TN 16 (05-07)

GN 02250.301 T2 Waiver Decisionmaker

A. Policy

Waiver determinations are made in the FOs by claims representatives or higher-graded employees. The PC can also process waiver approvals (For PC instructions refer to GN 02201.023.) Waiver determinations on overpayments of $1,000 or less which meet the criteria outlined in GN 02250.350 can be made by service representatives. When a waiver determination is subject to management review for compliance with documentation requirements and regulations, the final decision on waiver rests with the decisionmaker and not the reviewer.

B. Procedure

1. Waiver Approval

If the material gathered in the initial waiver interview supports a waiver approval, make the determination based on that material. Review of the electronic or paper folder is not required in this situation. However, annotation of your decision is required in the DMS remarks.

2. Waiver Denial

If waiver cannot be approved based on the material initially gathered, follow the instructions in POMS GN 02270.000.

3. Management Review of T2 Overpayment Waiver Approvals

The amount and disposition of an overpayment waiver approval determines the level of review that is required. Use the chart in GN 02250.301.B.6. to determine the level of management review that is required when fraud is not involved. For fraud development, see GN 02201.050.

If the reviewer determines that the waiver approval does not have proper documentation and/or is not in compliance with regulations or SSA procedures, the case will be returned to the decisionmaker for correction. Once correction is made, if the decision is still to approve waiver of recovery, the decisionmaker will re-route the case to the appropriate reviewer for sign-off. If waiver of recovery cannot be approved, follow the procedures in GN 02270.000.

4. Management Review of T2 Overpayment Waiver Approvals With an Overpayment Balance of $20,000.00 to $74,999.99

Whenever the amount of the overpayment is $20,000.00 through $74,999.99, the overpayment dispositions must be reviewed by office management (MSS or higher) in order to insure the decision is both technically accurate and in conformance with POMS instructions

The Decisionmaker will:

  • Use his or her own PIN to enter the initial decision

  • Document the decision on DMS and on the SSA-635 per GN 02250.315. Prepare a brief write-up of your rationale in DMS.

  • Submit to a member of management for review if required by GN 02250.301B.6.

   

Office management (MSS or higher) will:

  • Review the decision for technical accuracy and conformance with POMS instructions.

  • If management approves, they will input the decision on the Review Waiver Disposition (DRWR). (MSOM DMS 006.005) and annotate DMS remarks of the action.

  • Return to the decisionmaker for notice completion and release.

REMINDER: Follow your regional instructions to determine if any further review is required.

5. Management Review and Concurrence of T2 Overpayment Waiver Approvals with an Overpayment Balance $75,000.00 or More

Management review is required when the overpayment balance is $75,000.00 or more.

The Decisionmaker will:

  • Use his or her own PIN to enter the initial decision

  • Document the decision on DMS and on SSA-635 per GN 02250.315.

  • Submit to a member of management for review and transmission to ARC-MOS CPS.

The management official will:

  • Review for technical accuracy and conformance with POMS instructions.

  • Send an email to the Center for Programs Support (CPS) mailbox for the ARC-MOS for review.

  • If a paper folder is relevant to the ARC-MOS waiver review, forward the file to the Regional Office Attn: CPS, note the paper file transfer in the email to CPS, transfer folder location to the RO on PCACS and annotate DMS remarks of actions taken.

  • If no paper folder will be forwarded, the management official will annotate that in the email to CPS.

   

Regional Office ARC-MOS CPS actions:

  • Annotate DMS regarding the receipt of email and folder if appropriate.

  • Review the decision to ensure it is both technically accurate and in conformance with POMS instructions.

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