WAVC03 – CAPTION

If You Think You Should Not Have To Pay Us Back

WAV001 – WAIVER RIGHTS NEW OVERPAYMENT

You have certain rights with respect to this overpayment and its recovery.

1. 1. 

   Right to Appeal: If you disagree in any way with this overpayment determination, you have the right, within 60 days of the date you receive this notice, to request that the determination be reconsidered. If you request this independent review of the overpayment determination, please submit any additional information you have which pertains to the overpayment.

2. 2. 

   Right to Request Waiver: You also have the right to request a determination concerning the need to recover the overpayment. An overpayment must be refunded or withheld from benefits unless both of the following are true:

   1. a. 

      The overpayment was not your fault in any way, and

   2. b. 

      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 reconsideration and/or waiver within 30 days, the overpayment will not have to be recovered until the case is reviewed. This review is described in more detail on the attached form SSA-3105, Important Information About Your Appeal, Waiver Rights, and Repayment Options. Please contact us if you need help completing the forms for requesting reconsideration (SSA-561-U2, Request for Reconsideration) and/or waiver (SSA-632-BK, Request for Waiver of Overpayment Recovery or Change in Repayment Options).

If you have any additional questions, please contact us, and have this letter with you so that we may help you more quickly.

WAV005 – CROSS PROGRAM RECOVERY FOR SUPPLEMENTAL SECURITY INCOME (SSI) OVERPAYMENT - USED WITH RCY002

You may not have to pay us back. Sometimes we can waive the collection of an overpayment, which means you won't have to pay us back. For us to waive the collection of the overpayment, two things have to be true.

• •

  It wasn't your fault that you got too much SSI money.

AND

• •

  Paying us back would mean you can't pay your bills for food, clothing, housing, medical care or other necessary expenses, or it would be unfair for some other reason.

If you think these are true about you, contact any Social Security office. You can ask for waiver at any time by completing the waiver form and returning it to us. The form is called Request for Waiver of Recovery or Change in Repayment Rate, Form SSA-632. We will be happy to help you fill out the form. If you ask for waiver after that time, we will stop collecting the overpayment while we decide if we can waive collection.

WCPC01 – CAPTION

Other Disability Payments Affect Benefits

WCP001 – NUMBER HOLDER INTENDS TO FILE FOR WORKERS’ COMPENSATION (WC)/PUBLIC DISABILITY BENEFITS (PDB)

We learned that you plan to file a claim for workers' compensation or public disability benefits. If you receive these payments, we may have to reduce (1) Social Security benefits.

At that time, (2) may also have to pay back any Social Security benefits that (3) not due. If you file a claim, please tell us the decision made on the claim right away.

WCP003 – NUMBER HOLDER RECEIVES WORKERS’ COMPENSATION (WC)/PUBLIC DISABILITY BENEFITS (PDB) PUBLICATION 05-10018

We have to consider workers' compensation and/or public disability payments when we figure a Social Security benefit. The following will explain how these payments affect Social Security benefits. For more information, please read the enclosed pamphlet, “How Workers' Compensation and Other Disability Payments May Affect Your Social Security Benefits.”

WCP004 – NUMBER HOLDER RECEIVES WORKERS’ COMPENSATION (WC)/PUBLIC DISABILITY BENEFITS (PDB) AND MONTHLY BENEFIT AMOUNT (MBA) IS NOT OFFSET

Your present (1) payments of (2) do not affect (3) Social Security benefits.

WCP007 – WORKERS’ COMPENSATION (WC)/PUBLIC DISABILITY BENEFITS (PDB) APPEAL PENDING

We will not reduce your benefit because of (1) (2) payments until a decision is made on the appeal of the claim. At that time, we may collect any money that should not have been paid.

WCP008 – TELLS AUXILIARY THAT NUMBER HOLDER INTENDS TO FILE FOR WORKERS’ COMPENSATION (WC)/PUBLIC DISABILITY BENEFITS (PDB)

If (1) receives workers' compensation and/or public disability payments, we may have to reduce your Social Security benefits. At that time, we may also have to recover any money that should not have been paid.

