SSA - POMS: GN 02210.030 - Request for Change in Overpayment Recovery Rate, Form SSA-634

A. A change in overpayment recovery rate

When we establish a Title II overpayment on an individual’s record the automated system will begin benefit withholding after the 60-day due process period expires. We recover the overpayment by withholding 10% of the individual’s monthly benefit amount until we fully recover the overpayment, see GN 02210.001. If an individual is unable to meet their ordinary and necessary living expenses because we are withholding 10% of their monthly payment, the individual may request a lower rate of recovery.

B. Requesting a different overpayment recovery rate within 12 or 60 months

When an individual requests a lower repayment rate, we must always attempt to negotiate a rate of withholding with the individual, which results in full recovery of the total outstanding debt within 12 months. We allow the individual to pay a minimum of $10.00 per month, if we can collect the debt within 12 months. We do not need the individual to provide information about their income, resources, or living expenses if we collect the debt within 12 months.

If we cannot collect the debt within 12 months, negotiate a rate that permits full recovery within 60 months. The individual must pay a minimum of $10.00 per month. If the individual requests to extend the recovery of the debt to 60 months, verbally collect the individual's allegations of their resources, income, and living expenses and document the information on the Remarks screen in the Debt Management System (DMS). Input the new rate of recovery in the Reconciling Recovery of Overpayments Accounting and Reporting System (ROAR).

NOTE:

Do not request an SSA-634, Request for Change in Overpayment Recovery Rate, if we can recover the total debt within 60 months.

Example: Documenting a request for a change in overpayment recovery rate on the Remarks screen in DMS:

Sally Snow's overpayment amount is $2,400.00. They requested that we withhold $120.00 per month beginning February 2018. Sally alleges resources of $0.00, Social Security benefits of $1,200.00, and living expenses of $1,000.00 per month. Sally will pay their debt within 20 months; therefore, I approved their request for partial withholding. I made the input in ROAR and sent a notice to them on January 6, 2018. – John Jones FO A12

NOTE:

If the individual receives Title II benefits and Title XVI payments, see GN 02210.045.

If the individual is receiving another type of cash public assistance (e.g. VA service and non-service related disability pensions, Temporary Assistance for Needed Families (TANF) (see GN 02250.110)), verify the assistance and withhold at the requested rate but no less than $10. Document the cash public assistance and withholding request on the Remarks screen in DMS. Do not ask the individual to complete form SSA-634.

C. Requesting a different overpayment recovery rate extending beyond 60 months

If the negotiated rate (lower than 10%) would not permit recovery within 60 months, the individual must complete the SSA-634 form. For instructions about completing the SSA-634, see section G below. Evaluate the individual’s income, expenses and resources as follows:

1.

Compare the monthly household expenses and the total monthly income to determine if the individual’s income exceeds their expenses.
2.

Review the individual’s financial information to determine if resources are below $3,000.00.

If the individual’s resources are below $3,000.00 and their income does not exceed adjusted expenses, consider approving a lower rate of recovery. However, do not allow them to pay less than 10.00 per month. If the individual's resources are below $3,000.00 and their income exceeds the adjusted expenses, consider approving a lower rate of recovery with the difference in the individual's income and expenses.

Example: Tom Greene requested a change in repayment rate that would extend their debt beyond 60 months. We sent an SSA-634 to them for completion. Tom's debt is $7,500.00. Tom has $1,500.00 in resources, expenses are $2,275.00, and income is $2,400.00. We determined that Tom can afford to repay $120.00 per month without financial hardship.

Exception: If the individual has a 100% Medicare Part D subsidy, take the following actions:

1.

Grant any request that is at a minimum $10.00.
2.

Do not request a completed Form SSA-634.
3.

Document the decision on the Remarks screen in DMS.

D. Denying a request for different rate of recovery

If you deny the request for a different rate of recovery, send a notice providing the basis for the denial and the manner in which we will recover the overpayment. Do not include a reconsideration paragraph. The decision as to the amount of withholding is an administrative action and not an initial determination. Document the Remarks screen in DMS.

E. Fraud conviction

If an individual has a fraud conviction or if we establish that similar fault exists for the debt, do not approve a request to lower the rate of withholding. The individual must pay the overpayment through full withholding. Notify the individual that we will not change the repayment rate because fraud or similar fault exists. Annotate the Remarks screen in DMS.

Example: Documenting a request for a lower rate of withholding when an individual has a fraud conviction on the Remarks screen in DMS:

Luke Brown requested partial withholding on April 4, 2018. On January 5, 2018, we determined that Luke’s overpayment resulted from fraud; therefore, I cannot approve their request. I sent a them a notice on April 27, 2018. – John Jones FO A12.

