TN 31 (02-97)
NL 00703.196 Partial Waiver Approval with Personal Conference — Current Pay
Document Identifier for Aurora: E3196
DPS Notice: Partial Waiver Approval (Pers Conference Decision)
A. EXHIBIT LETTER
We are writing about your request that we waive the collection of your Social Security overpayment. Based on the facts we have, we can 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 incorrect.
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 We Will Collect Your Overpayment
We will collect your overpayment from your monthly Social Security payments. You will receive another letter that will explain when we will start collecting your overpayment and the amount we will withhold.
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 5-day period.
You will have to have a good reason for waiting more than the 60 days to ask for a hearing.
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.
B. REQUESTING INSTRUCTIONS
amount of overpayment
amount of overpayment waived
overpayment refund amount
narrative explanation why overpayment cannot be waived
narrative explanation for denying without fault
overpayment refund amount
C. TYPING INSTRUCTIONS
Use Form SSA-L2000-C2 (Universal Notice) and follow the notice standards. Because the requested fill-ins and paragraphs may vary according to different situations, follow the requester's instructions carefully.