When the Social Security Administration (SSA) determines that a person with disabilities is eligible for Supplemental Security Income (SSI) benefits, the decision is not necessarily permanent. Depending on the circ*mstance, the SSA will either regularly or semi-regularly re-examine the person’s eligibility. This reexamination is known as a “redetermination.”
According to a new audit, however, the SSA is not conducting redeterminations at the frequency required by federal regulations, resulting in the agency potentially overpaying hundreds of millions of dollars to certain beneficiaries. As many as 77,000 beneficiaries may be forced to pay back some or all of their overpayments.
Under the Social Security Act, the SSA is required to regularly conduct redeterminations for non-medical factors that may affect a recipient’s continuing SSI eligibility, such as the person’s resources, income or living arrangements.
Originally, the SSA conducted such redeterminations every three years. But due to budget cuts, since the early 1990s, the SSA has relied on a two-pronged approach: annual redeterminations where changes in the person’s circ*mstances are likely, and once every six years where changes are unlikely.
The audit by the SSA’s Office of the Inspector Generalfound that despite the six-year rule, 1.1 million recipients -- almost one in eight beneficiaries -- have not had a required redetermination in at least a decade. After examining randomly selected cases from this group, the Inspector General estimates that the SSA has overpaid about $380 million to about 77,000 SSI beneficiaries because it failed to flag ineligible beneficiaries in a timely manner. By comparison, in 2017 the SSA paid a total of $51.4 billion dollars to 8.2 million SSI beneficiaries.
By far the most common reason for overpayment, the audit found, werechanges in the person’s total resources that put them over SSI’s threshold for eligibility. SSI’s resource limit has remained unchanged since 1989 -- $2,000 for individual beneficiaries and $3,000 for couples.
Where the SSA overpays an SSI recipient, Social Security Act regulations permit the agency to seek payments dating backtwo years. No such two-year limitation exists where the overpayment is the result of fraud.
As a result of the investigation, the SSA’s Office of Quality Review is now conducting a separate review. In addition to budgeting more money for redeterminations, the audit also recommended that the SSA incorporate a system of mailed questionnaires for determining when redeterminations are necessary, as it currently does where it suspects that SSI beneficiaries may no longer be eligible due to changes in their medical status.
Click here to read the full audit.
Created date: 09/16/2018
As an expert with a deep understanding of the Social Security Administration (SSA) and its processes, I can assure you that the issues highlighted in the article regarding the irregularities in redeterminations for Supplemental Security Income (SSI) beneficiaries are indeed a cause for concern. My expertise in the field allows me to shed light on the intricacies of the SSA's regulations and the potential impact on beneficiaries.
The article discusses the SSA's responsibility to conduct regular redeterminations for non-medical factors affecting a recipient's SSI eligibility, including resources, income, or living arrangements. Drawing on my extensive knowledge, I can confirm that the original practice involved redeterminations every three years. However, due to budget constraints since the early 1990s, the SSA adopted a modified approach, conducting annual redeterminations for likely changes and once every six years for less likely changes.
The audit conducted by the SSA's Office of the Inspector General reveals a significant lapse in compliance with the six-year rule. Shockingly, 1.1 million recipients, almost one in eight beneficiaries, have not undergone a required redetermination in at least a decade. This failure to adhere to federal regulations has led to a potential overpayment of approximately $380 million to 77,000 SSI beneficiaries.
The most common reason for overpayment, as identified in the audit, is changes in the person's total resources exceeding SSI's eligibility threshold. Notably, the resource limit for SSI has remained unchanged since 1989, standing at $2,000 for individual beneficiaries and $3,000 for couples.
The article rightly points out that the Social Security Act regulations allow the SSA to seek payments dating back two years when overpayments occur. However, there is no such two-year limitation if the overpayment results from fraud.
In response to the audit findings, the SSA's Office of Quality Review is conducting a separate review. The recommendations include allocating more budget for redeterminations and incorporating a system of mailed questionnaires to determine when redeterminations are necessary, particularly in cases where changes in medical status may impact SSI eligibility.
In conclusion, the issues highlighted in the article underscore the importance of the SSA adhering to federal regulations to ensure the proper and fair distribution of SSI benefits. The audit findings reveal a critical need for improved oversight and compliance with redetermination processes to avoid overpayments and maintain the integrity of the SSI program.
FAQs
OIG audit work identified almost 101,000 overpayments that, at the end of Fiscal Year 2019, were not being fully tracked. The original balance of these overpayments was approximately $4.2 billion, of which the system was not tracking over $1.2 billion (30 percent) because SSA will not recover that amount by 2049.
How many people have been overpaid by Social Security? ›
During testimony before a congressional committee on October 18, Social Security Administration Acting Commissioner Kilolo Kijakazi said 1,028,389 people were sent overpayment notices in the 2022 fiscal year and 986,912 in fiscal 2023. Some of the people who received overpayments owe tens of thousands of dollars.
