If we cannot approve the individual's waiver request after our initial review, we must offer the individual an opportunity to review their fie and present their case at a personal conference with an independent decisionmaker. This section provides guidance on:

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  When in the waiver process, we must provide an individual an opportunity for a file review and a personal conference;

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  Who may be a personal conference decisionmaker; and

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  Procedures to follow prior to scheduling a personal conference.

  For information on scheduling a file review and personal conference, refer to GN 02270.007.

When an individual requests a waiver, we review the information that the individual, their representative payee, or their attorney or other representative gives to us to support the individual's waiver request. If we cannot approve the waiver after our initial review, we must offer the individual an opportunity to review their case file and appear at a personal conference with an independent decisionmaker.

The independent decisionmaker must be a neutral party who independently reviews the case. A technician who participated in the initial waiver review and made the preliminary recommendation not to approve the waiver cannot be the personal conference decisionmaker.

For more information on who may be a personal conference decisionmaker, refer to GN 02270.003C.

We must notify the individual in writing of our proposal to deny the waiver request and schedule a file review and personal conference. We cannot take any recovery actions until the individual has had an opportunity for a personal conference.

For more information on scheduling the file review and personal conference, refer to GN 02270.007

If you are unable to locate the pertinent overpayment documents in the Evidence Portal, or from the IRG, request the paper folder using instructions in GN 03340.010B.1.

Prior to scheduling the file review and personal conference, the decisionmaker must complete these actions. The FO must request any paper claim files. The decisionmaker must gather the paper and all electronic claim files for overpayment and waiver information and any information the prior technician considered during the initial review and preliminary recommendation to propose the waiver denial. Query the Evidence Portal (EP) and review the paper claim files for information such as:

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  Form SSA-632, Request for Waiver of Overpayment;

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  Information about the proposed waiver denial;

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  Pay stubs or proof of income;

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  Resource information;

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  Other evidence about the overpayment, etc.; and

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  Any other evidence the decisionmaker might use to inform the waiver decision.

This information must be presented to the individual at the file review and personal conference, refer to GN 02270.013.

For Title II cases, if you have questions about information in the file, contact the jurisdictional processing center (PC) via a Modernized Development Worksheet (MDW).

Example 1:

Tammy is a Title II technician in Miami, Florida. Tammy processed a continuing disability review and determined that Jasmine was overpaid due to engaging in substantial gainful activity during the extended period of eligibility. We sent Jasmine an overpayment notice and they requested a waiver. Tammy did not participate in the initial review that led to the proposed waiver denial; therefore, they can be an independent decisionmaker for the personal conference.

Example 2:

Karen is a Title XVI technician in Los Angeles, California. As part of a scheduled redetermination, Karen verified Sonya's earned income. The income verification revealed that Sonya earned more than we estimated. When we input the verified wages, the system computed an overpayment. We sent Sonya an overpayment notice, and they requested a waiver. Karen did not participate in the initial review to deny the waiver; therefore, they can be an independent decisionmaker for the personal conference.