Effective Dates: 01/28/2025 - Present Previous | Next

TN 75 (01-25)

GN 02250.002 Processing a Waiver Request - Title II and Title XVI

CITATIONS:

Social Security Act §§ 204(b), 1631(b)(1)(B)

A. Introduction

This section provides guidance on:

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How we process a waiver and reconsideration when they are requested at the same time;
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The amount to consider for a waiver request; and
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How we process an approval or propose denial of the waiver request.

B. Policy

We may initiate waiver processing only after an individual requests a waiver. We must stop overpayment recovery when we receive the waiver request. We must refund any amount that we recovered in the month the overpaid individual requested a waiver and any subsequent months if we do not timely input the waiver request.

1. Waiver and reconsideration requested at the same time

An individual may request a reconsideration of the overpayment and a waiver at the same time. A formal determination or dismissal of the reconsideration is necessary prior to making a determination on the waiver request. If you make a reconsideration determination that does not fully eliminate the overpayment, process the waiver immediately after making your reconsideration determination.

For more information about processing an overpayment reconsideration, refer to GN 02201.025 for Title II and SI 02220.017 for Title XVI.

2. Amount to consider for a waiver request

An overpaid individual may request a waiver of overpayment recovery at any time. An overpaid individual may also request a waiver after we have partially or completely recovered the overpayment or denied a prior waiver request. We must determine whether to waive the original overpayment amount or the remaining balance. For guidance on the amount to waive, refer to GN 02250.310.

NOTE: For cases where we have recovered all or part of the overpayment via tax refund offset (TRO), refer to GN 02201.030E.2 and SI 02220.012F.4. For cases where we have notified the individual of TRO but an offset has not taken place yet, refer to GN 02201.030D.2. and SI 02220.012E.3. and SI 02220.012.

3. Approving a waiver or proposing to deny the waiver

When we develop a waiver request, the initial decision maker must determine if they can fully approve the waiver or if they need to propose a denial. If the initial decision maker recommends a partial waiver approval or proposes to deny the waiver, they must refer the waiver to an independent decision maker for a file review and personal conference. For more information about processing a waiver approval or proposed denial, refer to GN 02250.002C.

NOTE: If you cannot approve a waiver under the administrative tolerance provision, and the overpaid individual’s address is outside the United States, refer to GN 02215.010 for Title II and SI 02220.005B.1.d. for Title XVI.

C. Procedure

If an individual contacts us to request a waiver:

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Determine who may request a waiver, refer to GN 02250.001E.
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If the original overpayment amount is $2,000 or less, process the waiver request under the administrative tolerance provision according to GN 02250.350.
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If the original overpayment amount is more than $2,000, the waiver request must be in writing on form SSA-632-BK (Request for Waiver of Overpayment Recovery), or be completed on form SSA-632-BK with a technician over the telephone. For more information on taking waiver request over the phone, refer to GN 02250.002C.1.
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Process a waiver request for an overpayment of more than $2,000 according to GN 02250.002C.3 for Title II and GN 02250.002C.4 for Title XVI.

1. Taking a waiver request over the phone

If an individual requests a waiver and you are unable to approve the waiver under the administrative tolerance provision and the individual would like to complete the SSA-632-BK over the phone, complete these steps:

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Open Inform and select the SSA-632-BK form.
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Complete the attestation script before and after the interview as shown in GN 00201.015F.3.
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Go over the questions with the waiver requestor and input their responses into the fillable form.
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In the Remarks field, input the following language after reading the Penalty Clause to the individual: Signature attested after reading the Penalty Clause.
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Check the appropriate box for the authorization to obtain financial account information.
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Save the completed form as a pdf file to the FO’s Shared drive. Delete the file from the Shared drive as soon as business has been completed.
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Upload the completed form into WorkTrack 2.0 using the “Upload a Batch” process. See the WorkTrack 2.0 User Guide for more information.
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Mail a printed copy of the completed SSA-632 to the waiver requestor.
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Complete the waiver procedures. For Title II waiver procedures, refer to GN 02250.002C.3. For Title XVI waiver procedures, refer to GN 02250.002C.4.
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Continue normal business processes to profile and assign the waiver to a technician for completion. The technician will evaluate the waiver request to determine whether the waiver request can be approved.

2. Propose to deny procedure

When we cannot fully approve a waiver request, we must provide the overpaid individual an opportunity for a file review and personal conference before we can make a partial waiver approval determination or deny the waiver request. We must:

a. Title II

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Input the denial using the DRWD screen in DMS (refer to MS DMS 006.004).
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Document the relevant facts of the overpayment(s) and provide the rationale for denying the waiver in DMS Remarks. The proposed waiver denial determination must be clear and reflect the following facts:
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  How the overpayment(s) occurred;
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  The dates of the overpayment(s);
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  The total amount of the overpayment(s); and
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  The reason we cannot approve the waiver (including a fault determination, and if not at fault, why recovery is not against equity and good conscience, not deemed to defeat the purpose of the Act or does not defeat the purpose of the Act).

