PROGRAM OPERATIONS MANUAL SYSTEMPart GN – GeneralChapter 022 – OverpaymentsSubchapter 70 – Personal Conference Procedures When Waiver Cannot be ApprovedTransmittal No. 11, 11/19/2020
This is a Quick Action Transmittal. These revisions do not change or introduce new policy or procedures.
Summary of Changes
GN 02270.005 FO Action on Receiving Folder - Personal Conference
Section A.3, we updated this section to allow technicians to make a waiver determination on all the information in the file, if a person has a legitimate reason for not participating in a person conference.
Field Office (FO) Managers may delegate decision-making authority to GS-11 claims representatives or higher positions regardless of the amount of the overpayment.
The overpaid individual is entitled to a fair and full hearing before an impartial decisionmaker. Therefore, an FO employee who has participated in the overpayment proceedings in a case cannot be a decisionmaker for the personal conference. Participation in the case means having made a determination about any fact that is material to the pending waiver determination: fault, ability to repay, credibility or veracity of the overpaid person.
The decisionmaker participated in the overpayment proceedings when, after reviewing the request for waiver, the file (if any) and any supporting evidence, he or she made the preliminary recommendation not to approve the request for waiver. The decisionmaker did not participate in the overpayment proceedings when he or she developed the underlying changes to the record that caused the overpayment.
SSA must provide suitable private space for conducting the personal conference, generally in the FO. If the person does not want to come to the conference site, the decision maker may conduct the conference by telephone or by video teleconference.
If the individual elects to conduct the personal conference by video teleconference, the individual will designate the location for his or her end of the video teleconference.
Consider conducting a face-to-face conference at locations other than the FO on a case-by-case basis, and only in limited circumstances when
all other means of conducting a personal conference have been ruled out, or
conducting a personal conference by any other means would infringe upon the person’s right to a hearing.
SSA cannot take any recovery action until the person has had reasonable opportunity for a conference. If the person has a legitimate reason for not coming to the conference site or participating in a telephone or video teleconference (e.g., the person is in prison and the prison does not allow outside communication of any kind), and the SSA decisionmaker is unable to go to the person, make a waiver determination on all the information in the file.
If the person refuses to come to the FO or have a telephone or video teleconference without a legitimate reason (e.g., he just does not want to travel or talk to us by telephone or video teleconferencing), he or she forfeits the opportunity for the conference and, a waiver decision is made on the existing record. If it is unfavorable, SSA begins recovery of the overpayment.
The decision maker reviews the folder to:
become familiar with it;
note additional development needed and take action to complete it;
identify potential disclosure problems (GN 02270.009B.);
identify matters to discuss with the person;
identify problems which could interfere with the scheduling or holding of the conference.
If a completely favorable decision can be made based on the record:
Prepare an SSA-635 and notice;
Proceed as in GN 02270.015.
If the decision maker
concludes the fact or amount of overpayment is incorrect but there is still an overpayment, or
questions but is not sure that the fact or amount of overpayment is incorrect,
Schedule the conference on the waiver request and process the request. Alert the PC to any other issues when returning the folder.
Send a letter to the person to schedule both the dates and times for the personal conference and the folder review in the FO (GN 02280.810). This notice explains that, if the person prefers, the folder review and the conference can be held by telephone or video teleconference. The person also has the option to have the folder review and personal conference in the same day as long as the claimant consents in writing on the SSA-795. If the person wishes to pursue these options, the notice instructs him or her to call us and lists a contact number.
NOTE: The date for the folder review should be no earlier than 10 days from the date the letter is mailed and the date for the conference should be at least 5 days after the folder review date.