TN 2 (01-08)

DI 23020.010 Potential or Actual Overpayment Cases

A. General

The Disability Determination Services (DDS) should be alert to possible situations in which a potential or actual overpayment may exist. Expedite case processing whenever the possibility of an overpayment is present.

B. Continuing Disability Cases

The possibility of an overpayment is inherent in Continuing Disability Review (CDR) cases in which the benefits have been identified for suspension, but have not yet been suspended. These cases include all CDR cases, except those where benefits have been suspended, which can be identified by one or more of the following indicators:

  • Electronic Disability Collect System (EDCS) case flagged as “Benefits Suspended”;

  • Form SSA-881-U3 is checked to show “Benefit Payments have been suspended”;

  • An Administrative Message in the folder requesting suspension of benefits (and benefits have not been reinstated); or

  • Form SSA-3925-C1 (Determination of Benefit Adjustment) showing benefits are stopped is in the file.

Process these CDR cases following the existing instructions in “The CDR Evaluation Process” (DI 28005.000).

C. Adverse Reopening

Potential or actual overpayments may also exist on any case that undergoes post adjudicative review by the Program Service Center-Disability Review Section (PSC-DRS), Disability Quality Branch (DQB), Office of Disability Operations (ODO), or where the DDS reopens a favorable decision on its own motion.

Increasingly, the ODO reviews are done after the DDS or the Field Office (FO) has effectuated a favorable decision and benefits have been initiated. Cases of this type which are returned to the DDS for a reversal or for further development should contain wording to alert the DDS to the possibility of reopening and the need for due process. Process cases reopened on the DDS's own motion according to existing instructions.

To Link to this section - Use this URL:
DI 23020.010 - Potential or Actual Overpayment Cases - 02/15/2008
Batch run: 01/15/2019