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Refer the waiver for a personal conference. For additional information on scheduling and conducting a personal conference, refer to GN 02270.003 through GN 02270.015.

b. Title XVI

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Document the relevant facts of the overpayment(s) and provide the rationale for denying the waiver on a DROC in the Consolidated Claims Experience (CCE). For more information on the Report of Contact page in CCE, see MS 08122.010. For non-MSSICS/CCE cases, document on the SSA-5002 (Report of Contact) and fax it into the Evidence Portal (EP). The proposed waiver denial determination must be clear and reflect the following facts:
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  How the overpayment(s) occurred;
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  The dates of the overpayment(s);
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  The total amount of the overpayment(s); and
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  The reason we cannot approve the waiver (including a fault determination, and if not at fault, why recovery is not against equity and good conscience, not deemed to defeat the purpose of the Act or does not defeat the purpose of the Act).

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Refer the waiver for a personal conference. For additional information on scheduling and conducting a personal conference, refer to GN 02270.003 through GN 02270.015.

3. Title II procedure

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Stop recovery as of the month we receive the waiver request and refund the amount recovered in the month the overpaid individual requested a waiver and any subsequent months. Request the Processing Center (PC) refund the amount.
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Input the initial waiver protest reason using the Protest/Stop Recovery Request (FO) (DRPF) screen in the Debt Management System (DMS). For more information about the DRPF screen, refer to MS 01106.019.

NOTE: Do not process or post a Title II waiver request for a Title XVI cross-program recovery overpayment. For more information about processing a Title XVI waiver, refer to GN 02250.002C.4.

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Annotate DMS Remarks to document your actions.
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For more information on proposed to deny waiver procedures, refer to GN 02250.002C.2. For more information on Title II waiver approval procedures, refer to GN 02250.002C.3.a.

a. Title II waiver approval procedure

When approving a waiver request for more than $2,000, take the following actions:

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Document your determination on form SSA-635 (Waiver Determination). For instructions on how to document a determination on SSA-635, refer to GN 02250.315.
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If you determine a second pin review is necessary, refer to GN 02250.301.
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Input the waiver approval decision to Recovery of Overpayment Accounting Reporting (ROAR) using the Waiver Disposition (DRWD) screen in DMS. For more information on the DRWD screen, refer to MS 01106.004.
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You must annotate the waiver approval on the DMS Remarks (RMKS) screen by stating “Refer to the SSA-635 dated mm/dd/yyyy documenting the waiver determination in the Evidence Portal (EP), name and title of deciding or reviewing official, office code and date of the decision.” For more information on EP, refer to MS 09701.001.
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Prepare a waiver approval notice using DPS. For instructions on how to prepare the waiver approval notice, refer to GN 02250.370B and GN 02250.370C.
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If you are approving a waiver for an overpayment that we completely recovered, request the Processing Center (PC) refund the amount approved and ask PC to repost the overpayment to the ROAR.
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  Document this on DMS Remarks:
  
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  You are approving a waiver request for an overpayment that has been completely recovered.
  
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  You are sending an SSA-5002 to the PC for them to refund the amount we recovered for the approved waiver.
  
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  You are asking the PC to create a new ROAR event to repost the overpayment.
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  Once reposted, immediately enter the waiver request and approval.
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  Complete an SSA-5002 requesting PC refund the overpayment and repost the overpayment to the ROAR.
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  Send the SSA-5002 to PC via Evidence Portal using the document type OTHER-Other Document. Check “Yes” does this document require involvement by the Processing Center.
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  Check the Master Beneficiary Record (MBR) and ROAR after 15 days. If the overpayment is not reposted, send a manager-to-manager request. For more information on modes of requesting assist with the PC, refer to GN 01070.228.

4. Title XVI procedure

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Stop recovery and post the waiver request date to the SSR using the Modernized Supplemental Security Income Claims System (MSSICS) Direct SSR Update and the Waiver (UOWV) screen. For more information on stopping recovery and changing overpayment decisions, refer to MS 00304.008. For more information on the UOWV screen, refer to MS 00304.009.
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If the system does not refund the amount recovered, refund the amount recovered in the month the overpaid individual requested a waiver and any subsequent months by the Automated One Time Payment (A-OTP) process. For instructions on the A-OTP process, refer to SM 01901.005 and MS 00304.007 through MS 00304.009 and MS 00303.022.
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For more information on proposed to deny waiver procedures, refer to GN 02250.002C.2. For more information on Title XVI waiver approval procedures, refer to GN 02250.002C.4.a.

a. Title XVI waiver approval procedure