is highly proficient in navigating the nuanced particulars of each case, guaranteeing that you receive invaluable insights and customized assistance to meet your distinct needs.

Leave a Comment

Your email address will not be published. Required fields are marked *