TN 19 (08-11)

GN 02604.160 Revoking a Penalty for Good Cause

Citations:

Regulation 404.454

A. Policy for revoking a penalty

It is the beneficiary’s right and responsibility to establish good cause. We can revoke a penalty if the beneficiary provides good cause for failure to file his or her annual earnings report timely.

B. Procedure for considering the good cause request

Consider the following when taking into account the beneficiary’s reasons for failing to file a timely report:

  • circumstances that prevented the beneficiary from understanding the reporting requirements;

  • any physical, mental, educational or linguistic limitations that the individual has; and

  • whether SSA’s action or misinformation misled the beneficiary.

C. Procedure for good cause approval

Find good cause for filing a late report if the beneficiary alleges any of the circumstances listed in this section. Accept a good cause explanation under these circumstances only for the first violation. We require corroborating evidence for all subsequent violations and for good cause reasons not specified in this section. For guidance on acceptable miscellaneous good cause see GN 02604.160D.11. (in this section).

D. Examples of good cause reasons

1. Inability to obtain records due to serious illness or death

  • The beneficiary or a member of his or her immediate family was seriously ill and the beneficiary filed the annual earnings report within 60 days after recovery; or

  • A member of the beneficiary’s family died, and the beneficiary filed the annual earnings report within 60 days after the family member’s date of death; or

  • The beneficiary's or employer's records were destroyed by fire or otherwise damaged, and the beneficiary filed the annual earnings report within 60 days after filing a tax return with the Internal Revenue Service (IRS), or the beneficiary previously reported the damage to SSA; or

  • The beneficiary's employer or a member of the employer’s immediate family was seriously ill or died and the beneficiary filed the annual earnings report within 60 days after recovery or date of death, respectively.

2. Timely report to another agency

  • The beneficiary sent the annual earnings report timely to another government agency in good faith. For example, the report reaches SSA late because the beneficiary mistakenly, but in good faith, sent the report to the Veteran's Administration.

  • The beneficiary previously filed an incorrect annual earnings report.

3. SSA delay

The beneficiary requested the annual earnings report form no less than two weeks before the due date and SSA failed to furnish the form timely.

4. IRS extension

  • The IRS granted an extension for filing an income tax return, and

  • The beneficiary filed the annual earnings report by the IRS extended filing date.

5. Year of application

  • The late annual earnings report is for the first year of entitlement; and

  • The application for benefits contained sufficient information to suspend all or a portion of benefits and the record was not subsequently refuted or rescinded. Refer to the information on reliance upon previous report in the NOTE below in GN 02604.160D.7. in this section.

6. Year of termination

  • The beneficiary filed the annual earnings report late for the year of termination; and

  • The beneficiary believed no report was necessary (e.g., earnings exceeded the limit after benefits terminated).

7. Reliance upon previous report

The beneficiary relied upon a previous work report which he or she did not subsequently refute or rescind that:

  • he or she filed before the close of the annual earnings report year, and

  • contained sufficient information to suspend all or a portion of benefits.

    If the beneficiary alleges he or she filed the annual report timely, refer to GN 02604.160D.11. (in this section) for more information on acceptable miscellaneous good cause reasons.

    NOTE: Since these situations are also reason for administrative tolerance, it is not necessary to establish a penalty field. For information on revoking a penalty for administrative tolerance, see GN 02604.170.

8. Year of full retirement age (FRA)

  • The beneficiary filed a late annual earnings report for the months before FRA in the year of FRA, and

  • The beneficiary believed no report was necessary.

9. Physical, mental, educational, or linguistic limitations

The beneficiary did not file a timely report because he or she had a physical, mental, educational, or linguistic limitation (including a lack of speech and understanding of the English language) which prevented him or her from understanding the reporting responsibilities.

10. Misleading action or misinformation by SSA

If the beneficiary alleges that SSA furnished misinformation, and he or she provides sufficient information about his or her circumstances to enable SSA to make a reasonable decision. He or she must provide corroborating evidence, about the circumstances in the case including (but not limited to):

  • when and where it occurred,

  • who gave the alleged misinformation,

  • what actions he or she took after receiving it, and

  • whether he or she reasonably should have questioned — or accepted — the misinformation or taken some other action based on his or her abilities.

It is not necessary to contact the alleged source of the misinformation for verification (such as other Field Offices (FO), Teleservice Centers (TSCs), and Processing Centers (PCs)) except in very unusual circumstances.

If you believe the beneficiary has met the burden of proof by providing reasonable evidence of his or her circumstances, accept “misinformation” as the good cause reason for not assessing the penalty.

11. Acceptable miscellaneous good cause reasons

In addition to the good cause reasons listed in GN 02604.160D.1. through GN 02604.160D.10. (in this section), good cause may be found in other situations. However, corroborating evidence is required for the first violation, as well as subsequent violations.

The following are some examples of acceptable miscellaneous good cause reasons:

  1. The beneficiary alleges he or she filed the annual earnings report timely and has corroborating evidence, such as:

    • a friend who accompanied the beneficiary to the FO and states he or she saw the beneficiary prepare (or mail) the report, or

    • the Master Beneficiary Record (MBR) indicates the beneficiary previously filed his or her annual earnings reports timely.

  2. The representative payee died or was unaware of the event, and the beneficiary was unaware of the reporting requirement.

    NOTE: A change from the (living) payee who filed a late report to another payee is not good cause. For more information on representative payee considerations, see GN 02604.150A.3.a.

E. Procedure for good cause denials

Deny good cause for late filing if the beneficiary does not meet any of the examples of good cause reasons in GN 02604.160D (in this section). Assume that the beneficiary knows to report his or her annual earnings timely because we explain reporting requirements in:

  • application interviews

  • reporting instructions supplied at time of filing

  • periodic check stuffers

  • award notices or other letters

  • periodic questionnaires

  • mass media announcements, and

  • information posted on Socialsecurity.gov

F. Procedure for verifying and documenting the good cause reasons

1. MBR review is required

Review the MBR to verify the good cause reason previously used. For details in the work control (WKCON) data line, refer to SM 00510.470. If the beneficiary uses the same reason, do not accept it.

2. Documentation required on the SSA–553 (Special Determination)

Document all findings of good cause on Form SSA-553 or its equivalent and fax to the PC for imaging.

3. Processing Center (PC) and field office (FO) responsibility

The PC or FO that receives the request to revoke a penalty will make the good cause decision. The Office of Quality Performance (OQP) will conduct an end-of-line quality review.


To Link to this section - Use this URL:
http://policy.ssa.gov/poms.nsf/lnx/0202604160
GN 02604.160 - Revoking a Penalty for Good Cause - 06/09/2014
Batch run: 06/09/2014
Rev:06/09/2014