TN 2 (09-01)

SI 02201.022 SSI Responsibility - Eligible Couple Cases

A. Policy

1. Responsibility of Members of Eligible Couple

When payments were received during the same period by both an individual and his/her eligible spouse and an overpayment results, each is individually responsible for repayment of his/her own overpayment as well as for the other member's overpayment.

Even if the members of a couple are no longer eligible as a couple (e.g., either now eligible as individuals or neither currently eligible, whether or not presently married and/or living together), each remains responsible for any overpayment.

Responsibility accrues at the time an overpayment occurs and does not shift because of a change in marital status.

2. Recovery Priority

  • Attempt recovery first from the individually responsible person (including his/her representative payee or estate, if applicable).

  • If recovery proves to be unsuccessful against the individually responsible person, attempt recovery from the responsible spouse.

  • If waiver of recovery has been approved for the individually responsible person, do not pursue recovery from the responsible spouse.

3. Recovery Waived

The member of the couple for whom waiver was not applicable is responsible for repayment only for the amount actually overpaid such individual (i.e., the amount for which the individual is individually responsible).

4. Offsetting

In the rare situation where one member of the couple has incurred an overpayment and the other member has an underpayment due, do not delay issuance of the underpayment. Withhold the additional amount due one member of a couple when the underpaid spouse offers to have his/her underpayment applied to the responsible spouse's overpayment. Apply this offsetting only after the responsible spouse has exhausted his/her appeal rights.

B. Examples

1. Responsibility

Mr. Highfield, an individual receiving a $513 monthly title XVI payment, reports marriage in August 2000 to another recipient receiving $513 monthly. Redetermination results in an adjustment of their payments, effective September 2000.

In December 2001, the recipient reports a divorce which was final November 2001. When redetermining eligibility and amount of payment, the interviewer becomes aware of previously unreported income for Mr. Highfield, resulting in a monthly $120 overpayment beginning July 2000. Mr. Highfield is overpaid $120 a month July 2000 through August 2000, $60 a month September 2000 through November 2001, and $62 for December 2001 (note that based on the change in marital status the Federal benefit rate for December is $513). Mrs. Highfield is overpaid $60 monthly September 2000 through November 2001 (note that she is underpaid $122 for December 2001 but this underpayment will be offset against her overpayment).

Although Mr. Highfield is responsible for Mrs. Highfield's entire overpayment, she is responsible only for his September 2000 through November 2001 overpayment because she was eligible as a member of a couple for only those months.

2. Offsetting – Couples' Case

a. EXAMPLE:

Not withholding underpayment due one member

Mr. and Mrs. Janice have each been receiving $266 a month. In November, it is learned that Mrs. Janice is in a public institution which she entered in July (Medicaid is not paying). A Notice of Planned Action (SSA-L8155) to stop her benefits effective January is sent. In December, Mrs. Janice is notified of her $1,330 overpayment for the period August through December. Although Mr. Janice is responsible for his wife's overpayment (i.e., recovery will be sought from him if recovery from his wife is unsuccessful), the underpayment of $352 due him for August through November should be paid along with his increased benefits effective December.

b. EXAMPLE:

Not a couple at time of overpayment

Mr. Roque had an overpayment of $1,000 which was being recovered by withholding $54 per month from his title XVI payment. In May he was married to an individual who filed for SSI disability benefits the same month. In September, Mrs. Roque received a favorable determination effective May. When establishing the couple record, Mrs. Roque's underpayment should not be offset against Mr. Roque's overpayment since they were not a “couple” at the time the overpayment occurred and, therefore, she is not responsible for repayment of his overpayment.