Social Security Webpage Revision List

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Revised 3/20/2018 Added:

Program Operations Manual System (POMS)

This is the manual that Social Security representatives use as a reference to make decisions.

Table of Contents

https://secure.ssa.gov/apps10/poms.nsf/partlist

This webpage is based on Program Operations Manual System (POMS). The difference is that this webpage gives pointers for better outcomes and helping everyone stay within the rules required for SSI payments.

Social Security Insurance Overpayment

The purpose of reviews by Social Security representatives is to root out fraud and make sure social security funds are distributed according to regulations. This should be the same objective of an SSI recipient. Key is intent to communicate with Social Security and to correct any missed information or any actual over payment.

How SSI Overpayments Can Happen

For recipients of SSI payments, all bank account balances must total no more than $2,000.00 with the exception of ABLE accounts. You cannot save for something as an explanation of why you went over $2,000.00. I have heard of examples of people saving for dental work. While I am not sure what the circumstances were, you may be able to pay in installments to the dentist.

One danger of going over the 2,000.00 dollar limit is when a person is hospitalized and your SSI payments no longer continue to go toward your housing. The SSI payments keep coming and even if you notify social security, it can take a while for them to adjust payments to a correct amount.

Another common danger of going over 2,000 dollar limit is uncleared checks. This is covered below.

To give you an example, your child is in a group home but is hospitalized for injury to self or others. This aggressive action has resulted in him being kicked out of the group home. I use kicked out because that is what it feels like for the parent, but the group home will use a more institutional word.

The action of leaving the group home results in SSI payments for room and board to stop and accumulate in the SSI recipient’s account. Depending on the length of stay in the hospital institution or until a new living situation can be found and/or when social security adjusts payment because of the new situation, it can accumulate greatly. This can lead to dilemmas of going over the $2,000.00 and keeping the overpayment so you can pay it back when social security asks for it or trying to stay below $2,000.00 by buying things the recipient can use.

This does not cover all possibilities of how SSI overpayment can happen.

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The Nuts and Bolts of Social Security Overpayment and Review by Social Security

Review of Financial Account(s) Information for Overpayment

Social Security must have written permission from you to access account information.

Social Security determines your account balance by the balance of all your accounts on the first day of a month. An SSI payment before the first of the month for that month is not included in the total of your account balance for that month to determine whether your account is below the $2,000.00 limit. An SSI payment can happen at the end of a month for the next month if the first day of the month falls on a holiday, Saturday or Sunday. If you get a statement from Social Security saying that your account(s) is over the $2,000.00 dollar limit and you owe Social Security, check and make sure that the calculation is correct because the above can be a mistake found in their calculations. This can be corrected in the review process with Social Security.

Uncleared checks can cause an account to go over the 2,000 dollar limit. An SSI recipient’s check registry can be used to determine that a check was written at such a date and along with a statement that proves the check cleared the account in a following month, this is enough proof to deduct that amount from the balance for determining actual available funds. “Since there is evidence that the claimant has written the check and legally obligated those funds in the account, and the records provide a complete and consistent picture of the account, the CR can deduct the amount of the uncashed check from the May 1st of the month balance. The CR can deduct the uncashed check because SSI equity value rules state that in determining equity value, we deduct encumbrances from the current market value (CMV).” This from the last entry in the operational manual linked below. There is further information on this webpage explaining the process of determining account balance.

Program Operations Manual System (POMS)

SI 01140.200 Checking and Savings Accounts

https://secure.ssa.gov/poms.nsf/lnx/0501140200

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Notifying and Communicating with Social Security

If you think your recipient’s account balance is going to go over the 2,000.00 dollar limit in the future it is better to notify Social Security as soon as possible and the reason why. Because a common reason for an accumulation of money in an account is a change of living circumstances, you can tell Social Security of the overpayment problem along with notify them of any change of address. Change of address of a Social Security recipient must happen as soon as you know of the change. If the account balance goes over the $2,000.00 beginning of the month limit (minus any SSI payment as explained in the above paragraph) you have 10 days to notify Social Security.

If your account goes over the 2,000 dollar limit because of an actual overpayment, it would be good to visit your local Social Security office with an actual check in hand for the overpayment. It is unlikely that the Social Security office will accept the payment at the office, but the attempt to correct the overpayment will be very beneficial to the SSI recipient under the review process.

The best way to notify Social Security is by phone or in person. The reason for this is that all calls or in person visits are noted as to what was discussed and time and date stamped. The payee, usually the mom of a person with intellectual or developmental disabilities, must make the call. There are two other ways of notifying Social Security, writing a letter and faxing. Both letter writing and faxing are not necessarily time stamped nor do they make it into an SSI recipient Social Security folder. Social Security document retention of communications from people who receive Social Security benefits is not that good.

Keep track of any communications with Social Security because if it is missing on the Social Security side you can show them your log and communications. During a review, you can ask to sign an affidavit stating how, when, and the content of the communication of the missing communication on the Social Security side. Even though calling or visiting Social Security is the best way to communicate with Social Security, it is good to follow up with a fax or letter where you retain a copy so that you can show it later.

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How to Engage with Social Security if you receive a Letter of Overpayment.