F. Effective date of lower recovery rate

1. Request made prior to any adjustment

Initiate withholding effective with the Current Operating Month (COM).

2. Request made after full adjustment initiated

Process the request in the month the individual requests the rate change. If you process the action later than the month the individual requested the rate change, pay the difference between what we withheld and what we should have withheld based on the request.

3. Lesser request made after partial adjustment initiated

Process the lesser amount effective with the COM.

G. Completing the SSA-634

1. Purpose of the SSA-634

The purpose of the SSA-634 is to gather information to assist technicians with determining if they can approve a change in an individual’s repayment rate if the individual cannot pay their entire debt within 60 months. The overpaid individual or an individual representing the overpaid individual can complete the form. A technician can assist with completing the SSA-634 if the individual requests our assistance. Sections H through N below provides guidance on completing each section of the form.

2. Request for a change in overpayment recovery rate from an overpaid individual who lives outside the United States

If the individual requesting a change in overpayment recovery rate does not live in the United States, obtain an SSA-634, if the individual says they cannot repay the debt within 60 months. Ask the individual to show the value of the resources, income, expenses, in local currency. After receiving the completed form, use the Treasury Reporting Rates of Exchange tables to convert the foreign currency to U.S. dollar amounts and specify the type of currency involved.

3. Proof of resources, income, and expenses

Inform the individual that they are responsible for providing proof of all resources, income and certain expenses. We do not require proof for food and miscellaneous household expenses, unless the expenses seem unusually high.

4. Storing the SSA-634

Fax the SSA-634 and the supporting documents into Evidence Portal.

H. Questions on the SSA-634

1. Section 1 - Identifying information

Questions 1 through 4

Question 1 - The individual must provide their name, SSN, and claim number, if any. If someone else is completing the SSA-634 on behalf of the overpaid individual, we ask for the identity of the organization or individual who is assisting the individual.

Question 2 - Enter the type of income the individual is currently receiving.

Question 3 - Enter the total amount that the individual owes to SSA.

Question 4 - Enter the monthly amount that the overpaid individual can afford to pay.

2. Section 2 - resources - things you have and own

Questions 5 through 6

Question 5.A - Enter the cash in the overpaid individual’s possession.

Question 5.B - Enter a detailed description of the financial accounts owned by the overpaid individual.

Question 6.A – If the overpaid individual owns more than one vehicle, enter a description, present value, loan balance, and the main purpose of the additional vehicles.

Question 6.B - Enter a detailed description of any real estate owned by the overpaid individual, if it is not where the overpaid individual lives.

Question 6.C - Enter a detailed description of any interest in any business, property, or valuables that the overpaid individual owns.

3. Section 3 - Monthly household income

Questions 7 through 9

Question 7 - Enter monthly employment information for the overpaid individual.

Question 8.A - Enter any support or contributions from any individual, agency, or organization that the overpaid individual receives.

Question 8.B – Enter whether the overpaid individual receives the support or contributions under a loan agreement.

Question 8.C – Enter the amount of the support or contributions that the overpaid individual receives.

Question 9 - Enter unearned monthly income for the overpaid individual.

4. Section 4 - Monthly household expenses

Question 10

Enter the monthly household expenses. Write the amounts in whole dollars and round any cents to the nearest dollar. Do not list an expense withheld from the individual’s paycheck, such as medical, child support, alimony, wage garnishments, etc. When reviewing the household bills do not double count the expenses if the overpaid individual uses a credit card for paying bills and making purchases. If the overpaid individual pays expenses by credit card, only list it as a credit card expense instead of a another expense for clothing, phone, gas for a vehicle, or etc.

5. Section 5 - Income and expenses comparison

Questions 11 through 12

Section 5 compares the monthly income with the monthly household expenses. We subtract the total monthly household expenses from the total monthly household income to determine if the individual has money to repay the overpayment. If the monthly expenses exceed monthly income, the overpaid individual must explain how they pay their monthly bills.

6. Section 6 - Financial expectations and funds availability

Question 13

Question 13.A - Requires the overpaid individual to let us know if they expect to receive an inheritance within 6 months of requesting the repayment change to determine if the individual’s resources may increase.

Question 13.B - This question totals the overpaid individual’s resources to determine if the individual has money to repay their overpayment.

Question 13.C - This question determines if the overpaid individual has any resources that they cannot convert to cash.

I. References

•

GN 02210.001 - Overpayment Recovery by Benefit Adjustment
•

GN 02210.045 - Rate of Overpayment Adjustment - Title II/Title XVI Beneficiary

Social Security

Program Operations Manual System (POMS)

GN 02210.030 Request for Change in Overpayment Recovery Rate, Form SSA-634