TN 61 (11-24)

GN 02250.370 Waiver Approval Notice - Title II and Title XVI

CITATIONS:

Social Security Act §§ 204(b), 1631(b)(1)(B), 1631(b)(4)

20 C.F.R. §§ 404.506, 404.904, 416.551, 416.556, 416.558, 416.1404

A. Introduction

We must send notice of the waiver determination to the overpaid individual, their representative payee, and their representative or legal guardian, if applicable. If an estate or distributee requested the waiver, we must send our waiver determination to the legal representative of the estate or the distributee,

For more information on who receives notices, refer to NL 10601.210 and NL 00801.001B.3.

For instructions on who is considered a representative, refer to GN 03910.020. For instructions on contacting a representative, refer to GN 03910.050

We must send a waiver approval notice if we approve the individual’s waiver request. We will waive recovery of an overpayment if: 

  • The individual is not at fault in causing the overpayment, AND

  • Recovery or adjustment:

    • impedes effective or efficient administration of the Social Security Act (administrative tolerance), refer to GN 02250.350; or

    • is deemed to defeat the purpose of the Act, refer to GN 02250.110, or

    • is against equity and good conscience, refer to GN 02250.150; or

    • defeats the purpose of the Act, refer to GN 02250.100.

We will also waive recovery of a Title XVI overpayment if the overpayment was due to the individual’s resources exceeding the limit by $50 or less, unless the individual willfully and knowingly failed to report the value of the excess resources correctly and in a timely manner, refer to GN 02250.090.

B. Policy

When we approve a waiver request, we relieve the individual from the obligation to repay the overpayment. We must send a waiver approval notice. The waiver approval notice must include:

  • That we approved the individual’s waiver request;

  • The overpayment amount;

  • The reasons that we approved the waiver request, which includes finding the individual not at fault and a determination that the individual meets one of the other waiver provisions (e.g., cannot pay their bills or paying us back would be unfair for some other reason);

  • That the individual does not have to repay the overpayment;

  • We will resume the individual’s benefits or payments, if applicable;

  • We will refund any benefits or payments that we withheld or recovered while the waiver determination was pending, if applicable. For more information on refunding monies after a waiver approval, refer to GN 02250.310; and

  • The appropriate appeal language. To determine the correct level of appeal, refer to GN 02250.380.

C. Title II procedures

Use the “Waiver Approval” notice located in the Overpayment section in the Document Processing System (DPS). Prepare and issue the notice with the appropriate appeal language.

Modify the approval notice to include language if we resume Title II benefits. Refund any Title II benefits that we previously withheld or recovered from the individual, if applicable.

Send the notice to the overpaid individual, their representative payee, and their representative or legal guardian, if applicable. If the overpaid individual has a legal guardian that is not their payee, send a manual notice to the legal guardian, if we have the legal guardian’s information. 

Store all waiver notices in the Online Retrieval System (ORS).

D. Title XVI procedures

When you approve a waiver request and input the determination, the system sends an SSA-L8166 to the individual and their representative payee.  The SSA-L8166 includes the title “Our Decision On Your Waiver Request.” For more information on who receives an SSI automated notice, refer to NL 00801.001B.3.

NOTE:When you approve a waiver request and input the determination, the system sends an SSA-L8166 to the individual and their representative payee.  The SSA-L8166 includes the title “Our Decision On Your Waiver Request.” For more information on who receives an SSI automated notice, refer to NL 00801.001B.3.

If you issue a manual waiver approval notice, use the “Waiver Approval” notice located in the overpayment section in the DPS.  Prepare and issue the notice, including appeal rights.  For more information on appealing a waiver, refer to GN 02250.380. Store all waiver notices in ORS. For more information about Title XVI manually prepared notices, refer to NL 00801.010.


To Link to this section - Use this URL:
http://policy.ssa.gov/poms.nsf/lnx/0202250370
GN 02250.370 - Waiver Approval Notice - Title II and Title XVI - 11/22/2024
Batch run: 11/22/2024
Rev:11/22/2024