WCP009 – NUMBER HOLDER APPEALS WORKERS’ COMPENSATION (WC)/PUBLIC DISABILITY BENEFITS (PDB)

We will not reduce your benefit because of (1) payments until you receive a decision on your appeal of the claim. Please let us know the decision on the appeal right away. At that time, you may have to pay back any Social Security benefits that you were not due.

WCP013 – ADVISES NUMBER HOLDER OF REVERSE JURISDICTION

Beginning (1), we are paying you a Social Security benefit that is not reduced due to (2) payments. This is because of a change caused by the State law which provides for the reduction of these payments to persons who receive Social Security disability benefits.

WCP015 – TRIENNIAL REDETERMINATION (EVERY 3 YEARS)

Based on your (1), every 3 years, we check to see if an increase in the national earnings level affects the amount of your monthly Social Security benefit. When we checked your monthly benefit amount, we found that (5) due more money.

WCP016 – MONTHLY BENEFIT AMOUNT (MBA) OFFSET DUE TO WORKERS’ COMPENSATION (WC)/PUBLIC DISABILITY BENEFITS (PDB) AND COST-OF-LIVING ADJUSTMENT (COLA) DUE

A cost-of-living increase is not reduced because of (1) workers' compensation and/or public disability payments.

WCP019 – WORKERS’ COMPENSATION (WC)/PUBLIC DISABILITY BENEFITS (PDB) STOPS – NUMBER HOLDER AGE 65 MINUS ONE MONTH PRIOR TO DECEMBER 19, 2015

Beginning (1), we are not reducing your benefit because of (2) payments. We do not reduce benefits for months when the disabled worker is age (3) or over.

WCP020 – USED WITH WCP003

The pamphlet explains how we reduce your Social Security Disability benefits if the money which you and your family would receive from Social Security and (1) adds up to more than 80 percent of your monthly average earnings. We found that 80 percent of your average current earnings is (2).

WCP021 – NUMBER HOLDER NEEDS PROOF FOR EXPENSES

If you had any expenses related to your claim for (1) payments, please give us proof that you paid these expenses. These expenses may include medical, legal, or other related expenses. We may be able to deduct some of these expenses when we figure (2) Social Security benefits.

WCP022 – CHANGE IN AVERAGE CURRENT EARNINGS (ACE) AMOUNT

We told you earlier that we might change the amount of your benefits when we got more facts about the money you earned while you were working. Using the new facts about your earnings, we found that 80 percent of your average current earnings was (1).

WCP023 – NUMBER HOLDER BENEFITS SUSPENDED FOR WORKERS’ COMPENSATION OFFSET - NO LUMP SUM INVOLVED

We have to take into account your (1) of (2) when we figure your Social Security benefits. Because of (5), your monthly Social Security benefits are not payable (4).

WCP024 – NUMBER HOLDER'S MONTHLY BENEFIT AMOUNT (MBA) REDUCED DUE TO WORKERS’ COMPENSATION (WC)/PUBLIC DISABILITY BENEFITS (PDB)

We have to take into account your (1) of (2) when we figure your Social Security benefits. Because of (3), we changed your monthly Social Security benefits to (4) beginning (5).

WCP025 – AUXILIARY MONTHLY BENEFIT AMOUNT (MBA) CHANGED DUE TO WCPDB AND ENTITLED AUXILIARY

We changed your monthly benefit to (1) beginning (2) because we started paying another person on this record. When we figured your benefit, we had to take into account (3) (4) payments.

WCP026 – AUXILIARY MONTHLY BENEFIT AMOUNT (MBA) CHANGED DUE TO WORKERS’ COMPENSATION (WC)/PUBLIC DISABILITY BENEFITS (PDB) AND TERMINATED AUXILIARY

We changed your monthly benefit to (1) beginning (2) because benefits to another entitled person stopped. When we figured your benefit, we had to take into account (3) (4) payments.

WCP027 – NUMBER HOLDER HAS EXCLUDABLE AMOUNTS FOR EXPENSES

When we figure how much to reduce (1) benefits, we do not count certain medical, legal or other expenses which were paid out of your (2) payments. We excluded (3) when we figured (4) benefits.