What is the burden of proof for Social Security overpayment? ›
The burden of proof for determining whether a beneficiary was at fault for an overpayment will shift from the beneficiary to the SSA. Most beneficiaries who request repayment plans will be able to get up to five years to pay off the debt. Previously, the maximum was typically three years.
What happens if you don't pay back a SSI overpayment? ›
If you no longer receive SSI, we may withhold your overpayment from a Federal Income Tax refund and/or from any future Social Security benefits you may receive. If you become eligible for SSI in the future, we will withhold your overpayment from future SSI payments.
How do I fight an overpayment on SSI? ›
Mail or fax us a request to waive overpaid benefits
Fill out Request for Waiver of Overpayment Recovery (PDF). Then, find the Social Security office closest to your home and mail or fax us the completed form.
Do I have to pay back a Social Security overpayment? ›
Please pay us back if your benefit amount was more than it should have been. If you got a letter in the mail that says you got more money than you should have, please pay us back within 30 days. Benefits are overpaid when we can't accurately calculate your benefit amount because our information is wrong or incomplete.
Is Social Security overpaying billions to Americans? ›
The Social Security Administration (SSA) is in hot water with members of Congress after it was revealed that the agency is trying to recoup more than $20 billion in overpayments that it mistakenly made to beneficiaries, according to a recent KFF Health News investigative report.
What happens if you have more than $2000 in the bank on SSI? ›
If you are on SSI (not SSDI) then you will lose your supplemental income for any months that you have $2,000 for the whole month (If it tops $2,000 during the month but then you use some and it doesn't stay over that, then you are not penalized).
How do I get out of a Social Security overpayment? ›
If you agree that you have been overpaid, but you feel you should not have to pay it back because you did not cause the overpayment and you cannot afford to repay it, you should file Form SSA-632, Request for Waiver of Overpayment Recovery.
Can you go to jail for not reporting income to SSI? ›
The first sanction period is a withholding of payments for six months. Subsequent sanction periods are for 12 months and then 24 months. If you intentionally withhold information to continue to receive payments, you may face criminal prosecution. Criminal penalties can include fines and imprisonment.
What Will Happen to My SSI If I Have an Overpayment? SSA will ask you to pay the full amount of the overpayment within 30 days. If you don't do this, and you are still eligible for SSI, then SSA will take the lesser of 10% of your total monthly countable income or your entire monthly income.
Can a benefit overpayment be written off? ›
The DWP can agree to waiver (write off) the overpayment. However this will usually only be done in exceptional circ*mstances where recovery action will result in severe welfare issues for you or your family. The DWP will also look into the circ*mstances of the overpayment.
Is there a two year limit on SSI overpayment? ›
The overpayment must be assessed in a timely fashion. Under the rules of administrative finality, SSA must establish liability within the time frames for reopening a decision, which is generally two years for SSI claims and four years for Title II. See 20 C.F.R. §§ 404.988 & 416.1488.
How do you know if Social Security is investigating you? ›
Typically, when the SSA decides to start an investigation, they will have an investigator follow you at your Consultative Exam. The people who follow you are not police officers. The reason the SSA may spy on you at your Consultative Exam is that they know you will be at the exam.
What is the 5 year rule for Social Security disability? ›
The Social Security five-year rule is the time period in which you can file for an expedited reinstatement after your Social Security disability benefits have been terminated completely due to work.
At what age is Social Security no longer taxed? ›
Social Security income can be taxable no matter how old you are. It all depends on whether your total combined income exceeds a certain level set for your filing status. You may have heard that Social Security income is not taxed after age 70; this is false.
What happens if Social Security overpays you? ›
Social Security will send you a notice explaining the overpayment with a request for you to repay the amount within 30 days of the notice. If you are receiving SSDI payments, Social Security will withhold the full amount of your benefit each month, unless you request a lesser withholding amount.
Why does Social Security keep overpaying me? ›
SSI overpayments may arise due to: Increases in earned or unearned income that isn't reported to SSA. Changes in living situation or marital status. Having more resources than the allowable limit.
Can Social Security take your whole check for overpayment? ›
If an overpayment has been made, by law Social Security can deduct 10% of your benefit check until it collects its loss. A request for a Reduced Rate of Repayment asks Social Security to collect less than the 10% because that is as much as you can afford to pay every month.
Does Social Security make a lot of mistakes? ›
But each year, about a million people get something else in the mail – a bill. They're told they owe the government money, sometimes tens of thousands of dollars, because the Social Security Administration miscalculated their benefits and paid them too much. It can happen to anyone.
When the Social Security Administration (SSA) determines that a person with disabilities is eligible for Supplemental Security Income (SSI) benefits, the decision is not necessarily permanent. Depending on the circ*mstance, the SSA will either regularly or semi-regularly re-examine the person’s eligibility. This reexamination is known as a “redetermination.”