Effective Dates: 11/25/2024 - Present Previous | Next

TN 71 (11-24)

GN 02250.061 Misinformation From an Official Source — Waiver - Title II and Title XVI

CITATIONS: Social Security Act §204(b) and §1631(b)(1)(B); 20 C.F.R. §404.507, §404.510(a), §404.510(b), §404.511, §416.550, §416.552

A. Introduction

This section provides guidance to make a fault determination for waiver requests based on an allegation from the overpaid individual or representative payee who relied on misinformation from an official source.

B. Policy

Misinformation is information that is incorrect or incomplete. An official source is an SSA employee, or other government employee, who the individual reasonably believed was connected with administering our benefits. An official source does not include the media or individuals from other organizations (e.g., a nonprofit organization like Legal Aid) or individuals like a family member.

An individual’s reliance upon misinformation from an official source regarding our rules or policies may cause an overpayment. We will determine an overpaid individual is not at fault for an overpayment if they or their representative payee relied on information provided by an official source regarding our rules or policies

NOTE: Many individuals receive aid and services from federal government agencies, such as a government social worker who works for the Department of Veteran Affairs. The overpaid individual could reasonably consider a federal government employee to be an official source when the federal government agency administers benefits or provides similar aid or services.

1. When an individual receives misinformation

An individual is misinformed when they receive information from an official source that subsequently proved to be incorrect. Misinformation can be given both orally and in writing.  A routine SSA notice is never a source of misinformation. However, a non-routine notice may be a source of misinformation. For example, misinformation does not apply to:

  • •

    Automatic Earnings Reappraisal Operation (AERO) notice received by an individual who has received an incorrect benefit computation; or

  • •

    routine notices of eligibility determinations (e.g., a call-in notice and Cost of Living Adjustment (COLA) notice).

However, a non-routine notice may be a source of misinformation. Examples of non-routine notices are:

  • •

    Notice of Revised Determination; or

  • •

    Notice of Planned Action (NOPA).

2. Misinformation from an official source

Find the individual not at fault in causing the overpayment if you determine that an overpayment, which resulted from the individual's action or lack thereof, was caused by misinformation from an official source. Approve the waiver under the against equity or good conscience provision. For policy and procedures for developing against equity and good conscience, see GN 02250.150.

If an individual relied on information from someone who is not an official source, consider whether the individual is not at fault because they misunderstood SSA’s entitlement and eligibility rules as described in GN 02250.021B.4.

3. How to apply misinformation

Receiving misinformation may cause the whole, or part of, the overpayment. Apply misinformation for the entire overpayment when the reliance on the misinformation caused the entire overpayment.

Do not apply misinformation for the entire period if the reliance on misinformation did not cause the whole overpayment or if the individual at some point received and could have acted on correct information.  In this situation, apply misinformation only to the part of the overpayment caused by misinformation.

If you establish misinformation, find the individual not at fault and recovery is deemed to be against equity and good conscience (refer to GN 02250.150).

4. Correct information incorrectly applied

Be alert to situations where the individual has incorrectly applied correct information. A correct answer to a general question may be incorrect when applied to an individual’s specific situation and would not constitute misinformation. Determine if the individual alleging misinformation asked a general question without providing specific details of their situation.  If the individual misunderstood information given to them, we may find the individual not at fault, refer to GN 02250.021B.4.

C. Procedure for handling waiver requests in misinformation cases

Obtain a full explanation on Form SSA-795 (Statement of Claimant or Other) for the individual’s reliance on incorrect information in their own words.  Have the individual describe the information received, when it was received (if known), and the official source who provided the information. Review the individual's record to determine if there is support for the individual's allegations of misinformation.  If development does not preclude a finding of misinformation and the detailed allegation is consistent with the facts of the case, resolve any doubts in favor of finding that the beneficiary did receive misinformation.  You may find the individual was not misinformed if there have been previous allegations for the same reason (refer to GN 02250.021B.2).

Document the misinformation finding in section 18 of the SSA-635.

D. Examples

1. Situation is misinformation

Kai got married in 2010. We discovered that their spousal benefits should have terminated in September 2020 when Kai divorced the number holder. Kai alleged that they called the FO to report their divorce and a Claims Specialist told them that since they were married for 10 years, Kai could continue receiving benefits so long as their youngest child was under age 16. Misinformation can be established because Kai relied on incorrect information from an official source and Kai's reliance on the misinformation caused the overpayment. We will waive the overpayment because Kai was not at fault in causing the overpayment and we deem recovery against equity and good conscience.

2. Situation is not misinformation

Damon is overpaid due to work. Damon alleged that they called the 800 number and a Customer Service Representative explained how working part-time would affect their benefits. Damon began working in March and estimated working 10 hours per week In June, Damon received a raise and increased their work to 30 hours per week. Based on the facts in this case, it appears that Damon misapplied correct information. Misinformation cannot be found. However, we may still find Damon not at fault if he misunderstood information given to him (see GN 02250.021B.4).

3. Misinformed from a non-official source

Emory works for the local school district and plans to retire soon. Prior to employment in the educational system, they worked at various grocery stores and food chain restaurants. Emory asked the school district human resources (HR) department staff a question regarding the school district retirement benefits and SSA retirement benefits. The HR staff explained that since Emory has reached full retirement age and is currently working, they should file for SSA retirement now and file for the school district retirement benefits when they are ready to retire from the educational system. The staff informed Emory since the benefits are totally different, neither benefit would be affected, and they could collect both benefits in full. Misinformation cannot be established because Emory relied on incorrect information from a non-official source.  However, we may still find Emory not at fault if they misunderstood the rules based on the information received from the HR staff (refer to GN 02250.021B.4).

 

To Link to this section - Use this URL:
http://policy.ssa.gov/poms.nsf/lnx/0202250061
GN 02250.061 - Misinformation From an Official Source — Waiver - Title II and Title XVI - 11/25/2024
Batch run: 12/19/2024
Rev:11/25/2024