POMS Reference

GN 02250: Waiver Provisions for Title II and Title XVIII Overpayments

TN 15 (08-99)

Policy

A person must be notified of the decision made on his/her request for waiver. Store all personal conference notices in the Online Retrieval System (ORS)

1. Waiver Approved

Notice of a waiver approval must include:

  1. The fact that waiver was approved and repayment is not needed.

  2. Information about resumption of benefits or repayment of benefits withheld, if benefits were suspended or withheld.

  3. Appropriate appeal paragraph. If waiver was approved without a personal conference, use the reconsideration paragraph. If waiver was approved after personal conference, use the hearing paragraph. If combined waiver/ reconsideration case, use the hearing paragraph. Use the “Waiver Approval Letter” in DPS for this purpose.

2. Waiver Not Approved

Notice that waiver cannot be approved or is only partially approved must include:

  1. The reason waiver cannot be approved, including the basis for all findings regarding fault, ability to repay and/or equity as long as they are consistent with and support the waiver determination. For example, if the person is at fault but cannot afford to repay, the notice should not discuss defeat the purpose.

  2. The appropriate statutory and regulatory basis for the determination. (For title II, section 204(a) and (b) of the Act and sections 404.506 - 404.512 of SSA Regulations No. 4.

  3. A request for refund or information about withholding and the reconsideration or hearing paragraph. To determine the correct appeal level, see GN 02250.380. Use the “Waiver Denial”, “Partial Waiver Approval”, or “Personal Conference (Waiver allowed/denied)” as appropriate.

3. Combined Waiver/Reconsideration

If reconsideration affirms the overpayment determination in whole or in part and waiver cannot be approved, the notice must include:

  1. An SSA-662 explaining the reason for affirmation.

  2. The fact that waiver cannot be approved.

  3. A statement that the person will be contacted for scheduling a personal conference and that recovery will not begin until after the personal conference.

  4. The appropriate statutory and regulatory basis for the waiver determination. Use “Reconsideration and Waiver Denial” or the “Waiver Approval Letter” referred in 1.c., as appropriate.

    NOTE: Do not address recovery or include the hearing paragraph.