TN 7 (09-17)

DI 60099.075 Appeal Process for BOND Overpayments

Similar to the annual earnings test under normal retirement rules, a Benefit Offset National Demonstration (BOND) beneficiary provides an estimate of earnings during the year.

When the BOND beneficiary provides an annual earnings estimate of earnings higher than the applicable SGA amount, we apply a $1 for $2 benefit offset following DI 60099.040.

An overpayment occurs when we need to apply additional benefit offset based on the annual earnings posted at the end of the year. The master beneficiary record (MBR) displays BOND overpayments by the type of event (TOE) code of 80 with an explanation of BOND/BOPD DEMO.

A BOND beneficiary may request an overpayment reconsideration or waiver on the overpayments.

The BOND work continuing disability review (CDR) unit (L5R) is responsible for adjudicating the reconsideration requests on BOND overpayments.

The field offices (FO) are responsible for processing waiver requests and hearing requests (forward hearing requests to ODAR).

A. BOND beneficiary inquires about overpayment

1. Overpayment event type is BOND/BOPD DEMO

Abt assists the BOND beneficiaries with notice explanation and waiver or reconsideration forms. For more information on Abt call center staff, see DI 60099.025C.

a. Waiver inquiry

If the beneficiary decides to file a waiver, take the following actions:

  • follow usual procedures to post the informal waiver request in Debt Management System (DMS) to stop overpayment recovery (for information on waiver request, see GN 02201.034);

  • send the notice in DPS titled “Request for Waiver Cover Letter”;

  • complete an SSA-632-BK (Request for Waiver of Overpayment Recovery or Change in Repayment Rate) to send to the beneficiary;

  • refer BOND beneficiaries to the Abt call center after providing the Form SSA-632-BK. Find the call center numbers in DI 60099.030A.

b. Reconsideration inquiry

If the beneficiary is in the FO and files a reconsideration on a BOND issue, take the following actions:

  • secure the Form SSA-561-U2 (Request for Reconsideration);

  • update DMS to stop overpayment recovery;

  • store the SSA-561 in eView or NDRED;

  • refer the BOND beneficiary to the Abt call center after providing reconsideration forms. Find the call center number in DI 60099.030A; and

  • send a modernized development worksheet (MDW) to L5R notifying them of the action you have taken.

If the beneficiary is not in the FO, take the following actions:

  • mail the SSA-561 to him or her with a courtesy return envelope to L5R at the following address:

L5R
6401 Security Blvd.
3rd Floor Operations
OPD 3-E-25F
Baltimore, MD 21235
  • update DMS by keying an “explanation” request to stop recovery;

  • update the remarks section to show that the beneficiary requested a reconsideration and the date you mailed the SSA-561 to him or her;

  • send a modernized development worksheet (MDW) to L5R notifying them of the action you have taken; and

  • refer BOND beneficiaries to the Abt call center after providing reconsideration forms. Find the call center number in DI 60099.030A.

2. Overpayment event type is not BOND

Follow the existing rules for processing any other overpayments on the beneficiary’s record (including Disability DIB Cessation), even if he or she has a BOND overpayment on the ROAR, or is currently in BOND. For overpayment processing instructions, see GN 02201.001.

If L5R receives any reconsiderations that are not BOND offset related:

  • receipt into DMS and transfer to the FO of jurisdiction,

  • fax into the electronic folder eView or NDRED, and

  • send an MDW to the FO of jurisdiction.

3. Incorrect payments

A beneficiary may not appeal incorrect payments. An incorrect payment occurs when we put a beneficiary in deferred payment status to apply the $1 for $2 benefit offset for estimated earnings over the annual BOND amount in DI 60099.005.

Similar to the retirement annual earnings test, the system automatically places the beneficiary in deferred status for an incorrect payment to apply the $1 for $2 offset. The system collects the incorrect payments from the payable months and places the beneficiary in current pay only after collecting all of the incorrect payment.

If it appears, the incorrect payment has been collected and the beneficiary remains in deferred status, send a high priority MDW to L5R. NOTE: Do not issue critical payment or immediate payment (IP) to the individual under these circumstances.

