When is a Payment Improper?
The Social Security Administration (SSA) takes very seriously its responsibility to reduce instances of improper payments. The SSA will deem payment improper if any payment results from an individual’s failure to report an event, an individual’s intentional false reporting of an event, or an individual’s failure to act on available information affecting the payment. Basically, if you fail to inform or update the SSA with pertinent information about your earnings, the SSA may deem any payment based off the inaccurate earning information as improper. You may be responsible for paying back any portion of an improper payment. If you are unable to afford the repayment of the improper payment, you may submit form SSA-632 and request that the repayment be waived.
When can Repayment of an Improper Payment be Waived?
42 C.F.R. § 404(b)(1) specifically states “in any case in which more than the correct amount of payment has been made, there shall be no adjustment of payments to, or recovery by the United States from, any person who is without fault if such adjustment or recovery would defeat the purpose of this subchapter or would be against equity and good conscience.” This means an individual is eligible to waive the repayment on any improper payment if the individual is without fault and recovery would defeat the purpose of receiving benefits or would be against equity and good conscience.
Who is “Without Fault?”
While there are many technical ways the SSA may find an individual without fault, an individual is generally found to be without fault where they acted under an honest, reasonable, and good faith misunderstanding of the SSA rules. An individual accused of receiving improper payments must demonstrate unusual or unavoidable circumstances that led the individual to be unaware that they broke one of the SSA rules. The SSA will evaluate this standard on a person-to-person basis, so it is most beneficial to file form SSA-632 and explain in full detail why the individual is without fault in receiving the improper payment.
When does Recovery of an Improper Payment “Defeat the Purpose?”
The overarching purpose of the Social Security Act is to provide aid to those individuals with any mental or physical impairment that prevents them from making a substantial living. Recovery of an improper payment would defeat the purpose of the Social Security Act in situations where the individual receiving benefits needs all of their current earnings to provide for their ordinary and necessary living expenses. An individual must prove they are unable to repay the overpayment and needs every penny of their income to pay for their necessary living expenses.
When does Recovery of an Improper Payment go “Against Equity and Good Conscience?”
Recovery of an improper payment would be against equity and good conscience if an individual changed their position for the worse on the good faith reliance that their benefit payments would continue. This means recovery of an improper payment would be against equity and good conscience when an individual makes substantial life changes on the reliance that benefit payments will continue. The individual must show that they are in a worse position than prior to receiving payments, and the change of position was done in the honest belief that the individual would continue to receive payments.
Do You Need Legal Advice from an Experienced Social Security Attorney?
It can be a challenge to navigate the SSA rules and regulations, but you don’t have to go at it alone. When dealing with such circumstances, it is to your advantage to seek legal advice from a skilled social security attorney. With such an advocate in your corner, you will push toward a positive outcome for your legal case.
Whitcomb, Selinsky, McAuliffe, PC has demonstrated skill and experience dealing with SSDI, SSI, and related matters. If you need legal advice, please do not hesitate to contact us for assistance. You can reach the attorneys at Whitcomb, Selinsky, McAuliffe, PC by phone at 866-476-4558 (toll free) and 303-534-1958 (toll) or online by completing a simple form on our website.
Tags: Social Security Law