When we cannot approve the individual's waiver request after our initial review, we
must provide the individual the opportunity for a file review and personal conference.
At the file review, the individual has the opportunity to review all overpayment-related
evidence in the claims file and the evidence we used to determine that we could not
approve the individual's waiver request. The purpose of the personal conference is
to give the individual the opportunity to appeal personally, to testify, and to provide
additional evidence and arguments to support their waiver request.
We must send a notice to the overpaid individual that includes:
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The fact that we cannot approve the waiver based on the information we have;
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The dates, times, and location of the file review and personal conference. The date
of the personal conference must be at least five workdays after the date of the file
review. Refer to GN 02270.007F for an exception;
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The procedure for reviewing the claims file prior to the personal conference;
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The option to conduct the personal conference in the field office (FO), by telephone,
or by video teleconference. We inform the individual that if they elect to conduct
the personal conference by video teleconference, they will designate the location
for their end of the video teleconference;
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All other information necessary to fully inform the individual about the personal
conference, including their right to be represented, present evidence, or bring witnesses
to question.
Do not include this information in the notice:
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Appeal rights (because you have not made an initial determination on the waiver request);
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Overpayment recovery options (e.g., refund request or payment adjustment).
NOTE: If the overpaid individual's address is outside the United States, refer to GN 02215.010.
If the individual cannot come to the originally designated FO for a legitimate reason
(e.g., the individual is incapacitated) and they are unable to appear meaningfully
by telephone or video teleconference (e.g., the individual is hard of hearing ) the
decisionmaker will make arrangements to travel as far as necessary to conduct the
conference.
When an individual requests a face-to-face personal conference and the decisionmaker
is from a FO other than the individual's servicing FO, the manager may arrange for
an employee from another office to travel to the individual's servicing FO. For more
information on who may be a personal conference decisionmaker, refer to GN 02270.003C.
After we schedule the file review and personal conference, the individual may choose
to decline to attend the personal conference, or they may fail to appear at the personal
conference. If the individual declines a personal conference, we will make a waiver
determination based on the information in the file. If the individual does not appear
for the scheduled personal conference, reschedule the personal conference. If the
individual fails to appear for a second scheduled personal conference, we will make
a waiver determination based on the information in the file, refer to GN 02270.007G.1.
NOTE: We will also make a waiver determination based on the information in the file if the
individual is unable to come to the FO or participate in a telephone or video teleconference
and the decisionmaker is unable to go to the individual's location (e.g., the individual
is incarcerated and the facility does not allow any outside communication).