TN 10 (08-21)

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 rare situations, one member of a couple will have a collectible overpayment while the other member is due an underpayment. The underpayment due a member of a couple is not held solely to determine whether it may be applied to the overpayment of his or her liable spouse. The additional amounts due one member are netted against overpayment to the other only when:

  • The underpaid spouse offers to have his or her underpayment applied to the responsible spouse's overpayment; and

  • The overpaid spouse has exhausted his or her appeal rights.

B. Examples of issues involving repayment and offsetting for couples

1. Responsibility for repaying overpayment

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 of not withholding underpayment to offset spouse's overpayment

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 of non-SSI couple at the 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.

c. Example 1 of offsetting one member's overpayment with the other member's underpayment

In January 2020, we issue an initial overpayment notice to John, an SSI recipient who has an SSI eligible spouse (Jayne). John is overpaid $2,500.00. John files a reconsideration appeal in January 2020. We issue an unfavorable reconsideration decision in April 2020. John files a request for a hearing in April 2020. The ALJ issues an unfavorable decision in August 2020. John files a request for Appeals Council review in September 2020. The AC issues an unfavorable decision in March 2021. John files no further appeal on the overpayment decision. John does not request a waiver of the overpayment. In June 2021, John's spouse, Jayne, reports her verified earnings to SSA for the period March 2020 through April 2021 that are less than the estimates on which we based her SSI payments for that period. Jayne is due an underpayment of $6,000.00. She offers to have $2,500.00 of her underpayment withheld to repay John’s overpayment. We may apply part of Jayne's underpayment to repay John's overpayment because Jayne offered, and John’s appeal rights have been exhausted.

d. Example 2 of offsetting one member's overpayment with the other member's underpayment

In January 2021, we issued an initial notice to Kai that she was overpaid $1,500.00 during the period of February 2020 through June 2020. Kai did not appeal the overpayment decision. In May 2021, Kai’s eligible spouse, Kevin, reported his verified earnings for February 2020 through March 2021. Kevin’s verified earnings were less than the estimates on which we based his SSI payments for the period. Kevin is due an underpayment of $5,500.00. Kevin offers to have $1,500.00 of his underpayment applied to Kai’s overpayment. We may accept Kevin’s offer because Kai’s appeal rights have expired.

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SI 02201.022 - SSI Responsibility - Eligible Couple Cases - 08/18/2021
Batch run: 08/18/2021