SSA’s Process for Overpayment Findings and Waiver Requests, § 404.523

The Social Security Administration (SSA) has a specific process in place to handle situations involving overpayment and waiver requests.

This article breaks down the key aspects of the process, as outlined in §404.523, to provide a clear understanding of how the SSA makes its determinations and what to expect if you’re dealing with an overpayment situation.

1. Issuance of Written Findings: Following a hearing or record review, the SSA will issue written findings, including the rationale for their decision. These findings determine whether the overpayment, or part of it, is past due and legally enforceable. This decision is considered the final agency action regarding the past-due status and enforceability of the overpayment.
2. Waiver Request Determination: If the SSA determines that a waiver request cannot be granted, they will issue a written notice in accordance with subpart J of the regulations. During any further administrative review of the waiver request, the referral of the overpayment to the Department of the Treasury will not be suspended.
3. Distribution of Findings: Copies of the findings will be distributed to the overpaid individual and their attorney or representative, if applicable.
4. Referral to the Department of the Treasury: If the findings affirm that all or part of the overpayment is past due and legally enforceable and the waiver request cannot be granted, the SSA will refer the overpayment to the Department of the Treasury. No referral will be made if the SSA reverses its prior finding, or if they determine that waiver of the overpayment is appropriate upon considering the waiver request.

Jane’s Situation: Jane, a Social Security beneficiary, received a notice from the SSA stating that she was overpaid by $2,000. The notice informed her that she could request a waiver if she believed the overpayment wasn’t her fault and repaying it would cause financial hardship.

1. Requesting a Hearing Jane decided to request a hearing with the SSA to contest the overpayment, as she believed the amount was incorrect. After submitting her request, the SSA scheduled a hearing to review her case.
2. Issuance of Written Findings After the hearing, the SSA reviewed Jane’s case and determined that the overpayment was $1,500, not $2,000 as initially stated. They issued written findings with a supporting rationale, explaining that the overpayment was past due and legally enforceable. Jane also requested a waiver, which the SSA reviewed separately.
3. Waiver Request Determination Upon reviewing Jane’s waiver request, the SSA found that the overpayment was not her fault and that repaying the amount would cause her significant financial hardship. They decided to grant the waiver, effectively waiving their right to collect the $1,500 overpayment.
4. Distribution of Findings The SSA sent copies of the written findings to Jane and her attorney, informing them of the reduced overpayment amount and the granted waiver.
5. No Referral to the Department of the Treasury Since the waiver was granted, the SSA did not refer Jane’s overpayment to the Department of the Treasury for collection. Jane was relieved to learn that she would not be required to repay the $1,500.

Jane’s story illustrates how the SSA handles overpayment situations and waiver requests according to §404.523. By understanding the process and working with the SSA, Jane was able to successfully contest the overpayment amount and obtain a waiver, relieving her of the financial burden.

Conclusion: Understanding the SSA’s process for handling overpayment situations and waiver requests is crucial if you find yourself in such a situation. By familiarizing yourself with §404.523 and its key provisions, you will be better equipped to navigate the process and work with the SSA to resolve any overpayment issues.

https://www.ssa.gov/OP_Home/cfr20/404/404-0523.htm