TN 112 (02-24)

SI 02220.026 SSA-634 Request for a Change in Recovery Rate - SSI

CITATIONS:

Section 1631(b) of the Social Security Act

A. The overpayment recovery rate

When we establish a Title XVI overpayment on an individual's record the automated system will begin check adjustment at the 10 percent rate 60 days after the date of the automated or manual overpayment notice (See SM 01310.400 and SM 01311.105) if the overpaid individual or their representative do not respond to the overpayment notice within 30 days, or the individual (or representative) does not request a reconsideration or a waiver during an interview concerning the overpayment. If the individual is unable to meet their ordinary and necessary living expenses because we are withholding 10 percent of their monthly payment, the individual may request a change in the rate of recovery.

1. Requesting a change in the rate of adjustment or recovery

  1. a. 

    A recipient may request a different rate of adjustment or recovery at any time.

  2. b. 

    Honor a request to reduce the rate of adjustment:

    At the 10 percent rate unless:

    • The Department of Justice (DOJ) or Office of the Inspector General (OIG) has determined that the overpayment was the result of fraud, willful misrepresentation, or concealment of material information (see SI 02220.016);

    • The Office of Counsel to the Inspector General has imposed a civil monetary penalty (see GN 02230.050, Civil Monetary Penalty (CMP)-Overview);

    • A Claims Specialist (CS) or higher has determined that the overpayment resulted from similar fault, misrepresentation or concealment of material information by the SSI recipient or their deemor; or

    Below the 10 percent rate when:

    • When the individual cannot meet ordinary and necessary living expenses at a higher rate.

  3. c. 

    Do not honor requests to recover overpayments by monthly check adjustment from recipients subject to the payment limit for FLA-D. However, accept any refund(s) offered.

  4. d. 

    Do not change the rate at which a penalty is assessed.

  5. e. 

    Do not change the rate of recovery imposed as a penalty when SSI recipients spend excluded burial funds on other expenses not related to their burial.

  6. f. 

    Renegotiate the rate of recovery of conditional payment when the individual's income or ordinary and necessary living expenses change.

2. Changing the proposed rate of adjustment or recovery

  1. a. 

    Negotiate the effective month of the new, negotiated rate (SM 01311.125).

  2. b. 

    When the recipient requests a rate of adjustment or recovery that is less than the 10 percent rate:

    • Determine that the recipient is not actually requesting a waiver.

    • Negotiate a rate that will result in full overpayment recovery within 12 months. If this is not possible, try to arrange for full repayment within 60 months.

    • Set a rate of adjustment or recovery that is appropriate for the financial situation of the individual. Determine a rate that allows the individual to meet their current necessary and ordinary living expenses.

    • If the requested adjustment or recovery rate will not result in full overpayment recovery within 60 months, complete form SSA-634, Request for Change in Overpayment Recovery Rate to evaluate the SSI recipient's ordinary and necessary living expenses.

      NOTE: 

      The rate of adjustment can never be less than $10.00.

  3. c. 

    When the recipient requests a rate of adjustment higher than 10 percent:

    • Explain that the maximum required rate is 10 percent.

    • Obtain a signed SSA-795 stating the recipient:

      Understands that the usual rate of adjustment is 10 percent; and

      Is voluntarily requesting a higher rate of adjustment.

    • Document the request for change in recovery rate, the overpayment sequence number, overpayment sequence date, the requested rate of recovery, the reason why it was approved, and your unit code on the Report of Contact page. For non-MSSICS cases, document the information on an SSA-5002 and fax it into NDRed.

  4. d. 

    Post a change to the 10 percent recovery rate when:

    • You approve a recipient's request for a higher or lower recovery rate (SM 01311.125); or

    • A 10 percent recovery case goes into Goldberg Kelly status and no money was withheld for the prior month (SM 01311.128).

      NOTE: 

      Other changes, such as Cost of Living Adjustment (COLA), interstate move, etc., are automatically computed.

3. Denying a change in a rate of adjustment

Manually prepare and issue a notice (SSA-L8166-U2) explaining the reason for the denial.

Document the request for change in recovery rate, the overpayment sequence number, overpayment sequence date, the requested rate of recovery, the reason why it was denied, and your unit code on the Report of Contact page. For non-MSSICS cases, document the information on an SSA-5002 and fax it into NDRed.

B. Completing the SSA-634

1. Purpose of the SSA-634

The purpose of the SSA-634 is to gather information to assist technicians with determining if they can approve a change in an individual’s repayment rate if the individual cannot pay their entire debt within 60 months, or if the current recovery rate will not allow the individual to afford their ordinary and necessary living expenses. The overpaid individual or an individual representing the overpaid individual can complete the form. A technician can assist with completing the SSA-634 if the individual requests assistance. Subsection C below provides guidance on completing each question on the form.

