SSA May Waive Overpayments Resulting From Appeals of Benefit Termination
Persons receiving disability benefits are sometimes reviewed by the Administration to determine whether the medical conditions causing disability have improved. Where the Administration finds sufficient evidence of medical improvement, benefits are terminated.
Persons whose benefits are terminated can file appeals of that termination. If they appeal within 10 days of the termination, they may request that their benefits continue to be paid while their appeals are pending. See 20 C.F.R. ' 404.1597a(f)(1) and 20 C.F.R. ' 416.996(a). If those appeals ultimately fail, the benefits paid in the interim are considered an "overpayment" which the Administration is normally entitled to recover.
Social Security regulations, however, permit persons in this situation to request waiver of the overpayment recovery. See 20 C.F.R. ' 404.1597a(j)(1) and 20 C.F.R. ' 416.996(g)(1).
In order for such a requested waiver to be approved, the person requesting the waiver must be found to be "without fault" in the creation of the overpayment. The regulations provide that persons whose overpayments are the result of a request for continued benefit payment while appeals are pending will be found "without fault" if the appeals were filed in"good faith" See 20 C.F.R. ' 404.1597a(j)(3) and 20 C.F.R. ' 416.996(g)(2).
Furthermore, those regulations require the Administration to assume the appeals were filed in good faith unless the individual failed to cooperate during the appeals process. Such failure to cooperate is established, for example, where the individual failed without sufficient explanation to attend a Consultative Examination.
Many persons whose benefits have been terminated fail to request that benefits be paid during the pendency of their appeals. Often this can be attributed to fear - the fear of becoming obligated to repay thousands of dollars as a result of an arbitrary unfavorable determination. The Social Security regulations governing these situations can, if known, help to alleviate those fears.
