We reviewed the overpayment determination and found it *F1. The enclosed Form SSA-662
explains our reasons. (E3119.1)
How To Pay Us Back
Please refund this overpayment within 30 days. Make your check or money order payable
to "Social Security Administration". Include the claim number shown above on the check
or money order, and send it to us in the enclosed envelope.
*F1
If we do not receive your refund within 30 days, we plan to recover the overpayment
by withholding your full benefit starting with the payment you would normally receive
about *F2. We will continue withholding your benefit until we fully recover the overpayment. (3100A)
Or
We will recover the overpayment from the payment you would receive about *F1. The
reduced payment will be *F2. You will receive your regular monthly payment about *F3.
(3100B)
Or
To recover the overpayment, we will withhold the payment you would normally receive
*F1 about *F2. You will receive *F3 monthly payment again about *F4. (3104B)
If you believe that the reconsideration determination is not correct, you may request
a hearing before an administrative law judge of the Office of Disability Adjudication
and Review. If you want a hearing you must request it not later than 60 days from
the date you receive this notice. You should make your request through any Social
Security office.
You have the right to request a determination concerning the need to recover the overpayment.
This is called waiver. You may request waiver anytime. A request for waiver will be
approved if both of the following are true:
-
1.
The overpayment was not your fault in any way, and
-
2.
You could not meet your necessary living expenses if we recovered the overpayment,
or recovery would be unfair for some other reason.
If you request waiver, we may need a statement of your assets and monthly income and
expenses.
If you request waiver within 30 days from the date of this notice, we will not start
to withhold any part of your benefits. If you request waiver after 30 days, we will
stop any withholding while we consider your waiver request. And, if we asked you to
refund the overpayment, you won't have to make refund while your waiver request is
being considered.
If you request waiver and after reviewing your request we cannot approve it, we will
notify you in writing of our reasons.1
A personal conference with a Social Security employee will then be scheduled for you
so that you can explain why you do not believe your waiver request should be denied.
More information about the personal conference is given in the notice if we cannot
waive recovery of your overpayment.
If you disagree with the waiver decision you have other appeal rights. These appeal
rights will also be explained in detail in the waiver determination notice. (E3119.2)
If You Want Help With Your Appeal2 (REPC01)
You may choose to have a representative help you. We will work with this person just
as we would work with you. If you decide to have a representative, you should find
one quickly so that person can start preparing your case.
Many representatives charge a fee only if you receive benefits. Others may represent
you for free. Usually, your representative may not charge a fee unless we approve
it. Your local Social Security office can give you a list of groups that can help
you find a representative.
If you get a representative, you or that person must notify us in writing. You may
use our Form SSA-1696 "Appointment of Representative." Any local Social Security office
can give you this form. (REP002)
Even if you do not want to request waiver or a hearing, call us at 1-800-772-1213
if the planned withholding of your benefit will cause hardship or you prefer to refund
the overpayment balance so that withholding of your payment is not necessary. (3119C) Domestic
Or
Even if you do not want to request waiver or a hearing, please call, write or visit
*F1 us at 1-800-772-1213 if the planned withholding of your benefit will cause hardship
or you prefer to make full refund of the overpayment so that further withholding of
your payment is not necessary. Please take this letter with you if you do visit an
office. (3119D Foreign)
If You Have Any Questions
We invite you to visit our website at www.socialsecurity.gov on the Internet to find general information about Social Security. If you have any
questions, you should contact *F1. You may also write to the Social Security Administration,
P.O. Box 17769 Baltimore, Maryland 21235, U.S.A. Please be sure to include your claim
number if you do write. However, if you visit an office, please take this letter.
It will help the people there answer your questions. (3901D Foreign)
Or
Suspect Social Security Fraud?
Please visit http://oig.ssa.gov/r or call the Inspector General's Fraud Hotline at 1-800-269-0271 (TTY 1-866-501-2101).
If You Have Any Questions
We invite you to visit our website at www.socialsecurity.gov on the Internet to find general information about Social Security. If you have any
specific questions, you may call us toll-free at 1-800-772-1213, or call your local
Social Security office at 1-*F3- *F4- *F5. We can answer most questions over the phone.
If you are deaf or hard of hearing, you may call our TTY number, 1-800-325-0778. You
can also write or visit any Social Security office. The office that serves your area
is located at:
*F6
*F7
*F8
*F9 *F10- *F11
If you do call or visit an office, please have this letter with you. It will help
us answer your questions. Also, if you plan to visit an office, you may call ahead
to make an appointment. This will help us serve you more quickly when you arrive at
the office. (CTDO Domestic)
Enclosures (3):
Form SSA-662
Form SSA-70-10281
Refund envelope3
1 If the beneficiary lives outside the U.S., omit the next two sentences.
2 If the beneficiary has an attorney or lives outside the U.S., omit this paragraph.
3 If overpayment is less than or equal to the monthly payment, omit refund envelope.