Read the letter and note the time period that the letter states an overpayment occurred and the amount. Gather documents for the time period. The chances are you know why and how the account(s) went over the 2,000 dollar limit. If you disagree with the fact stated in the letter, the letter will give you two ways of challenging the Social Security assessment. One is the “Request For Reconsideration” (Form SSA-561). The other is a “Waiver Of Recovery or Change Repayment Rate” (form SSA-632). You can ask for both. There is no harm.

Request For Waiver Of Overpayment Recovery Or Change In Repayment Rate Form SSA- 632

The intent of this form is for someone who knows that an overpayment has happened and is requesting a complete waiver of the collection of that overpayment or a change in the amount to be paid back each month. The change is requested because of hardship. Collection is done by a reduction in SSI payments.

A wavier of all the overpayment is unlikely to happen through this process. You will not get a reduction in the amount of overpayment to be collected. A wavier or reduction in the collection of overpayment can happen under the reconsideration process.

Request for Reconsideration Form SSA-561

This is the process where you appeal the original determination of overpayment. You can provide facts and documents that Social Security did not have in making their original determination. You can point out miscalculations like the SSI payment being included when it should have been excluded as explained previously.

There are three ways to appeal. While the “Case Review” may seem to be the easiest as you can mail in or fax documents and never visit the local social security office, it can actually consume more of your time and is the least likely to get a satisfactory determination if you have good justification that the overpayment is not your fault and that you have tried to remediate the overpayment.

The only real difference between an informal and formal conference is the ability to bring outside parties to support your case in a formal conference. Either way you will meet the person deciding your case. Having personal interaction with the person deciding your case can be beneficial if you remain calm and composed and your intent is to come to an equitable resolution. The Social Security representative meets many people who are less than calm, so being calm works in your favor.

Before an informal or formal conference takes place you have a chance to set up a meeting in which you get to see what documents Social Security has based their original decision on. You can ascertain any communication or documents that are missing. Often the person giving you the documents will be the person making the decision on your case. They probably did not make the original decision that Social Security overpayed SSI payment(s). You can talk to them about your case and ask questions. You can explain what information is missing by Social Security like communications or a check not cashed in a timely manner. You can ask them what they need from you to prove what you are saying is true. Be friendly and build up a relationship. This first meeting can make the second meeting go smoothly with a transfer of documents and missing information.

During the second meeting of a formal or informal conference, you will meet with the Social Security representative who will make the decision on the overpayment on your case. You can give them copies of missing communications and check registry if needed. If the communication was time sensitive and Social Security does not have a copy of the communication, you will be asked or can ask to sign an affidavit stating the date and time you sent the communications and a summary of what was contained in the communications. If part of the problem is a check written on a certain date, but not cashed until the following month, besides a copy of your check registry, also bring the actual check registry to show the representative. Again keep the meeting cordial and friendly, this will work in your favor.

The Social Security representative will not make the decision at the formal or informal conference. You will get a letter in the mail shortly thereafter stating the decision.

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The Perpetual Error That Social Security Calculations Make That Compounds Overpayment For Following Months.

Looking only at the beginning account balance of each month fails to look at the expenditures of the SSI recipient, if the overpayment had not been made or had been rectified earlier. Currently Social Security takes months to figure out SSI overpayment and calculates a lump sum, but if Social Security figured out the overpayment sooner, a recipient’s expenditures would reduce the beginning account balance more quickly.

So for example: With an account balance at the beginning of the month of $2,400. The SSI payment is $733.00 and the recipient’s expenditures for the month are $733.00. So an SSI payment is made in that month with a beginning account balance of $2,400 + $733.00 = $3,144.00 but the expenditures are subtracted $3,144 - $733.00= $2,400, and we are back to the original beginning balance this can go on perpetually as long as expenditures do not exceed $733.00 or Social Security stops paying for one month. If the above happens for 12 months, a recipient could owe 12 X $733.00= $8796.00 but they really do not owe that because that is not the true overpayment. Only the original first payment of $733 that put the account above $2000 is the overpayment. This becomes a big problem when an overpayment is held in order to pay back Social Security and waiting for Social Security to figure out an overpayment.

Furthermore, by saying a SSI recipient owes a lump sum after X number of months instead of looking at it as each month’s overpayment, you are actually penalizing them more than they are worth. To illustrate, take the above example for 6 months with an account balance at the beginning of the month of $2,400. The SSI payment is $733.00 and the recipient’s expenditures for the month are $733.00. The person would have an account balance of $2,400 for six months and on the six month they have an emergency expenditure of $500.00 which drops their account below $2,000. So lump sum they owe 6 months x $733.00 SSI= $4,398.00, but if $733.00 had been taken out each month and they still have to pay the fixed living expense of $733.00 each month, their account would be decimated to a negative $1,998.00. Overpayment is arbitrary to a good extent when Social Security is figuring out overpayment in lump sum and the X months of overpayment are determined to have stopped only when the beginning account balance goes below $2,000.00 or the time from reporting the overpayment by recipient and Social Security investigates and notifies. Thus poor people are penalized needlessly.

It is a “catch-22” situation for SSI recipients realizing their account will be over $2,000. Social Security will not take back the overpayment until they realize they have overpayed. An SSI recipient who holds onto the overpayment in their account will compound their overpayment problem. If they go out and spend the money on what they really do not need at the time to get below $2,000 in their account, they are out that frivolous spending amount and they will still owe the overpayment to SSI. This just makes them poorer often at no fault of their own.

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