SI 02201.007 Supplemental Security Income (SSI): Overpayment Fraud

A. If you suspect the overpayment is the result of fraud

1. If you suspect that an overpayment was the result of fraud, stop or suspend all recovery efforts, including sending the initial overpayment notice, until:

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You no longer suspect fraud, or
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Your investigation does not result in a referral to the Office of the Inspector General (OIG).

2. If you refer the case to OIG for review and:

a. OIG returns the case within the 60-day review period without prosecuting

The field office (FO) will determine if fraud or similar fault exists as described in SI 04070.020. If fraud or similar fault exists, complete SSA-553 Special Determination and fax it into NDRed using the Evidence Portal (EP) at View Evidence-Evidence Portal (ssa.gov); Issue an overpayment notice to the recipient or representative payee. The notice will include an explanation that fraud or similar fault exists and describe the evidence we used to make the determination. The notice will also include appeal rights.

b. OIG provides no response to the case referral within 60-days

The FO will prepare and issue the notice of overpayment on the 61st day. Include an explanation that we have determined fraud or similar fault and describe the evidence we used to make our determination.

B. Possibility of fraud discovered after the expiration of the period for reopening

1. If the possibility of fraud as a cause of the overpayment is first discovered after the expiration of the period for reopening:

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Limit the overpayment period and recovery efforts to the period that has been reopened under the rules of administrative finality. For information on administrative finality, refer to SI 04070.000.

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Do not send the initial notice of overpayment until one of the conditions are met in SI 02201.007A.

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When one or more of the conditions are met in SI 02201.007A, send an initial overpayment notice showing the full period and amount of the overpayment.

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Resume recovery efforts.

2. If OIG accepts your referral

If the OIG accepts your referral, do not begin or resume any recovery action until the OIG completes its processing.

3. If OIG has declined prosecution

If the OIG has declined prosecution, a revised determination of overpayment is required. Send a revised initial overpayment notice showing the full period of the overpayment and the full amount of the overpayment.

C. Referral of fraud aspects to the OIG

If you refer the fraud aspects of the overpayment to the OIG,

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Stop or suspend all recovery efforts.

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Diary for 60 days for the OIG to review your fraud referral.

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If the OIG completes its review before the 61^st day and does not accept the referral, resume recovery efforts.

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Send the initial overpayment notice.

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Post the notice date (use the UOSD screen). For information on the use of the UOSD screen, refer to MS 00304.006.

If by the 60th day the OIG notifies you either that its review is not complete; or, that it has accepted the case, do not begin or resume recovery efforts until the OIG either declines your referral or completes its processing of the accepted case.

While the OIG is reviewing your referral or after the OIG accepts your referral, inform the OIG of any events that affect either the fraud issue or the overpayment. Some examples are a request for waiver, an offer of compromise settlement, or an offer of a refund. If by the 60th day OIG has not responded, request a status update from them.

D. References

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SI 02220.000 Recovery Procedures for Supplemental Security Income Overpayments
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SI 02220.005 Documenting the Supplemental Security Income (SSI) Overpayment
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SI 02220.010 SSI Overpayment -- Notifying the Individual
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SI 02220.017 SSI Overpayment – Request for a Different Rate of Adjustment, Reconsideration or a Waiver
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SI 02220.020 Cross Program Recovery (CPR) of SSI Overpayments from Monthly Title II Benefits
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SI 02220.030 SSI Overpayment – Compromise Settlement

To Link to this section - Use this URL:
http://policy.ssa.gov/poms.nsf/lnx/0502201007

SI 02201.007 - Supplemental Security Income (SSI): Overpayment Fraud - 12/23/2025
Batch run: 12/23/2025
Rev:12/23/2025

Social Security

Program Operations Manual System (POMS)