We are writing about your request that we waive the collection of your Social Security
overpayment. Based on the facts we have, we will waive the collection of part of your
Social Security overpayment of $ (1) . You will not have to pay back $ (2) of this overpayment. However, this means that you still have to pay back $ (3) of this overpayment.
Below, we explain why we cannot waive all of your overpayment.
The Reason for Our Decision
For us to waive the collection of your overpayment, two things have to be true.
It was not your fault that you got too much Social Security money.
Paying us back would mean you cannot pay your bills for food, clothing, housing, medical
care, or other necessary expenses, or it would be unfair for some other reason.
Based on the facts we have, you do not meet both of these rules. The following will
tell you why.
We apply three tests when we decide if you are at fault in causing an overpayment.
The first is whether you made an incorrect statement or a statement which you knew
or should have known was incorrect. The second is whether you failed to give us timely
information which you knew or should have known was important. The third is whether
you accepted payments which you either knew or could have been expected to know were
Therefore, based on the facts we have, we cannot waive the collection of $ (6) of this overpayment. This means that you must pay this money back.
How To Pay Us Back
You should refund this overpayment within 30 days. You can send us a check or money
order for the full amount of your overpayment of $ (7) . Make your check or money order out to the Social Security Administration. Be sure
to put your claim number, (8) , on it. Please use the enclosed envelope to mail the check or money order to us.
If you cannot send the full amount now, send as much as you can. Then contact any
Social Security office. You can pay the rest of the money you owe by making monthly
If You Disagree With The Decision
If you disagree with this decision, you have the right to appeal. Your appeal can
cover both your reconsideration and waiver denial. A person who has not seen your
case before will look at it. That person will be an administrative law judge. The
administrative law judge will review your case and look at any new facts you have
before deciding your case.
You have 60 days to ask for a hearing.
The 60 days start the day after you get this letter. We assume you got this letter
5 days after the date on it unless you show us that you did not get it within the
You will have to have a good reason for waiting more than the 60 days to ask for a
You have to ask for a hearing in writing. We will ask you to sign an SSA form HA-501,
called "Request for Hearing." Contact one of our offices if you want help.
If You Want Help With Your Appeal
If You Have Any Questions
If you have any questions, you should call, write, or visit any Social Security office.
If you visit an office, please bring this letter. It will help us answer your questions.