For MSSICS or Consolidated Claim Experience (CCE) cases, the decision maker must document
all of the personal conference decision information on the Report of Contact page
in CCE. For more information on the Report of Contact page in CCE, see MS 08122.010.
For both MSSICS and non-MSSICS cases, the technician must fax all supporting documentation
into NDRed using the Evidence Portal (EP). For more information on EP, see MS 09701.001.
If the case is not in MSSICS:
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Prepare, date, and sign the special determination (form SSA-553).
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Document the personal conference decision in either the Report of Contact page in
CCE or form SSA-553.
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Include sufficient information on the determination to document the file that the
interviewer provided the liable person an opportunity to review their folder; and
whether they attended the personal conference.
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Include whether the liable person reviewed the file and whether they contested any
of the information reviewed.
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Review the updated information obtained since the preliminary waiver decision determination
in file or the proposed waiver denial notice.
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Note in your personal conference decision if anything was confirmed or refuted as
a result of the personal conference or additional evidence submitted, and whether
new information affected the final determination.
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The determination documents the explanation entered on the DPS Personal Conference
(Waiver Allowed/Denied) notice.
For instructions on completing the SSA-553, see GN 01010.365. The post personal conference determination should describe the appropriate fault
and recovery decisions and explain the decision by citing evidence in the record:
Was the liable party at fault in causing the overpayment according to SI 02260.010 and SI 02260.015?
If yes, who was at fault and how did you reach this conclusion? For example, did the
debtor:
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Fail to report information timely that was relevant to their eligibility or payment
amount;
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Receive duplicate payments for one or more months; or
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Conceal or misstate facts affecting their eligibility or payment amount?
If no, why were they not at fault?
If the recipient or payee was not at fault, refer to the evidence in the file to explain
why the recovery met or did not meet the criteria for either:
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Impede effective or efficient administration of Title XVI of the Act (SI 02260.030);
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Defeat the purpose of Title XVI of the Act (SI 02260.020); or
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Adverse changes in financial circumstances following a waiver denial (SI 02260.040)?
Further action by the decision maker will depend on the type of waiver decision. Waiver
approval notices are usually systems generated (see NL 00803.205). For a list of exclusions, see NL 00801.010. Waiver denial notices are always manual (see NL 00803.210).
The decision maker prepares and issues the notice of waiver decision if the notice
is not automated. DPS personal conference notices include:
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Personal Conference (Waiver Allowed/Denied);
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Personal Conference and Folder Review (Resched);
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Personal Conference and Folder Review (Waiver/Recon);
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Personal Conference Appointment Letter;
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Personal Conference Letter (No-Show);
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Personal Conference Refused; and
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Waiver Denial for Defeats the Purpose.
If the liable individual is a legal guardian or representative payee, send a manual
notice of the approved waiver request to the liable legal guardian or representative
payee.
For waiver decision notices, see NL 00803.200, Notice of Waiver Decision – General. For a complete list of circumstances that require
a manual notice, see NL 00801.010B.2.
a. Waiver approval specific actions
When making a decision to waive overpayment recovery:
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Post the approved waiver decision to the SSR using MSSICS Direct SSR Update and the
UOWV screen. For waiver input instructions, see MS 00304.009; and
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Refund any funds recovered for the overpayment period covered by the approved waiver
request. Use the A-OTP process to refund the recovered amount. For instructions on
the A-OTP process, see SM 01901.005 and MS 00304.003 through MS 00304.009 and MS 00303.022;
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If the approved waiver covers months in which payments were adjusted to recover the
waived overpayment, refund the amount withheld;
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Do not refund funds if there is either another collect decision (i.e., different period
of overpayment) or an unresolved overpayment;
b. Partial waiver approval or denial specific actions
When we decide to deny a waiver request in full or approve waiver of recovery for
part of the overpayment, enter the denial or partial approval using Direct SSR Update
(UOWV) screen. See MS 00304.007 through MS 00304.009.
c. Waiver denial after a request for access to financial information (AFI)
When making a decision to deny a waiver request after considering the 'recovery defeats
the purpose' waiver provision, and if SSA received financial information through Accuity:
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Send the DPS notice titled, "Waiver Denial for Defeats the Purpose" to the overpaid
individual. If the liable adult has a representative payee, you must send the notice
to the liable individual, not the representative payee.
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Explain to the overpaid individual that, while they may contact Accuity with questions
concerning the financial information they provided to SSA, the overpaid individual
must submit any appeal request on the waiver decision to SSA, not to Accuity.