SI CHI02220.005 Mandatory Review of Certain Title XVI Overpayment Dispositions (RTN - 11/2022)

See SI 02220.005

A. Background

The Chicago Regional Office (RO) reviews overpayment determinations only when national instructions require RO concurrence. Certain non-collect overpayment determinations require concurrence from the Assistant Regional Commissioner for Management and Operations Support (ARC-MOS):

1. Compromise settlement offers greater than $5,000 and less than $20,000

A compromise settlement is when an individual offers to repay the government a lesser amount than the total debt amount owed. If the Government accepts the offer, a portion of an overpayment is deemed uncollectible (NY TAC) as negotiated in the settlement agreement. See instructions in SI 02220.030 SSI Overpayment – Compromise Settlement, SI 02220.031 SSI Overpayment – Processing of Compromise Offers, and SM 01311.290 Compromise Settlement – Y TAC.

2. Non-collect determinations for overpayments over $20,000

Common non-collect disposition decisions for overpayments over $20,000 include:

  • Waiver approvals

  • Unwilling to repay (DB TAC)

  • Unable to repay (DC TAC)

  • Unable to locate/individual is out of the country (DM TAC)

  • Uncollectible overpayment (N TAC)

  • Erroneous systems computed overpayments (NT TAC)

  • Incorrect overpayment on an uncorrectable record (Z TAC)

B. Pre-RO referral procedure

When technicians refer a case for concurrence to the ARC-MOS, the technician and a member of management must ensure the following issues are addressed:

1. Administrative finality issues

Ensure the overpayment amount and period is correct. If a single overpayment sequence exceeds the two-year period administrative finality limit, and there is no indication of fraud or similar fault, it is likely that the amount of the overpayment was incorrectly determined. This could result in the correct overpayment being less than $20,000 and ultimately not requiring RO concurrence. Refer to SI 04070.000 Administrative Finality – SSI.

2. Uncollectible debts due to death

Follow instructions in SI 02220.053 Suspension and Termination of Supplemental Security Income (SSI) Overpayment Recovery Efforts for a Deceased Individual, and SI 02220.045 Supplemental Security Income (SSI) Overpayment Recovery from an Estate.

3. Waiver Cases

  1. a. 

    Ensure all fields on the SSA-632-BK are fully and properly completed per instructions in SI 02260.005 Completing the SSA-632-BK (Request for Waiver of Overpayment Recovery).

  2. b. 

    Ensure the information in Sections 5-11 of the SSA-632-BK reflects the current income and expenses of the liable overpaid individual(s), where required. Additionally, per SI 02260.005B.3, if the overpaid person is no longer receiving SSI or other needs based income, they are responsible for providing proof of all income and certain expenses and assets per GN 02250.255 Documents to Support a Request for Waiver of Overpayment Recovery. Expenses not requiring proof are food and miscellaneous household expenses, unless the expenses seem unusually high.

  3. c. 

    Waivers filed after March 1, 2016, where the disposition finds that recovery of the overpayment defeats the purpose of Title XVI of the Act (SI 02260.020), must include Access to Financial Institution (AFI) responses in the file as required by Section 834 of The Bipartisan Budget Act of 2015.

4. Overpayments due to statutory benefit continuation (SBC) payments while appealing a medical cessation decision

  1. a. 

    Fault determination is based on whether or not the claimant appealed in good faith and complied with all levels of the appeals process. See SI 02260.007 Waiver Procedures for Disability Cessation Cases.

  2. b. 

    Ensure no appeal is pending, and the appeal period has been exhausted.

  3. c. 

    The SSA-632-BK must not be completed until all appeal periods have been exhausted. Send a notice of dismissal for any waiver request received during the appeal period. See GN 02250.305 When a Waiver Determination Will Not Be Made.

  4. d. 

    Ensure the Notice of Overpayment was issued after the appeal period was exhausted. If the notice was issued pre-maturely, a revised notice should be issued with the appropriate paragraph advising this notice revises previously issued notice dated XX/XX/XXXX. Additionally, the technician should update the SSR with the revised notice date.

C. Development and documentation

Ensure all necessary evidence used to make the overpayment determination is present in the electronic file. It is imperative that all supporting documentation is faxed into the electronic file prior to emailing a request for concurrence to the RO. Necessary evidence that is not present in the electronic file will result in evidence requests from the SSI Policy Team via email or non-concurrence. Control the request by adding an issue on the Development Worksheet (DW01).

A member of management may email the RSI/SSI Policy Team's mailbox, CHI.ARC.MOS.CRSI.SSI@ssa.gov, alerting the RO of the case requiring review. The email must include:

  • Claimant name;

  • Claimant SSN; and

  • Attach the completed Chicago Region SSI Overpayment Approval Request coversheet on the SSI Policy Team Website.

D. RO Action

The RO SSI policy team reviews requests in the order they are received. Within 2 business days of receipt, RO will email confirmation to the Field Office (FO) mailbox. Any cases returned without concurrence and resubmitted by the FO for further review, will be addressed in the order received as a new case.

1. RO non-concurrence

If the RO reviewer is unable to concur with the proposed decision, the reviewer will notify the FO via email with a written explanation for non-concurrence.

For cases requiring additional development and/or a personal conference, the FO mailbox will be notifed via email and include detailed feedback explaining why the case does not comply with POMS. If the FO fails to provide requested information in the prescribed time period, the case will be returned with written feedback.

2. RO concurrence

The RO reviewer will notify the FO via email with instructions on completing the two-pin process and coordinate the necessary input.

E. Exhibit

The Chicago Region SSI Overpayment Approval Request form is available in a word document under “Overpayments” on the Chicago SSI Policy Team website.


To Link to this section - Use this URL:
http://policy.ssa.gov/poms.nsf/lnx/0502220005CHI
SI CHI02220.005 - Mandatory Review of Certain Title XVI Overpayment Dispositions (RTN - 11/2022) - 10/05/2022
Batch run: 01/23/2024
Rev:10/05/2022