Effective Dates: 10/18/2024 - Present Previous | Next

SI DAL02220.005 Documenting the SSI Overpayment - More than $35,000 (TN 3-10/2024)

A. Background

The Dallas Regional Office (RO) reviews overpayment determinations only when national instructions require RO concurrence.

Per SI 02220.005, the following overpayment determinations require concurrence by an RO reviewer on behalf of the Assistant Regional Commissioner for Management and Operations Support (ARC MOS) when the overpayment exceeds $35,000:

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    Waiver (Approved),

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    Unwilling to Repay,

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    Unable to Repay,

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    Uncollectible,

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    Erroneous,

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    Unable to Locate/ Out of Country,

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    Compromise Settlement, and

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    Incorrect Overpayment.

NOTE: When there is a compromise settlement offer for an overpayment exceeding $5,000 but less than $35,000, follow instructions in SI 02220.031.

Any determination to collect the overpayment (D-TAC, G-TAC or K-TAC) does not require RO concurrence. Any determination to deny the waiver does not require RO concurrence. Any determination to refer the overpayment to another agency (MJ, MO, MT, and MS-TAC) does not require RO concurrence.

B. Procedure before referral

Before referring a case to the RO for concurrence, please review the case to make certain that the overpayment was correctly determined and clearly identified. In many cases, overpayments exceeding $35,000 occur for the following reasons:

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    Statutory Benefit Continuation - When the claimant is overpaid due to statutory benefit continuation, check to make certain that no appeal is pending on the issue of the cessation. Per SI 02260.007, we do not send a notice or otherwise address an overpayment caused by statutory benefit continuation until the appeal period has expired and no appeal has been filed. Do not send these overpayments for review and resolution while an appeal is pending on the medical cessation;

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    Administrative Finality Issues - If a single overpayment spans a period of more than the 2-year period normally permitted by the rules of administrative finality, check to make certain that fraud or similar fault was developed. If there is no fraud or similar fault, it is likely that the amount of the overpayment was incorrectly determined. (See SI 04070.010.)

C. Procedure for referral

In all cases, Dallas FOs submitting overpayment decisions for RO concurrence must submit the following evidence:

1. Waiver decisions

For waiver approvals, fax the SSA-632 (Request for Waiver or Overpayment Recovery or Change in Repayment Rate), all appropriate proofs, development, documentation, and the completed Exhibit in SI DAL02220.005E, into the Evidence Portal.

Open a vHelp ticket with the Primary Topic: SSI, Subtopic: Overpayments - Decisions More than $35,000 (Regional) and request RO review and concurrence.

2. Discontinued collections decisions

For discontinued collections (B, M, Z, NT, and N-TACs), fax the completed Exhibit in SI DAL02220.005E into Evidence Portal.

Open a vHelp ticket with the Primary Topic: SSI, Subtopic: Overpayment - Decisions More than $35,000 (Regional) and request RO review and concurrence. The Exhibit should clearly outline the actions taken prior to the recommendation to discontinue collection.

3. Compromise settlement offers

Follow the procedures in SI 02220.031. Open a vHelp ticket with the Primary Topic: SSI, Subtopic: Overpayment - Decisions More than $35,000 (Regional) and request RO review and concurrence.

NOTE: Do not transmit the disposition in MSSICS prior to RO review and approval. These overpayments require the 2-PIN process in MSSICS. The RO input to approve the determination requires input on the same day as the input made by the FO. The SSI staff will contact the field office to coordinate the two inputs.

D. RO Action

1. RO unable to concur

If the RO reviewer is unable to concur with the proposed decision, the reviewer will notify the FO explaining the reason(s) for return or asking for additional information.

2. RO concurs with the request

The RO reviewer will complete a Report of Contact or SSA-5002 approving the request. The reviewer will notify the FO and request that an employee from the referring FO coordinate the necessary input. The FO should not make any systems input until the RO has made contact with the results of the review.

E. Exhibit

Exhibit Overpayment Requiring RO Concurrence

To Link to this section - Use this URL:
http://policy.ssa.gov/poms.nsf/lnx/0502220005DAL
SI DAL02220.005 - Documenting the SSI Overpayment - More than $35,000 (TN 3-10/2024) - 10/18/2024
Batch run: 10/18/2024
Rev:10/18/2024