WCP028 – USED WITH WCP003 ONE BENEFICIARY’S MONTHLY BENEFIT AMOUNT (MBA) IS OFFSET- NUMBER HOLDER AGE 65 MINUS ONE MONTH PRIOR TO DECEMBER 19, 2015

We may continue to reduce or withhold (1) disability benefits until you reach age 65. We must take this action because of your (2) payments. (3) payments do not affect retirement benefits. You may be eligible for retirement benefits at age 62. To apply, please get in touch with us three months before (4) age 62.

WCP029 – NUMBER HOLDER'S WORKERS’ COMPENSATION (WC)/PUBLIC DISABILITY BENEFITS (PDB) CLAIM PENDING

If you receive workers' compensation and/or public disability benefit payments, we may have to reduce your Social Security benefits.

At that time, you may also have to pay back any Social Security benefits that (4) not due. Please let us know the decision on the claim right away.

WCP030 – NUMBER HOLDER BENEFITS SUSPENDED FOR WORKERS’ COMPENSATION OFFSET (WCOFFS) LUMP SUM INVOLVED

We consider your (1) of (2) when we figure your Social Security benefits. Because of (3), we cannot pay your Social Security benefits (4).

WCP031 – NUMBER HOLDER MONTHLY BENEFIT AMOUNT (MBA) REDUCED LUMP SUM AWARD PAYMENT INVOLVED

We consider your (1) of (2) when we figure your Social Security benefits. Because of (3), we changed your monthly Social Security benefits to (4) starting (5).

WCP032 – USED WITH WCP003 - INFORMATIONAL REPORTING

Please let us know right away about any:

• •

  Changes in your workers' compensation or public disability benefit payments.

• •

  Lump-sum award(s) you receive.

• •

  Other payments you receive that increase or decrease your workers’ compensation or public disability benefit payments.

WCP033 – NUMBER HOLDER'S WORKERS’ COMPENSATION (WC)/PUBLIC DISABILITY BENEFITS (PDB) STOPS < CURRENT OPERATING MONTH (COM) AND < (AGE 65 PRIOR TO DECEMBER 19, 2015 OR < FRA IF ON OR AFTER DECEMBER 19, 2015)

We do not reduce monthly Social Security benefits once your (1) payments stop. We changed your monthly benefit to the full rate of (2) beginning (3).

WCP034 – EMBEDDED WORKERS’ COMPENSATION (WC)/PUBLIC DISABILITY BENEFITS (PDB) PERIOD MONTHLY BENEFIT AMOUNT (MBA) CHANGE AND EFDS

Your monthly benefit is (1) for (2) (3) (4).

WCP035 – LUMP SUM AWARD PAYMENT - METHOD A USED

You have received a lump-sum award(s) of (1) to settle your (2) claim. A lump sum award affects Social Security benefits in the same way that periodic payments do. We treat a lump-sum award as if it were paid on a weekly basis.

When we figure how much to reduce (3) benefits, we treated the lump-sum as if you had been paid (4) each week. We excluded (5) for legal expenses, and (6) for medical expenses.

WCP036 – LUMP SUM AWARD PAYMENT - METHOD B USED

You have received a lump-sum award(s) of (1) to settle your (2) claim. A lump-sum award affects Social Security benefits in the same way that periodic payments do. We treat a lump-sum award as if it were paid on a weekly basis.

When we figured how much to reduce (3) benefits, we treated the lump-sum as if you had been paid (4) each week. We excluded (5) for legal expenses, medical and other expenses. For this reason, we lowered the weekly rate from (6) to (7).

WCP037 – LUMP SUM AWARD PAYMENT - METHOD C USED – USED FOR NUMBER HOLDER ONLY

You have received a lump-sum award(s) of (1) to settle your (2) claim. A lump-sum award affects Social Security benefits in the same way that periodic payments do. We treat a lump-sum award as if it were paid on a weekly basis.

When we figured how much to reduce (3) benefits, we excluded (4) for legal expenses, medical and other expenses. We treated the rest of the lump-sum, (5), as if you had been paid (6) per week. We will pay full benefits beginning (7).

WCP038 – NUMBER HOLDER RECEIVES PERIODIC PAYMENTS NO PROOF

We may have to change the amount of your benefits when we receive proof of the amount of your (1) payments.

