The overpayment amount is the difference between the amount we paid and the amount
we should have paid to a beneficiary. This includes the lump sum death payment (LSDP).
For more information regarding the LSDP, see RS 00210.010.
The overpayment period begins with the first month for which there is a difference
between what was paid and what was payable. The overpayment period generally ends
with the month before the current operating month (COM). This period is also known
as the retroactive period.
The retroactive period is not limited to a single month or a single year. For example,
a retroactive period can cover March 2009 through December 2012 (i.e. multiple months/years).
We must take into account all payments we issued for months in the retroactive period
and all amounts due for months in that period to determine if an individual is overpaid
as well as determine the overpayment amount.
In order to determine what we actually paid, look at the individual’s Payment History
Update System (PHUS) record. Keep in mind, the PHUS record was not available until
1984 and continuing. For cases prior to 1984, you might have to use the Master Beneficiary
Record (MBR) history or paper output. For additional information about the PHUS record,
see SM 00545.000.
In some situations, we withhold a Title II benefit payment to recover a prior Title
II overpayment, and the amount we withheld turns out not to be due the individual.
In this case, although the actions taken may establish a new ROAR record, the prior
overpayment remains outstanding. There are also situations when we withhold a Title
II benefit payment to recover a Title XVI overpayment via Cross Program Recovery,
and the amount we withheld turns out not to be due the individual. In this case, the
amount used to reduce or recover the Title XVI overpayment is now a Title II overpayment.
EXAMPLE: In May 2015, we are recovering Sharon’s $2,000 overpayment by withholding her entire
$100 monthly payment. In September 2015, we retroactively suspended Sharon’s benefits
effective May 2015. Because we were withholding Sharon’s monthly benefit payment to
recover her overpayment, we would not create a new overpayment. Instead, the $2,000
overpayment remains outstanding.