If the work estimate changes, the beneficiary should contact the Abt call center and submit a revised estimate of annual earnings (for more information on benefits other than current year, see RS 02510.005E.2. and for more information on appeals, which are not initial determinations, see GN 03101.080).

NOTE: If someone is requesting a CPS, you should call or email Management in L5R. The phone number is listed in DOORS.

B. FO procedure to process a BOND waiver

If the BOND beneficiary decides to file a waiver, follow these procedures:

1. Waiver inquiry

If the beneficiary, representative payee, or authorized representative wants to file a waiver:

Follow usual procedures to post the informal waiver request in DMS to stop overpayment recovery.

Send the notice in DMS titled “Request for Waiver Cover Letter” with the form SSA-632-BK.

Refer BOND beneficiaries to the Abt call center after providing the beneficiaries with the form SSA-632-BK. Find the Abt call center number in DI 60099.030 A.

2. Waiver received in FO

If the beneficiary returns the form SSA-632-BK directly to the FO, follow the usual procedures to post the waiver request in DMS. Check DMS for an explanation of how the BOND or BOPD overpayment occurred.

If an explanation is not in DMS, send an MDW request to L5R with the ISSUE of ‘explanation’ and a category of BOND overpayment (BONDOP). The L5R unit reviews the case and provides an explanation in the debt management system.

The FO should continue development needed for the waiver.

3. Waiver received in L5R

Prior to transferring the waiver request to the FO, L5R posts an explanation in the debt management system to explain how the overpayment occurred.

Determining without fault and the inability to re-pay is the FO’s responsibility.

L5R notifies the FO of the waiver request via MDW. The MDW should also include a summary of any evidence submitted. The evidence should be faxed into eView or NDRED.

4. National 800 Number Network (N8NN) process for BOND or BOPD waiver requests

If you receive a call from the beneficiary, representative, or authorized representative requesting an explanation of an overpayment notice, continue to follow procedures in TC 26001.080. However, if you do not find an explanation in DMS, complete a MDW, send the request to “L5R” and explain to the caller that he or she should contact the BOND call center at 1-877-726-6309 (877-7BOND09). Beneficiaries with hearing or speech impediments should call Abt’s TTY number at 1-877-726-6390 (877-7BOND90).

If the beneficiary, representative payee, or authorized representative calls and states that he or she wants to file a waiver, continue to follow procedures in TC 26001.080.

C. FO procedure to process BOND reconsideration requests

The BOND work CDR unit (L5R) is the only office with jurisdiction to make a decision on BOND overpayment reconsideration requests.

Forward all requests for reconsideration to L5R by:

  1. keying the reconsideration request in DMS;

  2. faxing the SSA-561-U2 and any accompanying evidence into the Certified Electronic Folder (CEF) or Non-Disability Repository for Evidentiary Document (NDRED) as appropriate;

  3. sending an MDW to L5R notifying them of the pending reconsideration request.

For additional information about reconsideration requests, see DI 60099.075A.1.b. in this section.

D. National 800 Number Network (N8NN) procedure to process a BOND reconsideration request

1. Request for reconsideration

If you receive a call from the beneficiary, representative payee, or authorized representative requesting to file reconsideration on an overpayment and he or she is a BOND beneficiary or is representing a BOND beneficiary, follow procedures in TC 26005.030.

If you mail the SSA-561-U2 to the beneficiary, representative payee, or authorized representative, send the SSA-561-U2 with a courtesy return envelope to the following address:

L5R
6401 Security Blvd.
3rd Floor Operations
OPD 3-E-25F
Baltimore, MD 21235

2. Reconsideration follow-up

If you receive a call from the beneficiary, representative payee, or the authorized representative requesting a status of the reconsideration filed by, or on behalf of a BOND beneficiary:

Send an MDW to L5R informing them of the status inquiry and any additional information the beneficiary may have provided.

Advise the caller that you have notified the office handling his or her claim and that he or she will be contacted.

For additional instructions on handling reconsideration requests, see TC 26005.030.


To Link to this section - Use this URL:
http://policy.ssa.gov/poms.nsf/lnx/0460099075
DI 60099.075 - Appeal Process for BOND Overpayments - 09/29/2017
Batch run: 10/02/2017
Rev:09/29/2017