TN 62 (11-24)

GN 02250.090 SSI Overpayment Waiver When Recipient's Countable Resources Exceed the Limit

A. Introduction

In some cases, an individual may be assessed an overpayment because their resources exceed the Title XVI limit by $50.00 or less. If the individual requests a waiver in this case, we will deem the overpaid individual to be not at fault and waive recovery of the overpayment, unless we find clear evidence the individual knowingly and willfully failed to report the excess resource(s) correctly and timely.

B. Policy

We will determine an overpaid individual to be not at fault and we will waive the overpayment if their overpayment is due solely to their own or their spouse’s countable resources exceeding the resource limit by $50.00 or less, unless we determine the overpaid individual willfully and knowingly failed to report the value of their resources accurately and timely.

1. Knowing and Willful Conduct

When determining if an overpaid individual’s failure to report a change accurately and timely was knowing and willful, consider whether the individual:

  • Willfully concealed information about their resources when they knew the information would affect their eligibility for Supplemental Security Income (SSI) (e.g., the individual did not disclose a resource after a similar overpayment occurred in the past, refer to GN 02250.090B.2.);

  • Knowingly provided incorrect information (e.g., knowingly provided incorrect information about the value of a resource or knowingly denied receiving a resource); or

  • Committed fraud or similar fault. For fraud and similar fault, refer to SI 04070.020.

To find a person knowingly and willfully concealed resources in any of these situations, we must find clear evidence the individual was fully aware of the requirements to report the resource, was fully aware that their resources exceeded the limit, and chose to conceal or provide incorrect information about the resources. In determining whether the individual acted knowingly and willfully, we must take into account any physical, mental, educational, or linguistic limitations the individual (or spouse) may have, refer to GN 02250.005.

2. Similar overpayment occurred in the past

We will not automatically find an individual knowingly and willfully failed to report accurately and timely merely because an individual incurred a similar overpayment in the past.  If an individual incurred a similar overpayment in the past, we will first determine whether our records document the individual received an explanation of both the cause of the overpayment and their reporting responsibilities. If they did receive an explanation, we will determine whether the failure to report accurately and timely was knowing and willful, depending on the circumstances surrounding the current and prior overpayment situations.  In evaluating these circumstances, we must consider the factors in GN 02250.090B.1.  For example, we must consider whether, given the individual’s particular circumstances, they understood and remembered the reporting responsibility.

NOTE: If a recipient is subsequently overpaid for exceeding the resource limit by $50.00 or less and you find they are not at fault in causing the overpayment, add another waiver decision of “EXCESS RESOURCES WITHIN TOLERANCE” on the Waiver (UOWV) screen in the Modernized Supplemental Security Income Claims System (MSSICS). For more information about the UOWV screen, refer to MS 00304.009.

3. Eligible SSI couple

The waiver denial applies to both members of the eligible couple only if there is clear evidence that both members willfully and knowingly concealed the correct amount of their resources.

For an example of how to apply the excess resource provision to an eligible SSI couple, refer to example 1 in GN 02250.090D.

C. Procedure

1. Applying a waiver monthly

Make a separate waiver determination for each month when there are multiple months in which the overpayment resulted solely from excess resources.

For an example of how to apply a waiver monthly, refer to example 2 in GN 02250.090D.

If any month of overpayment was caused by resources exceeding the limit by more than $50.00, do not apply this waiver provision for that month. Instead, we must determine whether the individual is at fault (refer to GN 02250.005) and whether another waiver provision applies such as deemed to defeat (refer to GN 02250.110), against equity and good conscience (refer to GN 02250.150) or defeats the purpose (refer to GN 02250.100).

If the waiver for an overpayment is under $2,000, determine if you can waive the overpayment under the administrative waiver tolerance. For more information on the administrative waiver tolerance, refer to GN 02250.350.

2. Waiver documentation and determination

If you waive recovery of an overpayment caused by resources exceeding the resource limit by $50.00 or less, you must:

Explain to the overpaid individual both the cause of the overpayment and the SSI reporting responsibilities.

Document that you have explained the reporting responsibilities, and the overpaid individual understands their reporting responsibilities. For more information about documenting waiver determinations, refer to GN 02250.315.

NOTE: 

Documentation is necessary because future overpayment disposition determinations may depend on whether we previously informed the individual of their reporting responsibilities. Add the waiver decision of “EXCESS RESOURCES WITHIN TOLERANCE” on the UOWV screen in MSSICS. For more information about the UOWV screen, refer to MS 00304.009. Use the Document Processing System (DPS) to prepare the “Notice of Administrative Waiver Excess Resources.” This notice is located in the DPS overpayment folder.

Add the waiver decision of “EXCESS RESOURCES WITHIN TOLERANCE” on the UOWV screen in MSSICS. For more information about the UOWV screen, refer to MS 00304.009.

Use the Document Processing System (DPS) to prepare the “Notice of Administrative Waiver Excess Resources.” This notice is located in the DPS overpayment folder.

3. When to propose to deny

Propose to deny the waiver for fault only if you have clear evidence the individual was fully aware of the requirements and of the excess resources and chose to conceal the resources. For more information about proposing to deny a waiver, refer to GN 02250.002C.2.

D. Examples

Example 1 - Eligible SSI couple

John is a member of an eligible couple and was overpaid when resources exceeded the limit by $30. John requested a waiver. John's spouse was at fault because we have clear evidence that their spouse willfully and knowingly failed to report excess resources. However, we do not have clear evidence of fault for John. Therefore, we will waive John's overpayment for each month.

Example 2 - Applying a waiver monthly

We discovered a Title XVI overpayment during a redetermination (RZ) in December 2023 where Jacob's resources, shown in the table, exceeded the $2,000 limit in October, November, and December 2023. We notified Jacob of the overpayment.  Jacob requested a waiver.  The technician reviewed Jacob's resources and found they exceeded the resource limit by $35 in October 2023, by $55 in November 2023, and by $45 in December 2023.

Because excess resources on October 1, 2023 and December 1, 2023 are below the $50.00 limit, and the technician found Jacob did not willfully and knowingly fail to report, the technician waived recovery of the overpayment for October 2023 and December 2023 based upon the excess resources waiver provision.

For November 2023, the technician needs to determine whether the individual is not at fault and if another waiver provision, such as administrative tolerance, deemed to defeat, defeats the purpose, or against equity and good conscience, applies.

Month of Overpayment

Amount of Resources

Amount resources exceeded the limit

October 1, 2023

$2,035

$35

November 1, 2023

$2,055

$55

December 1, 2023

$2,045

$45


To Link to this section - Use this URL:
http://policy.ssa.gov/poms.nsf/lnx/0202250090
GN 02250.090 - SSI Overpayment Waiver When Recipient's Countable Resources Exceed the Limit - 11/22/2024
Batch run: 12/19/2024
Rev:11/22/2024