This section provides guidance on how we determine that overpayment recovery is against equity and good conscience after an individual has requested a waiver and we have found the individual is not at fault.

Overpayment recovery is against equity and good conscience when:

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  An individual relied on an expected payment after receiving notice that they would receive payments from us or relied on the incorrect payment itself, and their financial position changed for the worse or they relinquished a valuable right (GN 02250.150C); or

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  For Title II, an individual receiving benefits on the same earnings record as the overpaid individual and lived in a separate household at the time of the overpayment and did not receive the money that resulted in an overpayment (refer to GN 02205.016C.9 for Title II); or

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  For Title XVI, a spouse did not receive the money that resulted in an overpayment and was legally separated from the overpaid spouse or lived in a separate household from the overpaid spouse at the time of the overpayment event (refer to SI 02201.030) for Title XVI).

We will deem recovery is against equity and good conscience in these situations:

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  The overpaid individual relied on misinformation from an official source (refer to GN 02250.061); or

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  An individual misunderstood our rules on allowable earnings and reasonably believed earnings prior to the first month of entitlement would be excluded. This applies only for months in which the individual’s earnings from employment did not exceed the total monthly benefits for that month; and does not apply where the individual’s earnings already exceeded the annual limit in the first month of entitlement, refer to GN 02250.025B.6; or

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  An individual reasonably believed that we counted their net earnings (take-home pay) instead of their gross earnings, refer to GN 02250.025B.5; or

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  A beneficiary’s death caused excess earnings, refer to GN 02250.016B.19; or

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  An individual is overpaid because of the family maximum, refer to GN 02250.016.B.15; or

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  We are unable to locate documents or documentation to support an overpayment, refer to GN 02250.011; or

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  We reopened a final determination under the one-year rule based on a change of position (refer to GN 04001.100, SI 04070.010C.2, SI 04070.040C) and issued a revised determination, which resulted in an overpayment; or

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  An adult individual was overpaid as a child and had a representative payee at the time of the overpayment, refer to GN 02250.150E.

This information describes when an individual's position changes for the worse or they relinquish a valuable right.

If we overpaid a minor child who is now an adult and the individual had a representative payee at the time of the overpayment, we will find they are not at fault (refer to GN 02250.016B.7). We will deem recovery is against equity and good conscience.

These are examples of situations when an individual may be in a worse position because of their reliance on the notice of or receipt of benefits, which we stopped or reduced.

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  Increased housing costs: An individual might have moved to a more expensive residence or signed a lease based on the assumption of receiving benefits. Due to the individual no longer receiving benefits, the loss of the benefits could make it difficult to cover the higher housing costs, putting them in a worse financial position.

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  Increased debt: If an individual accumulated debt, such as student loans, based on the expectation of ongoing benefits, the cessation of those benefits could lead to an inability to repay those debts, resulting in financial hardship.

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  Long-term contract: An individual may have entered into a long-term contract or commitment (e.g., vehicle lease agreement or service contract) based on the assumption of continued benefits, which could result in financial difficulty if the benefits are later reduced or stopped.

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  Reduced income: An individual may have reduced their work hours or stopped working because they were relying on Social Security benefits for their income. When benefits stop, they might be in a worse financial position due to the lost income and potentially having less earning potential as a result of their reduced work.

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  Education and training: An An individual may have enrolled in school or training that requires tuition based on the expectation of ongoing benefits.  The cessation of those benefits could lead to an inability to continue payments or could lead to increased educational expenses or missed work opportunities.

These are examples of situations where we may find an individual relinquished a valuable right in reliance on the notice of an award of benefits or in reliance on the receipt of benefits.

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  Missed an opportunity: An individual missed an opportunity they would have received if their benefit amount were lower or if they were not receiving benefits.

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  Turned down assistance: An individual declines or does not take advantage of other forms of financial assistance (like public assistance or community aid) because they expect to receive benefits to support themselves. We may find the individual relinquished their right to that additional support.  Public assistance could include lodging in a homeless shelter.

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  Assistance denied: An individual is denied another form of financial assistance because the individual is receiving or is expected to receive SSA benefits.  We may find the individual relinquished their right to that additional support.

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  Changed employment: An individual leaves a job or reduces their working hours based on the expectation of SSA benefits providing necessary income.  We may find that they have given up stable employment income if they cannot return to a similar level of employment.

If an estate requests a waiver and we determine that the deceased overpaid individual was not at fault for the overpayment, we will find recovery from the estate is against equity and good conscience if the deceased overpaid individual meets the criteria for against equity and good conscience.  If a distributee requests a waiver and we determine that the distributee is not at fault for the overpayment, we will find recovery from the distributee is against equity and good conscience if the distributee meets the criteria for against equity and good conscience.

For more information on evaluating fault when an estate or distributee requests waiver, refer to GN 02250.005.

For more information on closed estates, refer to GN 02215.070.  For more information on general recovery from an estate or distributee, refer to GN 02215.050, 02215.055, 02215.070.

Example 1:

Noah received SSI as a child. We determined that Noah was overpaid $3,000 due to deemed resources when they were still a child.  At that time, we notified Noah and Noah’s representative payee of the overpayment.  We recovered a portion of the overpayment by payment adjustment until Noah’s benefits ceased at age 18.  At age 19, Noah requested a waiver of the entire original overpayment.  We presume Noah is not at fault because Noah was a child and had a representative payee at the time of the overpayment and there was no evidence of fault.  We deem recovery of the remaining amount at the time that Noah turned 18 years old, as against equity and good conscience because Noah was a child with a representative payee when they were overpaid. We will waive only the portion of the outstanding overpayment while Noah was an adult.  We will not waive the overpayment amount that was recovered when Noah was a child as against equity and good conscience.

Example 2:

Keisha received child’s benefits. We determined that they were overpaid $4,000 at age 13 due to their parent’s wages. We notified Keisha and the representative payee of the overpayment.  Keisha is now an adult and receives benefits on the same record as a DAC. Keisha requested a waiver.  We presume that Keisha is not at fault because Keisha was a minor child and had a representative payee at the time of the overpayment. We deem recovery is against equity and good conscience under this provision because Keisha is now an adult. We will waive only the portion of the outstanding overpayment while Keisha was an adult.  We will not waive the overpayment amount that was recovered when Keisha was a child as against equity and good conscience.