WCP039 – AUXILIARY BENEFITS SUSPENDED - WCOFFS DUE TO NUMBER HOLDER'S WORKERS’ COMPENSATION (WC)/PUBLIC DISABILITY BENEFITS (PDB)

We have to take into account (1) (2) when we figure your Social Security benefits. Because of (3), (4) monthly Social Security benefits are not payable (6).

WCP040 – AUXILIARY MONTHLY BENEFIT AMOUNT (MBA) CHANGED DUE TO NUMBER HOLDER'S WORKERS’ COMPENSATION (WC)/PUBLIC DISABILITY BENEFITS (PDB)

We have to take into account (1) (2) when we figure your Social Security benefits. Because of (3), we changed your monthly Social Security benefit to (4) beginning (5).

WCP041 – MONTHLY BENEFIT AMOUNT (MBA) CHANGE DUE TO WORKERS’ COMPENSATION (WC)/PUBLIC DISABILITY BENEFITS (PDB) AND COST-OF-LIVING ADJUSTMENT (COLA) NOT PIC A

We have to take into account (1) (2) when we figure your Social Security benefits. Because of (3), we changed your monthly Social Security benefit to (4) beginning (5). This change also includes the cost of living increase.

WCP042 – NUMBER HOLDER MONTHLY BENEFIT AMOUNT (MBA) CHANGE DUE TO WORKERS’ COMPENSATION (WC)/PUBLIC DISABILITY BENEFITS (PDB) AND COST-OF-LIVING ADJUSTMENT (COLA) NO LUMP SUM INVOLVED

We have to take into account your (1) of (2) when we figure your Social Security benefits. Because of (3), we changed your monthly Social Security benefit to (4) beginning (5). This change also includes the cost of living increase.

WCP043 – NUMBER HOLDER MONTHLY BENEFIT AMOUNT (MBA) CHANGE DUE TO WORKERS’ COMPENSATION (WC)/PUBLIC DISABILITY BENEFITS (PDB) AND COST-OF-LIVING ADJUSTMENT (COLA) LUMP SUM INVOLVED

We have to take into account your lump-sum payment(s) of (1) when we figure your Social Security benefits. Because of (2), we changed your monthly Social Security benefit to (3) beginning (4). This change also includes the cost of living increase.

WCP044 – AUXILIARY MONTHLY BENEFIT AMOUNT (MBA) CHANGE FOR WORKERS’ COMPENSATION (WC)/PUBLIC DISABILITY BENEFITS (PDB), COST-OF-LIVING ADJUSTMENT (COLA) AND BENEFICIARY TERMINATED

We changed your monthly benefit to (1) beginning (2) because benefits to another entitled person(s) stopped. When we figured your benefit, we had to take into account (3) (4) payments. This change also includes the cost-of-living increase.

WCP045 – AUXILIARY MONTHLY BENEFIT AMOUNT (MBA) CHANGE FOR NUMBER HOLDER’S WORKERS’ COMPENSATION (WC)/PUBLIC DISABILITY BENEFITS (PDB), COST-OF-LIVING ADJUSTMENT (COLA) AND ANOTHER BENEFICIARY STARTS RECEIVING BENEFITS

We changed your monthly benefit to (1) beginning (2) because we started paying another person(s) on this record. When we figured your benefit, we had to take into account (3) (4) payments. This change also includes the cost-of-living increase.

WCP046 – AUXILIARY NOTICE – NUMBER HOLDER'S WORKERS’ COMPENSATION (WC)/PUBLIC DISABILITY BENEFITS (PDB) STOP – MONTHLY BENEFIT AMOUNT (MBA) NOT AFFECTED

We changed your monthly benefit to (1) beginning (2) because (3) present (4) payment(s) do not affect your monthly Social Security benefits.

WCP047 – NUMBER HOLDER MONTHLY BENEFIT AMOUNT (MBA) CHANGE AMOF DELETED FROM POST-MBR

We changed your monthly Social Security benefit to (1) beginning (2) because your benefits are not affected by your receipt of workers' compensation and/or public disability payments.

