A “request for reconsideration” is handled differently in title II and title XVI DCN overpayment situations:

If a request for reconsideration is filed with SSA within 30 calendar days of the date on the overpayment notice, overpayment proceedings will not begin if:

1. a. 

   The claimant asserts that he/she did not cash both checks, or

2. b. 

   The claimant maintains he/she never received the either or both check(s).

If a request for reconsideration falls anytime during the 60-day period, take the following actions.

1. a. 

   When a claimant receives an initial overpayment notice for a DCN and protests that overpayment, new policy dictates that a signed SSA-795 to this effect is required for title II and can be signed in the FO or sent to the claimant for signature with a return envelope addressed to the PC or FO. For title XVI, a signed SSA-561-U2 is required and must be received before overpayment recovery ceases.

   If available, the claims package can be sent out with the appropriate form to be completed and returned to either the PC or FO, as appropriate.

   IMPORTANT: If claims package/reconsideration forms are mailed to the claimant, ask him/her to contact SSA if the package is not received within 5 days.

2. b. 

   Claimant must complete and return an FMS-1133 for each check in question to SSA (1) within 30 days of receiving the package, or (2) after notification that the package is available (e.g., FO/TSC notifies claimant by telephone that package is in the FO and claimant states that he/she wishes to come into the FO to complete the form) or SSA will reinstate the overpayment collection.

3. c. 

   Establish a 30-day diary for the return of the completed claim form to SSA. If the FMS-1133 is returned within 30 days, overpayment recovery will not begin. If the completed claims package is received between the 31st day and the 60th day, overpayment recovery will be suspended but any monies already collected will not be returned.

4. d. 

   Inform the claimant that Treasury will not take any action on the allegation without a completed claim form FMS-1133 for each check in question.

5. e. 

   The completed claims package is forwarded to Treasury for a forgery determination.

Reconsideration must meet the good cause criteria found in GN 03101.020. If the request meets the good cause criteria, process according to GN 02406.310.

Since the request for reconsideration was not filed within the 60-day period and did not meet the good cause criteria, reconsideration is not appropriate. However, SSA will accept the completed FMS-1133 form(s) and send them to Treasury for a forgery determination. In addition,

• •

  DO NOT CEASE OVERPAYMENT RECOVERY.

• •

  If Treasury determines that forgery was involved, Treasury will reclaim the money and return it to SSA. SSA will refund any monies withheld from the claimant during the recovery period.

• •

  If Treasury determines that no forgery was involved, overpayment recovery is either already underway or has been completed.

• •

  Obtain a signed SSA-795 stating that the beneficiary requests reconsideration of the DCN overpayment.

• •

  Keep the SSA-795 with copy of the claims package.

• •

  If title II collection efforts have not been suspended, input protest/stop recovery (TC 23R to ROAR).

The FO or PC takes the following processing actions.

1. a. 

   Have claimant come into the FO and sign an SSA-795 (title II)/SSA-561-U2 (title XVI) or mail the appropriate form to the claimant with a return envelope addressed to the FO/PC which states he/she wishes to protest the DCN overpayment (can be sent with the FMS-1133 package). Have claimant call if claims package is not received within 5 days.

2. b. 

   If claims package is not available at the time the SSA-795 or SSA 561-U2 are sent out, have the claimant come into the FO or mail the blank FMS-1133 and check photocopy to the claimant with a return envelope addressed to the FO/PC. Instruct the claimant that the FMS-1133 must be returned in 30 days or recovery will recommence. Have claimant call the FO if the claims package is not received within 5 days.

3. c. 

   Diary for 30 days plus 5 mailing days for return of the FMS-1133 package.

4. d. 

   If the claimant wishes to come into the FO to complete the FMS-1133, the FO should diary for 30 days from the moment of notification to the claimant that the FMS-1133 is available.

5. e. 

   If a completed FMS-1133 is not received in SSA within 30 days plus 5 mailing days, begin/recommence overpayment recovery.

6. f. 

   Review the responses on the FMS-1133 (see GN 02406.160) before sending the package to Treasury.

7. g. 

   Diary for 90 days for the return of the CDN from Treasury. Check the Treasury Check Information System (TCIS) or call Treasury's general number at 855-868-0151 see if forgery determination is complete.

Treasury and SSA takes the following actions when forgery is not involved.

1. a. 

   DT will send a CDN to SSA. This should be received within 90 days of Treasury receiving the FMS-1133.

2. b. 

   DT will send a denial letter to the claimant specifying the basis of the denial. The letter will contain the opinion of the handwriting expert and will provide Treasury's return address and instructions in case the claimant wants to provide additional evidence and appeal the forgery determination within 60 days.

3. c. 

   Diary for 90 days for possible appeal of Treasury's forgery decision. Treasury will send a CDN if appeal is filed.

4. d. 

   Do not resume recovery until either the 60-day appeal period has elapsed, or Treasury makes a final determination on an appeal that forgery is not involved.

5. e. 

   After the appeal period has expired, FOs should ask their Regional Office (RO) and PCs should call their Operations Analyst to query TCIS to see if claimant appealed forgery determination. Information can also be obtained by calling Treasury at 1-855-868-0151. The technicians should call this number for all check claims, payment, and post-payment inquiries. Also check remarks on MBR/SSR, OR

6. f. 

   If the 60-day appeal period plus 30 additional days have elapsed and no appeal has been filed (i.e., no CDN received), resume overpayment recovery.

There is no overpayment. Credit will be returned to SSA via OPAC (Online Payment and Collection system). Also:

1. a. 

   PC/FO: Send a reconsideration determination to the beneficiary/recipient. Do not include waiver language.

2. b. 

