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 the "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 10 percent of your total monthly benefit or $10 (whichever is more)
starting with the payment you will receive about *F2. If the total benefit is less
than $10, we will withhold the entire benefit. We will continue withholding benefits
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 10 percent of the payment you will receive
*F1 until we recover the overpayment. We will do this starting with the payment *F2
will receive on or about *F3. (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 (REFC01)
Need more help?
1. Visit www.ssa.gov for fast, simple, and secure online service.
2. If you are in the United States, American Samoa, Guam, Northern Mariana Islands,
Puerto Rico, or the U.S. Virgin Islands, call us at 1-800-772-1213. If you are deaf
or hard of hearing, call TTY 1-800-325-0778.
3. You may also call your local Social Security office.
-
•
If you are in Canada, visit *F1 to find the office that services your area.
-
•
Contact your nearest Federal Benefits Unit (FBU). Visit *F2 for a list of FBUs.
-
•
Write to the Social Security Administration at:
P.O. Box 17769
Baltimore, Maryland, 21235-7769
USA
If you contact us, please refer to this letter. It will help us answer your questions.
How are we doing? Go to www.ssa.gov/feedback to tell us. (REF197)
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 envelope
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.