TN 2 (09-01)

SI 02201.010 SSI - What Is Not An Overpayment

A. Policy - general

1. Presumptive disability/blindness payments

Presumptive disability or blindness payments which would have been correct if the disability or blindness determination would have been favorable are not overpayments. However, if nondisability factors (excess income, SGA, resources, living arrangements, etc.) cause the presumptive disability/blindness payments to be incorrect, an overpayment results.

2. Early delivery of checks

If the individual negotiates an early delivered check and dies before the month for which payment is due, the early payment is not an overpayment.

B. Process

1. First day of the month rule

a. First day of month falls on a Saturday, Sunday or public legal holiday

If the first day of a month falls on a Saturday, Sunday or public legal holiday, any SSI payment for that month will be dated for payment on the first preceding day which is not a Saturday, Sunday, or public legal holiday. That is, payment will be made prior to the month for which payment is due.

b. Determine the amount of any excess

To determine the amount of any excess payment (and any underpayment), consider the early issued check to have been paid on the first day of the month following the early payment month.

For example, the January check will always be dated in December, because January 1 is a public legal holiday. However, consider the payment to have been made in January, not December.

2. Early delivered check — overpaid individual alive

When an early delivered payment was in excess of the amount due (either in part or in whole), regular overpayment recovery procedures apply. (See SI 02220.001)

3. Early delivered check — overpaid individual deceased

  • If there is an event in addition to death which causes the early delivered check to be an incorrect payment (for example, the recipient is in a public institution throughout the month of death), the early delivered check will not be an overpayment.

  • When there is representative payment and an early delivered check, it will be an overpayment unless the representative payee expended the incorrect amount on the deceased recipient.

4. Other situations which are not overpayments

  1. State administered supplemental payment.

  2. The only error was in the Federal/State payment composition.

    EXAMPLE:

    An individual received a title XVI manually computer retroactive payment of $100 composed of Federal funds of $80 and State funds of $20. Although there is no change in the amount of the recipient's payment, the FO determines that the $100 payment should have consisted solely of State funds. Since the recipient received the amount for which he/she is eligible, there is no overpayment.

  3. Payments to an eligible individual whose status changes to a member of an eligible couple (ineligible spouse now eligible).

    When eligibility is established for the previously ineligible spouse, the newly eligible spouse can be paid only the difference between what was paid the previously eligible individual and what is payable to the eligible couple. (See SI 02005.030A.3.c.)

    EXAMPLE:

    Jesse Bailey is receiving payments of $513. His wife was denied payments based on the application she filed in October 2000. On reconsideration, she is notified in January 2001 that she has been determined eligible effective October 1, 2000. Payment to the couple is $769 a month. Mr. Bailey is not overpaid for November through January. The difference between the eligible couple payment and the payment made to Mr. Bailey as an eligible individual is payable to the newly eligible spouse.

  4. Collection of improperly negotiated (forged) check amounts is under the jurisdiction of the United States Treasury Department.

  5. Penalty deductions. Assess a penalty deduction amount only by adjustment against Federal payments due (see SI 02301.100) or against an amount which otherwise would be payable to a survivor on behalf of the penalized recipient.

  6. Unnegotiated checks.

  7. Payment made after the month of death.

  8. Payments due the recipient but misused by a representative payee.

    The misused funds are an overpayment to the representative payee.

    NOTE: Funds misused by a representative payee are reissued to the SSI individual. However, if the SSI individual has been overpaid, the reissued funds will be used to reduce/recover the outstanding collectable overpayment.

  9. The retroactive conversion of a facility to a title XIX facility does not create an overpayment to a resident of the facility for the retroactive period (see SI 00520.700).

  10. Use of excluded burial funds for some other purpose (See SI 01130.409). However, such use may result in the imposition of a penalty.

  11. Emergency Advance Payments (EAPs) and Immediate Payments (IPs) (See SI 02004.001). EAPs and IPs are two ways to make payments to persons via Third Party Draft who are due SSI benefits and have a financial emergency. They both address the situation where certification to Treasury for regular payments, automated one-time payments (A-OTPs), or manual one-time payments (M-OTPs), cannot be made or would not be fast enough. The EAP and IP are advances against future SSI payments and must be recovered.

5. Exceptions

  1. Change from eligible individual to member of an eligible couple

    When two eligible individuals marry, they become an eligible couple the month after their marriage. Their payments as two eligible individuals in the month they marry are not overpayments. However, if they are each paid as eligible individuals for the month(s) after the month of marriage, they would be overpaid the difference between the two payments.

    EXAMPLE:

    Joseph Lynch and Debbie Green have each been receiving full SSI payments as eligible individuals living in their own household since July 2000. In late November 2000, they report that they married in October 2000. Effective November 2000, they should have been paid $769 a month as a couple. Payments in excess of the $769 payable to the couple are overpayments. Thus, if the Lynch's received payments as individuals ($513 each) for November and December 2000, each has been overpaid $257 for 2 months of November and December $1026-$769 = $257 x 2 = $514).

  2. Payments made after the month of death

    • When a representative payee negotiates a payment made to a recipient after the month of the recipient's death; or

    • When a member of an eligible couple dies and payment is made by direct deposit to a financial institution into an account which is jointly owned by the surviving eligible spouse.

      See GN 02408.600 for procedures on overpayments and reclamation of incorrect payments under 1986 Amendments. For electronic fund transfer payments after death in other situations, see GN 02602.050 and GN 02602.050.

  3. Representative payee liability

    If the payments were not due the recipient and were also misused by the representative payee, there would be an overpayment for which the representative payee would have personal liability (see SI 02201.021A.1.).

C. Procedure

1. Recipient deceased

If the individual negotiates the early delivered check and dies before the month for which payment is due, do not attempt recovery of the early payment.

Likewise, if there is an event (or events) which cause an early issued payment to be incorrect in addition to death (e.g., excess income), do not attempt recovery of the early payment.

2. Systems considerations

When an early payment has been made and the recipient dies before the month for which the payment is due, add an UNCOLLECTABLE decision (N TAC) through the UOPD screen (see MSOM BUSSR 004.008 and SM 01311.280).

3. Early payment made to a representative payee

When representative payment has been made, document the file showing how the incorrectly paid funds were expended. Do not attempt recovery when the documentation shows the funds were expended on the recipient.


To Link to this section - Use this URL:
http://policy.ssa.gov/poms.nsf/lnx/0502201010
SI 02201.010 - SSI - What Is Not An Overpayment - 02/25/2013
Batch run: 02/25/2013
Rev:02/25/2013