   PC: Title II - Input a transaction code of 25 to ROAR (reconsideration approval).

3. c. 

   FO: Title XVI - Credit will post to the SSR causing an excess decision. Delete the L-TAC entered earlier to suspend collection.

The FO or PC will take the following steps.

1. a. 

   Review the responses on the FM-1133 (see GN 02406.160) before sending the package to Treasury.

2. b. 

   Send the original to Treasury for a forgery determination.

3. c. 

   Diary for 90 days for the return of the CDN.

The FO or PC will take the following steps.

1. a. 

   Claimant cannot appeal Treasury's ’ determination since the requirements for a request for reconsideration were not met.

2. b. 

   Since overpayment recovery was not stopped while claim was at Treasury, recovery will continue until full recovery is made.

The FO or PC will take the following steps

1. a. 

   Stop overpayment recovery.

2. b. 

   Refund any monies collected while case was being processed at Treasury.

Treasury notifies the claimant of the forgery determination by letter and sends SSA the claims disposition (CDN).

If the determination is in favor of the payee (forgery involved), Treasury initiates reclamation of the money from the presenting bank. Once the money is reclaimed Treasury credits this amount back to SSA.

IMPORTANT: All CDNs should contain a final disposition advising SSA as to whether the check(s) was forged. FOs should contact the RO and PCs should contact their Operations Analyst for any CDN containing a vague disposition (e.g., “Settlement at Agency’s Discretion”).

Input a transaction code of 23 to ROAR (protest to recovery action) if not already on the record.

Input an L-TAC if not already on the record, pending Treasury's forgery determination.

The claimant should contact Treasury directly to protest Treasury's s original forgery determination. The notice of the forgery determination will provide instructions for the payee to appeal the decision to Treasury. However, if the claimant contacts SSA for assistance:

1. a. 

   Photocopy the letter at Exhibit L for claimant to complete.

2. b. 

   Assist the claimant by providing check identification information (number, symbol, program, etc.).

3. c. 

   Include as attachments any proof provided by the claimant to assist Treasury in its redetermination. DO NOT use the FMS-3864, Agency Recertification Followup, as a transmittal.

4. d. 

   Mark the envelope “FORMAL PROTEST” and mail to:

   Department of the Treasury
   
   Bureau of the Fiscal Service
   
   Check Claims Branch
   
   Exception Inquiries Section-Appeal
   
   P.O. Box 51318
   
   Philadelphia, PA. 19115–6318

   Materials can also be faxed to Treasury at 202-874-8447.

Prepare a 180-day diary to control for CCB response.

Appeals will be handled by a Treasury claims analyst who did not participate in the initial investigation. Any handwriting comparison conducted on appeal will be made by a handwriting expert other than the person who provided the original opinion.

Once Treasury makes a second determination, they send a CDN to SSA and a letter to the claimant either affirming or reversing their original forgery determination.

If denied at this appeal level (Treasury maintains there was no forgery), the denial letter will inform the claimant that he/she may have the right to file a lawsuit in federal court with respect to the denial.

The denial of an appeal, with respect to Treasury's forgery determination, is a final Treasury action. Judicial review of a determination is not permitted prior to denial of a timely appeal from a forgery claim.

Since the existence of the overpayment is based on Treasury's determination that the check(s) was not forged, a Social Security ALJ is not likely to reverse Treasury's determination. However, claimants may still pursue further appeals with SSA based on the reconsideration denial.

Take the following steps.

1. a. 

   Send a notice of reconsideration to the claimant based on Treasury's ’s decision that check(s) was not forged. Explain that Treasury's forgery determination is final and binding.

2. b. 

   Reinstate overpayment recovery. For title II, annotate PHUS via SSA-1257-U2 action code (AC-2) with the amount of the check. For title XVI, use MISSICS to remove the MT-TAC.

3. c. 

   Recovery should begin COM+1.

1. a. 

   Send a reconsideration determination to the beneficiary/recipient.

2. b. 

   For title II, prepare an SSA-1257-U2, AC-1 to null the event code 010 previously annotated to the PHUS record. Then input a transaction code of 25 to ROAR (reconsideration approval).

3. c. 

   For title XVI, delete any manual diary set but leave the MT-TAC in place as recovery is inappropriate.

Although the MBR and SSR indicate if a DCN has occurred in the preceding 2 years, neither title II nor title XVI has a dedicated query/field to indicate that a forgery determination has been requested, decided, appealed, denied, etc. The presence of this information is important to determining misuse/a pattern of reporting nonreceipt as well as providing a diary of due process events.

Remember that a title II protest can be recorded, and overpayment recovery ceased (if appropriate) as soon as the objection to the DCN overpayment is made. The title XVI protest should not be recorded, nor overpayment recovery ceased until the signed SSA-561 is received.

• •

  Claimant protests the overpayment resulting from the DCN and the date of the check(s) involved (Example: “MM/DD/YYYY Protest O/P of 11/03/97 CK”);

• •

  Date the FMS-1133 is sent to Treasury for a forgery determination (if known) (Example: “1133 Treasury MM/DD/YYYY”);

• •

  Treasury's decision on the forgery claim obtained from the claims disposition notice (Example: “MM/DD/YYYY No Forgery on 11/03/97 CK”);

• •

  Forgery claim denied and claimant protests the denial (Example: “MM/DD/YYYY protest Treasury denial”);

• •

  Beneficiary/recipient is true DCN abuser.  Add the phrase, “DCN Abuse - Input as C-stop until mm/yy” in the “RMKS” field on the SSR and/or “SPMSG” field on the MBR.  If additional DCN abuse occurs, the date should be changed to reflect the most recent occurrence of the abuse.