Identification Number:
GN 02250 TN 56
Intended Audience:See Transmittal Sheet
Originating Office:ORDP OISP
Title:Waiver Provisions for Title II and Title XVIII Overpayments
Type:POMS Full Transmittals
Program:All Programs
Link To Reference:
 

PROGRAM OPERATIONS MANUAL SYSTEM

Part GN – General

Chapter 022 – Overpayments

Subchapter 50 – Waiver Provisions for Title II and Title XVIII Overpayments

Transmittal No. 56, 05/20/2024

Audience

PSC: BA, CCRE, CS, DCR, DS, LDCR, LDS, PETE, RECONR, SCPS, TSA, TST;
OCO-OEIO: BTE, CS, FCR, PETL, RECOVR;
OCO-ODO: BTE, CST, CTE, CTE TE, PAS, PETE, PETL, RCOVTA, RECOVR;
FO/TSC: CS, CS TII, CS TXVI, CSR, CTE, DRT, FR, OA, OS, RR, TA, TSC-CSR;

Originating Component

OISP

Effective Date

Upon Receipt

Background

This transmittal increases the administrative waiver tolerance from $1,000 to $2,000.

Summary of Changes

GN 02250.350 Waiver Under the $1,000 Administrative Tolerance

Changed the title from "Waiver Under the $1,000 Administrative Tolerance" to "Administrative Waiver Tolerance of $2,000 or less".

Increased the administrative waiver tolerance from $1,000 to $2,000 throughout the document.

Throughout this section, replaced gender specific language with inclusive language per AO 40901.016.

GN 02250.350 Administrative Waiver Tolerance of $2,000 or less

A. Policy

When a liable person requests waiver and the total amount of that person's liability is $2,000 or less, recovery will be waived because it would impede the efficient administration of the Act unless there is some indication that the person may be at fault.

1. When the administrative waiver tolerance applies

Application of the $2,000 administrative waiver tolerance depends on the total amount of a person's liability. Thus a person who is liable for several overpayments, which total more than $2,000, even though each is $2,000 or less, cannot be considered for waiver under this tolerance. Likewise, if an overpayment of more than $2,000 has been reduced to $2,000 or less by repayment or collection, the tolerance does not apply.

Consideration of waiver under the tolerance is also dependent on overpayments to other members of the household. In single family situations where one request for waiver can be used for all household members, the largest liability any person has will determine if the tolerance applies. Thus if one household member has liability for an overpayment of $2,200, waiver under the tolerance cannot be considered for any other member of that household, even if their own personal liability is $2,000 or less.

If there is an indication that the person may be at fault in causing the overpayment, the tolerance cannot be used. Full waiver development is necessary. For example, the person requesting waiver is overpaid for the second time because of work and earnings. Since this is the second overpayment for the same reason, there is an indication that the person may be at fault. Also, if the overpayment was caused by receipt of duplicate payments and it has been proven that the person did receive both payments, there is an indication that the person may be at fault. Full waiver development must be done in both cases. This does not mean that without fault cannot be found, only that full waiver development is necessary. To determine whether a waiver request is appropriate under the administrative tolerance, you may use the Administrative Tolerance Decision Tree.

NOTE: An organizational payee is considered a “person” for the purposes of these instructions.

2. When reconsideration request applies

If the person requests a reconsideration on the amount of the overpayment and the person is liable for an overpayment of $2,000 or less, the reconsideration is treated as a request for waiver after the processing center (PC) makes a formal reconsideration determination or dismissal, if there will be no effect on current or future benefits per GN 02201.013E.1.

3. Development

Neither full development nor an SSA-632-BK (Request for Waiver of Overpayment Recovery or Change in Repayment Rate) is required for waivers which will be processed under this provision.

4. Who processes the request

The Field Office (FO) (CSRs and higher), the Payment Center (PC), or the Teleservice Centers (TSC) (TSRs and SPIKES) can process any waiver request involving the tolerance.

Only the PC can process reconsideration requests involving the tolerance.

B. Procedure

1. How to complete a request

Verify the amount of the overpayment before completing an administrative waiver request. If the requirements are met, input the waiver request to the system per MSOM DMS 006.002 (DRMU).

2. How to document the waiver determination

Annotate the waiver approval on the Debt Management System Remarks (RMKS) screen as follows “Waiver approval; overpayment is $2,000 or less.”

Send a waiver approval notice. Also annotate on the Remarks screen that a waiver approval notice was sent.

Until systems changes can be made, process these cases as follows:

  • Use the Waiver Disposition (DRWD) when processing waivers $2,000 or less. (MSOM DMS 006.004)

  • Use code 77 (Dollar Down Rounding) for the Decision Reason. (MSOM DMS 006.018)

  • Continue to use Waiver Approval Under $500 (Primary) DRWP and Waiver Approval Under $500 (Contingent) DRWC for waivers under $500. (MSOM DMS 006.006, MSOM DMS 006.007)


GN 02250 TN 56 - Waiver Provisions for Title II and Title XVIII Overpayments - 5/20/2024