This section provides guidance on how to process a waiver request when we are unable to locate and review the information necessary to verify an overpayment. In some instances, you may not be able to locate and review paper or electronic records to determine:

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  the amount of the overpayment; or

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  the overpayment period; or

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  the cause of the overpayment.

When evaluating a waiver request, if you are unable to locate and review paper or electronic records to determine the amount of the overpayment, the overpayment period, or the cause of the overpayment, you must assume the overpaid individual is not at fault and approve the waiver under the against equity and good conscience provision.

When evaluating a waiver request, attempt to locate and review documentation in paper or electronic records, which may contain information relevant to the overpayment amount, the overpayment period, and the cause of the overpayment in these locations:

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  Paper folder

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  Online Retrieval Notices (ORS),

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  Master Beneficiary Record (MBR),

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  Recovery Accounting and Reporting System (ROAR),

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  Payment History Update System (PHUS),

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  Debt Management System (DMS),

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  OPWiz,

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  Supplemental Security Income Record (SSR), and

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  Any records in any other electronic repository, such as Evidence Portal, Consolidated Claims Experience (CCE), eView, eWork, eComps, Paid vs. Payable charts, etc.

If you are uanble to deterine the amount of the overpayment, the overpayment period, or the cause of the overpayment, document the remarks screen of DMS for Title II cases, the Report of Contact Page in CCE for Modernized Supplemental Security Income Claims System (MSSICS) cases or an SSA-5002 (Report of Contact) for non-MSSICS cases with this information:

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  a detailed description of the electronic records or documents you reviewed to look for the overpayment information;

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  the date you reviewed the records;

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  your office code;

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  your name or unit code; and

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  an explanation that you approved the waiver against equity and good conscience because you do not have enough information to determine the amount of the overpayment, the overpayment period, or the cause of the overpayment.

1. 1. 

   For Title II, input the approval in DMS.

   For Title XVI, input the approval in CCE;

2. 2. 

   Document the waiver determination on Form SSA-635 (Waiver Determination);

3. 3. 

   Send the waiver approval notice, located in GN 02250.370.

Example 1:

Reaver received disability benefits from age 23 until age 26. Reaver filed for retirement benefits at age 67. When completing the application, the technician noticed an overpayment on Reaver’s record. Reaver told the technician they did not know what the overpayment was for and didn’t remember receiving a notice. The technician processed Reaver’s retirement application. After Reaver started to receive their retirement benefits, they received a letter stating they were overpaid $3,400. Reaver completed a waiver request and brought it to their local field office.

The technician looked through Reaver’s record to determine the cause of the overpayment and when the overpayment occurred. The technician reviewed Reaver’s MBR and ROAR which showed Reaver was overpaid $3,400 due to work at age 26. The technician was unable to locate a notice. The technician was unable to locate an SSA-821, paystubs, or any documentation showing how much Reaver earned during that time, if there were any IRWEs and the months of the overpayment. We must approve the waiver because Reaver is not at fault and recovery is against equity and good conscience.

Example 2:

During a redetermination, the office input an excess resource decision because Jadis failed to report a resource which caused a large overpayment. Jadis requested a waiver for the overpayment. Upon reviewing the record, we found the resource pages in CCE contained limited details regarding the type of resource that caused Jadis’s overpayment. Additionally, we found no notice in the file with an official determination giving the period, reason, and amount of the overpayment. We cannot determine if the overpayment is valid or correct since the record does not have any details to substantiate the resource that caused the overpayment. We must approve the waiver because Jadis is not at fault and recovery is against equity and good conscience.