2. Request for a change in adjustment or recovery rate from an overpaid individual who lives outside the United States

If the individual requesting a change in overpayment recovery rate does not live in the United States (e.g., former SSI recipient, or child of a military service member serving overseas), complete form SSA-634-BK if the individual, or their representative says they cannot repay the debt within 60 months. Ask the person to show the value of their resources, income, and expenses, in local currency. After receiving the completed form, use the Treasury Reporting Rates of Exchange tables to convert the foreign currency to U.S. dollar amounts and specify the type of currency involved.

3. Proof of income, expenses, and resources

Inform the individual that they are responsible for providing proof of all income, resources, and certain expenses. We do not require proof for food and miscellaneous household expenses, unless the expenses seem unusually high.

4. Storing the SSA-634

Fax the SSA-634 and the supporting documents into the Certified Electronic Folder (CEF) for disability claims or the Non-Disability Repository for Evidentiary Documents (NDRed) for non-disability claims. For the link to the NDRed application, see GN 00301.310.1.

C. Questions on the SSA-634

1. Section 1 - Identifying Questions (Questions 1 through 4)

a. Question 1

The individual must provide their name, SSN, and claim number, if any. If someone else is completing the SSA-634 on behalf of the overpaid individual, we ask for the identity of the organization or individual who is assisting the individual.

b. Question 2

Enter the type of income the individual is currently receiving.

c. Question 3

Enter the total amount that the individual owes to SSA.

d. Question 4

Enter the monthly amount that the overpaid individual can afford to pay.

2. Section 2 - Resources - things you have and own (Questions 5 through 6)

a. Question 5.A

Enter the cash in the overpaid individual’s possession.

b. Question 5.B

Enter a detailed description of the financial accounts owned by the overpaid individual.

c. Question 6.A

If the overpaid person owns more than one vehicle, enter a description, present value, loan balance, and the main purpose of the additional vehicles.

d. Question 6.B

Enter a detailed description of any real estate owned by the overpaid individual, if it is not where the overpaid person lives.

e. Question 6.C

Enter a detailed description of any interest in any business, property, or valuables that the overpaid individual owns.

3. Section 3 - Monthly household income (Questions 7 through 9)

a. Question 7

Enter monthly employment information for the overpaid individual.

b. Question 8.A

Enter any support or contributions from any person, agency, or organization that the overpaid individual receives.

c. Question 8.B

Enter whether the overpaid individual receives the support or contributions under a loan agreement.

d. Question 8.C

Enter the amount of the support or contributions that the overpaid individual receives.

e. Question 9

Enter unearned monthly income for the overpaid individual.

4. Section 4 - Monthly household expenses (Question 10)

Enter the monthly household expenses. Write the amounts in whole dollars and round any cents to the nearest dollar. Do not list an expense withheld from the person’s paycheck, such as medical, child support, alimony, wage garnishments, etc. When reviewing the household bills do not double count the expenses if the overpaid person uses a credit card for paying bills and making purchases. If the overpaid person pays expenses by credit card, only list it as a credit card expense instead of another expense for clothing, phone, gas for a vehicle, or etc.

5. Section 5 - Income and expenses comparison (Questions 11 through 12)

Section 5 compares the monthly income with the monthly household expenses. We subtract the total monthly household expenses from the total monthly household income to determine if the person has money to repay the overpayment. If the monthly expenses exceed monthly income, the overpaid person must explain how they pay the monthly bills.

6. Section 6 - Financial expectations and funds availability (Question 13)

a. Question 13.A

Requires the overpaid person to let us know if they expect to receive an inheritance within 6 months of requesting the change in recovery rate to determine if the person’s resources may increase.

b. Question 13.B

This question totals the overpaid person’s resources to determine if the person has money to repay his or her overpayment.

c. Question 13.C

This question determines if the overpaid person has any resources that they cannot convert to cash.

D. Related references

GN 00301.310 - The Non Disability Repository for Evidentiary Documentation (NDRed) Application - Overview

GN 02230.050 - Civil Monetary Penalty (CMP) - Overview

SI 02220.016 - SSI Overpayment - The 10 Percent Rate of Adjustment

SM 01311.125 - Establishing and Changing the Recovery Rate for Check Adjustment

SM 01311.128 - Check Adjustment While Record Under Goldberg-Kelly Protection


To Link to this section - Use this URL:
http://policy.ssa.gov/poms.nsf/lnx/0502220026
SI 02220.026 - SSA-634 Request for a Change in Recovery Rate - SSI - 02/15/2024
Batch run: 03/14/2024
Rev:02/15/2024