We have determined that you received $ (1) more in Social Security benefits than you were due. (2) .
How To Pay Us Back
You should refund this overpayment within 30 days. Please make your check or money
order payable to “Social Security Administration,” and send it to us in the enclosed envelope. (3) . Always include your claim number (as shown above) on your check or money order.
If we do not receive your refund within 30 days, we shall instruct the Railroad Retirement
Board to withhold your Social Security benefits until the overpayment is recovered.
The Railroad Retirement Board will advise you when the withholding will begin and
for how long. However, you will be given at least 30 days before the withholding begins.
If You Think You Should Not Have to Pay Us Back
3100C
If You Disagree With The Decision
3113A
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If you disagree with the decision, you have the right to appeal. A person who did
not make the first decision will decide your case. We will review your case again
and consider any new facts you have.
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You have 60 days to ask for an appeal. If you ask in the next 30 days, you will not have to pay us back until we decide your
case.
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Both the 30- and 60-day periods start the day after you receive this letter. We assume
you got this letter 5 days after the date on it, unless you show us that you did not
get it within the 5-day period.
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You must have a good reason if you wait more than 60 days to ask for an appeal.
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You have to ask for an appeal in writing. We will ask you to sign a form called “Request for Reconsideration.” The form number is SSA-561-U2. To get this form, contact one of our offices. We can
help you fill out the form.
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We are enclosing a pamphlet called “Important Information About Your Appeal and Waiver Rights.” Please be sure to read it.
Even if you do not want to request reconsideration or waiver, call us at 1-800-772-1213
if withholding of the monthly payment will cause hardship. Unless we hear from you
within 30 days, we will request the Railroad Retirement Board to withhold your benefits
as stated above.
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or 3113B
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If you disagree with the decision, you have the right to appeal. A person who did
not make the first decision will decide your case. We will review your case again
and consider any new facts you have.
-
•
You have 60 days to ask for an appeal. If you ask in the next 30 days, you will not have to pay us back until we decide your
case.
-
•
Both the 30- and 60-day periods start the day after you receive this letter.
-
•
You must have a good reason if you wait more than 60 days to ask for an appeal.
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•
You have to ask for an appeal in writing.
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We are enclosing a pamphlet called “Important Information About Your Appeal and Waiver Rights.” Please be sure to read it.
Even if you do not want to request reconsideration or waiver, please call, write or
visit (1) if withholding of the monthly payment will cause hardship. Please take this letter
with you if you do visit an office. Unless we hear from you within 30 days, we will
request the Railroad Retirement Board to withhold your benefits as stated above.
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If You Want Help With Your Appeal1
3100E
If You Have Any Questions
3901C
Enclosures (2):
SSA-3105
Refund envelope
1 If the person lives outside the U.S. or has an attorney, omit this paragraph.