Sixty Minutes did a piece yesterday on overpayments at Social Security. The written description indicates that it gave a good description of the plight of those overpaid but gave little or no attention to the underlying problems -- the overpayment rules created by Congress are brutal and complicated, the agency is critically understaffed, and the claimants can't afford to hire attorneys. And, no, legal aid isn't the answer. They're also critically underfunded.
Back in the dark ages when I was a CR (Pre-Regan), I was sat down and "against equity and good conscience" was "explained" to me because I apparently thought it meant what it said when indeed it did not. It was conditional on ability to repay, I was told. I seem to recall the OIG doing studies on waivers that they thought were wrong because of a too liberal interpretation of this, those should still be available and provide some longitudinal insight into institutional views of OPs and the waiver process.
ReplyDeleteFortunately I never got that training, or heard that explanation, and I am able to address overpayments based on the plain English meaning of the words and the legal regulations that apply.
ReplyDeleteI have returned cases to the DO to invite them to provide the evidence they relied upon in concluding there has been an overpayment. If that evidence missing, or conclusory, or incomplete or misinterpreted, then the overpayment is often without foundation, and equity and good conscience often prohibit prosecution.
I am not liberal. I strive to be fair. Those things should not be mutually exclusive.
When you are dealing with overpayments over $20,000.00, they aren’t decided at the FO level. Those have to be approved outside the local area.
ReplyDeleteI just recently had one that was rejected back to me. I attempted to use the “against equity and good conscience”.
It’s a long story, but at the end of the day, it’s for a minor child and the current payee was no the payee that was on the record when the OP occurred.
I was told not good enough. Guess they’ll be paying that one back.
ReplyDeleteThere's little to no money in it for an attorney to represent someone before SSA for an overpayment issue.
Nothing withheld by the agency for the attorney fee, and good luck trying to get a fee authorized and paid through the fee petition process. Difficult to make a living that way.
I don’t fault 60 minutes for this story. And the Agency should have had Kilolo go on to show some accountability. But this is misguided investigative journalism. Why are there so many overpayments? Congress pushes SSA to do millions of excess RZs and CDRs which directly result in overpayments. The solution? Fund the Agency to focus on the bread and butter (initial claims, phones, answering mail). Let’s stop the insanity.
ReplyDelete322pm spot on and no discussion of this
ReplyDeletethe system is set up so claimants with an overpayment CANNOT get representation (same for cessation cases)
you should always assume these cases are being done Pro Bono
I did an "overpayment" case pro bono based on a WC offset
The calculation was clearly wrong
I did multiple hearings and even the ALJ said I think you are correct but I dont understand and I will send it back to the payment center
In the end the client finally gave up...
“The client finally gave up.”
DeleteDing, ding, ding! That’s the hope, in all processes.
240pm - As a former Operations Supervisor (the Great Resignation took me to much greener pastures) who gave many overpayment liability trainings, you can make a determination that the claimant and the current payee are not liable for the overpayment because the overpayment occurred under the former payee. Then, you make a determination that the prior payee is liable for the overpayment that occurred while the prior payee was representing the claimant. If the prior payee is receiving benefits, a request needs to be made (if not SSI) to add the overpayment to the payee’s current record. If the prior payee is not receiving benefits, a request can be made so that when the prior payee is eligible to receive benefits, the overpayment will be on the MBR already. This is where these cases get tricky because it’s not a waiver issue, it’s a liability issue and there are separate POMS instructions on how to handle. Which, you know, everyone has time to read through on an average SSA workday. Hopefully this helps the minor child beneficiary who was affected.
ReplyDeleteYou’re correct and all of that takes time that they don’t give me. I have an alpha that spans 13 letters of the alphabet since the pandemic and all the retiring and resignations.
DeleteThat decision from higher up was pre-pandemic. I have yet to get back to that case. Currently it’s just sitting with a no collect diary attached.
6:29, the "ALJ said I think you are right but I don't understand..."
ReplyDeleteUnconscionable. It is the ALJ's responsibility to protect the claimant's due process rights, and that is simply impossible if you do not understand what you are looking at.
An ALJ who does not understand what they are looking at in a case cannot adjudicate it fairly. Go ahead - disabuse me of this conviction.
Signed, with love from one who spends as much time as necessary getting to the point where I understand the law and issues to make a full fair and reportable decision.
2:40 - citations, please? This looks incredibly useful.
ReplyDeleteThank you.
It is correct that very few practicing attorneys will take OP cases. However, it is a ripe area for law school clinics or some retired attorneys who want to give back OR a combination of the two.
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ReplyDeleteIt is almost impossible to find time to read complex and lengthy POMS instructions, while I am processing overpayment or workers' compensation cases. The workload demands that we move on to the next case. Ideally SSA management would give us enough time to work cases and read procedure during the workday.
Sometimes I access POMS on the SSA website at night, to read the procedure. . To figure out what to do on a case I'm in the middle of, the next day.
And even if you had time to read POMS, you’d still be stuck contending with the numerous instances where POMS is totally at odds with the actual law. There’s a good reason magistrate judges often jokingly say that the SSA is representing itself ‘pro se’ when working these cases up in chambers.
Delete@2:04
ReplyDelete"Ideally SSA management would give us enough time to work cases and read procedure during the workday." LOL
But if you have time to actually DO the work...
How are we going to get our phone answer rate down if we don't shove you on phones every free moment you have!!
How are we going to get our lobby customer average time down if we don't shove you on a reception window every free moment you have!!
How are we going to get our initial claims time for scheduling down if you don't have 6-7 claims to take from 9-4!!
Stop thinking like a regular employee and start thinking of the poor managers trying to meet THEIR metrics!!! How will they ever get promoted if they don't!!
Or their generous bonuses/awards.
DeleteFor SSI Overpayments, liability determinations and guidance are found in SI 02201.020 Supplemental Security Income (SSI) Overpayment: Who Is Liable (Responsible) for Repayment? Living Overpaid Individual. For T2 the POMS is GN 02205.007 Joint and Several Liability for Title II Overpayment Recovery.
ReplyDeleteI was being sarcastic in my earlier comment about employees having time to read and research policy. No one has the time to do their job and are expected to do the impossible everyday. I miss helping the public terribly and it is an absolute travesty what the agency has become.
I've had a hard time even getting some overpayments past the reconsideration stage. Of course, I can't get bogged down in doing these, but I will try a few that I think are really unfair. So many of the people making repayments are already living on the edge. More time needs to be dedicated to processing applications and reconsiderations on disability. The wait times there have become absurd.
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