9.1 Overpayments Flashcards
What is an overpayment in the context of SSA benefits?
Answer: “An overpayment occurs when a beneficiary receives more benefits than they are entitled to under SSA rules.”
Explanation: “Overpayments can result from changes in income, resources, or medical conditions that are not timely reported to SSA.”
Source: CFR §404.501.
What options do beneficiaries have to resolve an overpayment?
Answer:
“1. Repayment of the overpaid amount.”
“2. Request for a waiver of the overpayment.”
“3. Request for reconsideration of the overpayment decision.”
Explanation: “Beneficiaries may argue they were not at fault or that repayment would cause financial hardship.”
Source: CFR §404.506
What is the deadline to request a waiver or reconsideration of an overpayment?
Answer: “Beneficiaries must request a waiver or reconsideration within 60 days of receiving the overpayment notice.”
Explanation: “Timely action is critical to prevent enforced collection efforts by SSA.”
Case Scenario: Mary receives SSI benefits but fails to report an increase in her income from a part-time job. SSA determines that she was overpaid $1,200 over three months and sends her an overpayment notice.
Question: What are Mary’s options to resolve the overpayment?
Answer: Mary has three options:
Repay the $1,200.
Request a waiver of the overpayment.
Request reconsideration of the overpayment determination.
Legal Explanation: SSA allows beneficiaries to challenge overpayment determinations by requesting reconsideration or seeking a waiver if they were not at fault and repayment would cause financial hardship.
Key Resource: CFR §404.506 – Rules for overpayment waivers.
Key Takeaway: Beneficiaries can resolve overpayments through repayment, waiver requests, or appeals if they believe the determination was incorrect.
Case Scenario: Alex receives an overpayment notice but believes SSA made a mistake. He requests reconsideration within 60 days of the notice date.
Question: Does Alex’s reconsideration request protect him from repayment while SSA processes the appeal?
Answer: Yes, SSA typically suspends collection efforts while a timely reconsideration request is pending.
Legal Explanation: A timely appeal halts recovery actions until the reconsideration is resolved. Beneficiaries must act within the 60-day deadline to preserve this right.
Key Resource: CFR §404.907 – Timely reconsideration and suspension of collection efforts.
Key Takeaway: Timely appeals of overpayment determinations can suspend collection efforts during the appeals process.
Overpayments:
Beneficiaries can resolve overpayments by repayment, requesting waivers, or appealing determinations.
