POMS Reference

GN 02201: General Information Title II, Title XVI, and Title XVIII Overpayments - Part I

TN 35 (10-17)

Once we have made an overpayment determination, there might be a change to the individual’s record that requires us to recalculate the overpayment amount.

A. Additional benefit payments are due through the overpayment period

When we determine that additional benefit payments are due for months included in an overpayment period, we must recalculate the overpayment balance and update the individual’s record. Although the last month of the retroactive period remains the same, the first month of the overpayment period may change. For example, we might change the date of entitlement to an earlier date.

B. Overpayment status

Recalculating the overpayment amount is necessary regardless of current overpayment status (e.g., we affirmed the overpayment determination on appeal, we approved a request for waiver, recovery is in progress, etc.).

If we waived recovery for only a part of an overpayment, you must credit any additional benefits due first against that part of the overpayment that we did not waive and is still outstanding. For more information regarding an adjustment of an underpayment when a waiver is involved, see GN 02210.006.2.

C. Additional benefit payments due outside of the overpayment period

If additional benefits are due for months outside of the overpayment period, follow the instructions in GN 02210.006.2.

D. Examples of refiguring an overpayment

1. EXAMPLE 1

On April 10, 2008, we determined that Glenn Brown is overpaid $1,260 based on his 2007 annual report of earnings. We suspended his benefits from January 2008 through February 2008 because of his 2008 work and estimated earnings. His estimate for 2008 required no change in the 2008 suspension.

When Mr. Brown received his overpayment notice in April 2008, he did not protest the overpayment or its recovery. Beginning June 2008, we withheld his benefits to recover the overpayment. In July 2008, Mr. Brown revised his estimate of 2008 earnings. We determine that he is due $620 for January 2008 through February 2008 based on the revised estimate.

The additional benefits are due for months before the ending month of the retroactive period, which is April 2008, the month we made the overpayment determination and sent the notice. We use the additional money to recalculate Mr. Brown's overpayment and he is now overpaid $640 ($1,260 minus $620 equals $640). We send Mr. Brown a notice explaining the action(s) we took and his new overpayment amount that we continue to withhold from his benefits.

2. EXAMPLE 2

We last paid Bert Abdi disability benefits August 2008. On November 3, 2008, we determined and notified Mr. Abdi that he is overpaid $11,388 based on an April 2005 cessation of his disability benefits. We no longer considered Mr. Abdi disabled and we should have terminated his benefits effective April 2005.

On November 15, 2008, Mr. Abdi files an application for retirement benefits and requests waiver for his overpayment. Before we make the waiver determination, we determine that Mr. Abdi is entitled to a retirement benefit of $381 effective June 2008. Mr. Abdi is due $1,905 in retirement benefits for June 2008 through October 2008, the ending month of the retroactive period (i.e., October 2008, the month before we made the overpayment determination and sent the notice). We use the additional money to recalculate Mr. Abdi’s overpayment. His adjusted overpayment amount is $9,483 ($11,388 minus $1,905 equals $9,483). This is the amount we consider when we make our waiver determination.

3. EXAMPLE 3

Bella Bloom did not receive mother's benefits March 2009 through June 2009 because she did not have a child in care. We begin paying her benefits in July 2009.

On February 16, 2010, we notified Mrs. Bloom that she is overpaid $426 because she did not have a child-in-care from September 2009 through November 2009. She appeals the determination. On reconsideration, we establish child-in-care not only for December 2009, but also for June 2009. Mrs. Bloom is now due payments totaling $284 for June 2009 and December 2009 ($142 per month) which we use to adjust her overpayment amount to $142 ($426 minus $284 equals $142).

4. EXAMPLE 4

On December 13, 2009, we notified Ed Michaels that he is overpaid $1,890 in disabled child's benefits because his we should have terminated his benefits due to his June 2009 marriage. In light of Mr. Michaels’ waiver request, we waived recovery of $630 of his $1,890 overpayment. His overpayment balance is now $1,260.

On June 20, 2010, an Automatic Earnings Reappraisal Operation (AERO) adjustment results in a $2 increase per month effective January 2009. We credit the additional $10 due Mr. Michaels for January 2009 through May 2009 against the overpayment totaling $1,890. We notify Mr. Michaels about the recomputation of his original overpayment, which is now $1,880. We credit the additional $10 against the remaining balance of $1,260 that we did not waive. Mr. Michaels’ overpayment balance is now $1,250. The $630 that we waived earlier remains unchanged.