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https://www.ecfr.gov/current/title-20/chapter-III/part-404/subpart-F/section-404.506
Submission: On April 24 via manual from US — Scanned from DE
Submission: On April 24 via manual from US — Scanned from DE
Form analysis 9 forms found in the DOM
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ECFR
THE ELECTRONIC CODE OF FEDERAL REGULATIONS
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TITLE 20
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1. Title 20 —Employees' Benefits
2. Chapter III —Social Security Administration
3. Part 404 —Federal Old-Age, Survivors and Disability Insurance (1950- )
4. Subpart F —Overpayments, Underpayments, Waiver of Adjustment or Recovery of
Overpayments, and Liability of a Certifying Officer
5. § 404.506
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URL https://www.ecfr.gov/current/title-20/part-404/section-404.506 Citation
20 CFR 404.506 Agency Social Security Administration
--------------------------------------------------------------------------------
Subpart F of Part 404
AUTHORITY:
Secs. 204, 205(a), 702(a)(5), and 1147 of the Social Security Act (42 U.S.C.
404, 405(a), 902(a)(5), and 1320b-17); 31 U.S.C. 3711; 31 U.S.C. 3716; 31
U.S.C. 3720A.
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ECFR CONTENT
The Code of Federal Regulations (CFR) is the official legal print publication
containing the codification of the general and permanent rules published in the
Federal Register by the departments and agencies of the Federal Government. The
Electronic Code of Federal Regulations (eCFR) is a continuously updated online
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Learn more about the eCFR, its status, and the editorial process.
§ 404.506 WHEN WAIVER MAY BE APPLIED AND HOW TO PROCESS THE REQUEST.
(a) Section 204(b) of the Act provides that there shall be no adjustment or
recovery in any case where an overpayment under title II has been made to an
individual who is without fault if adjustment or recovery would either defeat
the purpose of title II of the Act, or be against equity and good conscience.
(b) We will apply the procedures in this paragraph (b) when an individual
requests waiver of all or part of a qualifying overpayment.
(1) For purposes of this paragraph (b), a qualifying overpayment is one that
accrued during the pandemic period (see § 404.501(a)) because of the actions
that we took in response to the COVID-19 national public health emergency,
including the suspension of certain of our manual workloads that would have
processed actions identifying and stopping certain overpayments.
(2) Notwithstanding any other provision of this subpart, we will presume that an
individual who requests waiver of a qualifying overpayment is without fault in
causing the overpayment (see § 404.507) unless we determine that the qualifying
overpayment made to a beneficiary or a representative payee was the result of
fraud or similar fault or involved misuse of benefits by a representative payee
(see § 404.2041).
(3) If we determine under paragraph (b)(2) of this section that an individual or
a representative payee is without fault in causing a qualifying overpayment we
will also determine that recovery of the qualifying overpayment would be against
equity and good conscience. For purposes of this paragraph (b)(3) only, “against
equity and good conscience” is not limited to the meaning used in § 404.509 but
means a broad concept of fairness that takes into account all of the facts and
circumstances of the case.
(4) If we determine that a primary beneficiary is not without fault with respect
to a qualifying overpayment under paragraph (b)(2) of this section, because it
was caused by fraud or similar fault or because of representative payee misuse,
we may still find that any auxiliary beneficiaries on the primary beneficiary's
record are eligible for waiver of recovery of the qualifying overpayment under
this paragraph (b). If an auxiliary beneficiary requests waiver of a qualifying
overpayment in accordance with this paragraph (b), we will waive recovery of the
overpayment if the auxiliary beneficiary meets all of the requirements of this
paragraph (b).
(5) The provisions of this paragraph (b) will apply to a qualifying overpayment
identified by December 31, 2020.
(c) If an individual requests waiver of adjustment or recovery of a title II
overpayment within 30 days after receiving a notice of overpayment that contains
the information in § 404.502a, no adjustment or recovery action will be taken
until after the initial waiver determination is made. If the individual requests
waiver more than 30 days after receiving the notice of overpayment, SSA will
stop any adjustment or recovery actions until after the initial waiver
determination is made.
(d) When waiver is requested, the individual gives SSA information to support
his/her contention that he/she is without fault in causing the overpayment (see
§ 404.507) and that adjustment or recovery would either defeat the purpose of
title II of the Act (see § 404.508) or be against equity and good conscience
(see § 404.509). That information, along with supporting documentation, is
reviewed to determine if waiver can be approved. If waiver cannot be approved
after this review, the individual is notified in writing and given the dates,
times and place of the file review and personal conference; the procedure for
reviewing the claims file prior to the personal conference; the procedure for
seeking a change in the scheduled dates, times, and/or place; and all other
information necessary to fully inform the individual about the personal
conference. The file review is always scheduled at least 5 days before the
personal conference. We will offer to the individual the option of conducting
the personal conference face-to-face at a place we designate, by telephone, or
by video teleconference. The notice will advise the individual of the date and
time of the personal conference.
(e) At the file review, the individual and the individual's representative have
the right to review the claims file and applicable law and regulations with the
decisionmaker or another SSA representative who is prepared to answer questions.
We will provide copies of material related to the overpayment and/or waiver from
the claims file or pertinent sections of the law or regulations that are
requested by the individual or the individual's representative.
(f) At the personal conference, the individual is given the opportunity to:
(1) Appear personally, testify, cross-examine any witnesses, and make arguments;
(2) Be represented by an attorney or other representative (see § 404.1700),
although the individual must be present at the conference; and
(3) Submit documents for consideration by the decisionmaker.
(g) At the personal conference, the decisionmaker:
(1) Tells the individual that the decisionmaker was not previously involved in
the issue under review, that the waiver decision is solely the decisionmaker's,
and that the waiver decision is based only on the evidence or information
presented or reviewed at the conference;
(2) Ascertains the role and identity of everyone present;
(3) Indicates whether or not the individual reviewed the claims file;
(4) Explains the provisions of law and regulations applicable to the issue;
(5) Briefly summarizes the evidence already in file which will be considered;
(6) Ascertains from the individual whether the information presented is correct
and whether he/she fully understands it;
(7) Allows the individual and the individual's representative, if any, to
present the individual's case;
(8) Secures updated financial information and verification, if necessary;
(9) Allows each witness to present information and allows the individual and the
individual's representative to question each witness;
(10) Ascertains whether there is any further evidence to be presented;
(11) Reminds the individual of any evidence promised by the individual which has
not been presented;
(12) Lets the individual and the individual's representative, if any, present
any proposed summary or closing statement;
(13) Explains that a decision will be made and the individual will be notified
in writing; and
(14) Explains repayment options and further appeal rights in the event the
decision is adverse to the individual.
(h) SSA issues a written decision to the individual (and his/her representative,
if any) specifying the findings of fact and conclusions in support of the
decision to approve or deny waiver and advising of the individual's right to
appeal the decision. If waiver is denied, adjustment or recovery of the
overpayment begins even if the individual appeals.
(i) If it appears that the waiver cannot be approved, and the individual
declines a personal conference or fails to appear for a second scheduled
personal conference, a decision regarding the waiver will be made based on the
written evidence of record. Reconsideration is then the next step in the appeals
process (but see § 404.930(a)(7)).
[61 FR 56131, Oct. 31, 1996, as amended at 73 FR 1973, Jan. 11, 2008; 85 FR
52914, Aug. 27, 2020]
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