On April 13, 2012, a U.S. District Court judge in New York issued a nation-wide class action court order in Clark v. Astrue (Clark).
Reduce Improper Payments and Increase Overpayment Recoveries
A Federal Employees' Compensation Act (FECA) payment is a type of workers’ compensation payment administered by the Department of Labor (DOL). When a beneficiary receives both Social Security Disability Insurance (DI) and FECA payments, SSA must reduce the DI benefits for the beneficiary and his/her family to ensure the combined DI benefits and FECA amounts do not exceed the higher of 80 percent of the beneficiary’s average current earnings or the total family benefit.
Section 1611(f) of the Social Security Act states that, with limited exceptions, no individual shall be considered eligible for Supplemental Security Income (SSI) payments for any month throughout which the individual is outside the United States.
Because Supplemental Security Income (SSI) is a needs-based program, the Social Security Administration (SSA) must evaluate recipients’ income and resources each month to determine payment eligibility and amounts. Recipients’ failure to report changes in financial circumstances timely can result in incorrect payments.
An overpayment is the total amount an individual received for any period that exceeded the total amount the individual should have been paid for that period. With a few exceptions, overpaid individuals are responsible for repaying the overpayments. SSA uses different methods to recover overpayments, such as benefit adjustment, the Treasury Offset Program, and Administrative Wage Garnishment.
Non-Entitled Debtors (NED) is a person or entity that owes a debt to SSA but may not be entitled to Social Security benefits or Supplemental Security Income payments. Examples include deceased beneficiaries’ representative payees (individual or organizational); persons who owe a court-ordered penalty or restitution; attorneys and non-attorneys who received excess fees; or persons who fraudulently or erroneously obtained benefits.
The Social Security Administration (SSA) may waive recovery of an overpayment if the person is without fault, and recovery would either defeat the purpose of the Social Security Act or be against equity and good conscience. A waiver is a permanent write-off of the overpayment, and SSA cannot subsequently collect the waived amount by any means. Generally, the overpaid person must request a waiver.
When SSA receives a report that a beneficiary or recipient has died, it records the date of death on the Master Beneficiary (MBR) or Supplemental Security Record (SSR) and terminates benefits. In addition, SSA’s Death Alert, Control, and Update System (DACUS) receives, processes, and records death information on SSA’s Numident. SSA uses death information from the Numident to create a record of death information called the Death Master File (DMF), which is available to Federal agencies and the public.
SSA administers several benefit programs, including the Old-Age, Survivors and Disability Insurance and Supplemental Security Income programs. The benefit amount payable to an individual under these programs depends on various factors. A change in one or more of these factors may result in a lower or no benefit payable to the individual. In these situations, until SSA learns of the change and adjusts the benefit, the individual is paid more than he/she is entitled to receive—an overpayment.
Benefit payments greater than the amount to which individuals are entitled are considered overpayments. When the Social Security Administration determines an individual has been overpaid, it generally initiates recovery actions regardless of the dollar amount.
In this report, we analyzed the cost-benefit of processing overpayments for the Retirement and Survivors Insurance (RSI), Disability Insurance (DI), and Supplemental Security Income (SSI) programs.