WCP060 - WORKER’S COMPENSATION (WC)/PUBLIC DISABILITY BENEFITS (PDB) STOPS- NUMBER HOLDER AGE 65 MINUS ONE MONTH AFTER DECEMBER 19, 2015

Starting (1), we will stop reducing your Social Security disability benefits because of your (2) payments. We stop reducing disability benefits when you full retirement age.

WCP061 - BENEFICIARY’S MONTHLY BENEFIT AMOUNT (MBA) IS OFFSET- NUMBER HOLDER AGE 65 MINUS ONE MONTH AFTER DECEMBER 19, 2015

We will continue to reduce or withhold (1) disability benefits until you reach full retirement age in (2). We must take this action because of your (3) payments.

Your (4) payments do not affect retirement benefits. You may be eligible for reduced retirement benefits at age 62. If you decide to apply for retirement benefits, please contact us three months before you reach age 62.

WDS009 – THIS UTI EXPLAINS TO THE BENEFICIARY THAT THE FOLLOWING YEAR WHEN HIS OR HER EARNINGS ARE KNOWN THE BENEFICIARY'S BENEFITS WILL BE REEVALUATED

After the year has ended and we know your actual earnings, we will review your record. We will compare the actual and estimated earnings to decide if we paid you more or less than you were due. We will then pay any benefits due, or we will ask you to pay us back if we paid too much.

WDS010 – REFER TO WORKSHEET HEADER NL 00730.149D

WDS012 – REFER TO WORKSHEET HEADER NL 00730.149D

WDS014 – REFER TO WORKSHEET HEADER NL 00730.149D

 

WDWC03 – CAPTION

Your Withdrawal Can Be Cancelled

WDW002 – REQUEST TO WITHDRAWAL CLAIM

We have approved your request to withdraw your claim for all Social Security benefits. This cancels our earlier decisions on your claim. You may withdraw a retirement claim only once in your lifetime.

WDW006 – CLAIM WITHDRAWAL

If you change your mind and want to receive these benefits, you may cancel your withdrawal by filing a written request with us. You have up to 60 days from the date you receive this letter to ask for cancellation. After the 60 days are over, you have to file a new application if you want to receive these benefits. You will not lose any benefits if you cancel your withdrawal within the 60 days.

WDW028 - SUSPENSION OF BENEFITS WHILE CLAIM WITHDRAWAL IS PROCESSED

You requested to withdraw your claim for (1) benefits. We are stopping benefits beginning (2) while we work on processing your withdrawal request.

We will send a separate notice requesting the amount you need to repay in order to withdraw the claim. After we work on your request, we will send a final notice explaining if the withdrawal request is approved or denied.

 

WDW029 - TERMINATION OF BENEFITS CLAIM WITHDRAWAL PROCESSED

If you change your mind and want to receive these benefits, you may cancel your withdrawal by filing a written request with us. You have up to 60 days from the date you receive this letter to ask for cancellation. After the 60 days are over, you have to file a new application if you want to receive these benefits. You will not lose any benefits if you cancel your withdrawal within the 60 days.

WEP013 – WINDFALL ELIMINATION PROVISION APPLIED FOR THE FIRST TIME

We reduced your Social Security benefits starting (1). This is the first month you received a pension based on work not covered by Social Security taxes.

When you receive this type of pension, we may apply the Windfall Elimination Provision to your Social Security benefits. This changes the way we figure your benefit amount. Your benefit amount is less than it would be if you were not receiving the pension.

To learn more about how non-covered pensions affect Social Security benefits, please view our factsheet titled “Windfall Elimination Provision,” that you can get at www.ssa.gov/pubs online.

WEP014 – WINDFALL ELIMINATION PROVISION REMOVED

We changed your benefit amount starting (1) because you:

• •

  Are impacted by the Social Security Fairness Act, which ended the Windfall Elimination Provision starting January 2024, or

• •

  Reached 30 years of substantial earnings covered by Social Security taxes, or

• •

  Stopped receiving a pension based on work not covered by Social Security taxes.

WFO004 - WINDFALL OFFSET IS REASON FOR SUSPENSION

We may have to reduce these benefits if you received Supplemental Security Income (SSI) for this period. When we decide whether or not we will have to reduce your Social Security benefits, we will send you another letter. We will pay you any Social Security benefits you are due for this period.