If the beneficiary alleges he or his spouse received a settlement from an employer
or former employer, in the tax year we used and has had a significant reduction in
his MAGI for the current or a more recent tax year than we used to determine IRMAA,
SSA will need MAGI and tax filing status information for the tax year he is asking
SSA to use and proof of the settlement and reason for the settlement.
A beneficiary may submit the following tax information:
An estimate of MAGI and tax filing status for the tax year they are requesting SSA
to use (current year or PY-1), or
A signed copy of the PY-1 tax return (or a filed amended tax return with an IRS letter
of receipt for PY-1) if PY-1 tax return shows a significant reduction in MAGI.
SSA will accept as proof of the settlement any evidence submitted by the beneficiary
that clearly documents the event such as:
A statement from an employer,
Court document showing settlement and terms, or
Statement from the employer’s attorney stating settlement and terms,
NOTE : If the beneficiary provides an estimate of MAGI, process the request using the estimate.
Request the beneficiary to submit a signed copy of the tax return once it has been
filed with the IRS. Once the filed tax return is received follow the procedures listed
in HI 01120.065. If a beneficiary alleges electronic filing, ask the beneficiary to print and sign
a copy of the electronic return. If a beneficiary is updating a MAGI estimate, follow
the procedures listed in HI 01120.065.