TN 2 (09-11)

NL 00720.390 WAV Waiver

WAV - Waiver

WAV001 OVERPAYMENT RECONSIDERATION AND WAIVER INFORMATION - INITIAL OVERPAYMENT NOTICE -REFUND REQUESTED, ADJUSTMENT NOT PROPOSED (A07) (F07)

(System Generated)

Caption: Do You Think We Are Wrong About The Overpayment?

You have certain rights with respect to this overpayment and its recovery.

1. Right to Appeal: If you disagree in any way with this overpayment determination, you have the right, within 60 days of the date you receive this notice, to request that the determination be reconsidered. If you request this independent review of the overpayment determination, please submit any additional information you have which pertains to the overpayment.

2. Right to Request Waiver: You also have the right to request a determination concerning the need torecover the overpayment. An overpayment must be refunded or withheld from benefits unless both of the following are true:

a. The overpayment was not your fault in any way, and

b. You could not meet your necessary living expenses if we

recovered the overpayment, or recovery would be unfair for some

other reason.

If you request waiver, we may need a statement of your assets and monthly income and expenses.

If you request reconsideration and/or waiver within 30 days, the overpayment will not have to be recovered until the case is reviewed. This review is described in more detail on the attached form SSA-3105, Important Information About Your Appeal and Waiver Rights. The people in any Social Security office will be glad to help you complete the forms for requesting reconsideration (SSA-561-U2, Request for Reconsideration) or waiver (SSA-632-BK, Request for Waiver of Overpayment Recovery or Change in Repayment Rate).

Even if you do not want to request reconsideration or waiver, please call, write or visit any Social Security office if you have questions or need more information. Please take this letter with you if you do visit an office.

WAV002 OVERPAYMENT RECONSIDERATION AND WAIVER INFORMATION- INITIAL OVERPAYMENT NOTICE, ADJUSTMENT PROPOSED (A09)

(Requested/Generated)

Caption: Do You Think We Are Wrong About The Overpayment?

You have certain rights with respect to this overpayment and its recovery.

1. Right to Appeal: If you disagree in any way with this overpayment determination, you have the right, within 60 days of the date you receive this notice, to request that the determination be reconsidered. If you request this independent review of the overpayment determination, please submit any additional information you have which pertains to the overpayment.

2. Right to Request Waiver: You also have the right to request a determination concerning the need to recover the overpayment. An overpayment must be refunded or withheld from benefits unless both of the following are true:

a. The overpayment was not your fault in any way, and

b. You could not meet your necessary living expenses if we

recovered the overpayment, or recovery would be unfair for some

other reason.

If you request waiver, we may need a statement of your assets and monthly income and expenses.

If you request reconsideration and/or waiver within 30 days, the planned withholding of your benefit to recover the overpayment will not take place until your case is reviewed. This review is described in more detail on the attached form SSA-3105, Important Information About Your Appeal and Waiver Rights. The people in any Social Security office will be glad to help you complete the forms for requesting reconsideration (SSA-561-U2, Request for Reconsideration) or waiver (SSA-632-BK, Request for Waiver of Overpayment Recovery or Change in Repayment Rate).

Even if you do not want to request reconsideration or waiver, please call, write or visit any Social Security office if you have questions or need more information. Please take this letter with you if you do visit an office. Unless we hear from you within 30 days, we will withhold your payment as shown above.

WAV002 FOREIGN RECONSIDERATION & WAIVER RIGHTS INITIAL OVERPAYMENT NOTICE ADJUSTMENT PROPOSED (F09)

(System Generated)

Caption: Do You Think We Are Wrong About The Overpayment?

You have certain rights with respect to this overpayment and its recovery.

1. Right to Appeal: If you disagree in any way with this overpayment determination, you have the right, within 60 days of the date you receive this notice, to request that the determination be reconsidered. If you request this independent review of the overpayment determination, please submit any additional information you have which pertains to the overpayment.

2. Right to Request Waiver: You also have the right to request a determination concerning the need to recover the overpayment. An overpayment must be refunded or withheld from benefits unless both of the following are true:

a. The overpayment was not your fault in any way, and

b. You could not meet your necessary living expenses if we

recovered the overpayment, or recovery would be unfair for some

other reason.

If you request waiver, we may need a statement of your assets and monthly income and expenses.

If you request reconsideration and/or waiver within 30 days, the planned withholding of your benefit to recover the overpayment will not take place until your case is reviewed. This review is described in more detail on the attached form SSA-3105, Important Information About Your Appeal and Waiver Rights. The people in any Social Security office will be glad to help you complete the forms for requesting reconsideration (SSA-561-U2, Request for Reconsideration) or waiver (SSA-632-BK, Request for Waiver of Overpayment Recovery or Change in Repayment Rate).

Even if you do not want to request reconsideration or waiver, please call, write or visit any Social Security office if you have questions or need more information. Please take this letter with you if you do visit an office. Unless we hear from you within 30 days, we will withhold your payment as shown above.

WAV005 CROSS PROGRAM RECOVERY – WAIVER REQUEST FOR SSI OVERPAYMENT (B83)

(Requested/Generated)

Caption: Your Benefits

You may not have to pay us back. Sometimes we can waive the collection of an overpayment, which means you won't have to pay us back. For us to waive the collection of the overpayment, two things have to be true.

  • It wasn't your fault that you got too much SSI money.

AND

  • Paying us back would mean you can't pay  (1)  bills for food, clothing, housing, medical care or other necessary expenses, or it would be unfair for some other reason

If you think these are true about you, contact any Social Security office. You can ask for waiver at any time by completing the waiver form and returning it to us. The form is called Request for Waiver of Recovery or Change in Repayment Rate, Form SSA-632-BK. We will be happy to help you fill out the form. If you ask for waiver after that time, we will stop collecting the overpayment while we decide if we can waive collection.

Fill-in values:

Fill-in (1) - Systems Generated

Choice 1: your

Choice 2: his

Choice 3: her


To Link to this section - Use this URL:
http://policy.ssa.gov/poms.nsf/lnx/0900720390
NL 00720.390 - WAV Waiver - 09/16/2011
Batch run: 09/16/2011
Rev:09/16/2011