SSI Overpayment Help

[needshelp576]

A disabled family member and his daughter owe SSI $20,000 in disability payments allocated over 3 years. Based on the following context, do they have a case to waive the debt? Can they ultimately prove that they were not at fault? And if the debt cannot be waived, who will social security consider responsible for the debt: the father, daughter, or both?

Context:

A mentally disabled father was labeled as a representative for his daughter's SSI disability payments. The daughter was a minor and unable to comprehend her father's actions. She left all responsibility regarding her SSI to her father because he was her representative and she was a minor. Three years ago, they get a letter stating his daughter was no longer disabled due to new medical evidence. The father then appeals this decision. Due to his comprehension deficits, he did not realize that payments garnered during the appeal process would have to be repaid if he lost the case. Three years later, he loses the case. He is now required to pay the three years worth of payments but cannot due to severe financial hardship. The daughter had no idea of the ramifications of her father's actions. She left responsibility of her SSI disability benefits to her father because he was her legal representative.

 

[Janke]

Did the pursue the appeal in good faith? Did they cooperate with the steps along the way?

They both need to complete SSA 632, keep a copy, submit it in person and get a receipt. These kinds of overpayments based on disability cessation become HUGE because SSA is so slow in holding hearings. So the recipient got paid for three years after it was decided she was no longer disabled. So fault does lie with SSA, but how much fault can be attributed to the recipient and the payee? Depends on details.

https://secure.ssa.gov/apps10/poms.nsf/lnx/0502260007

Did this all occur before age 18 or after? A common pattern is that a child meets the childhood rules for disability for SSI, but those rules don't apply as soon as the child becomes an adult. So SSA conducts an age 18 Continuing Disability Review and applies the adult rules. Some childhood conditions, like Attention Deficit Disorder, are not considered in the same way when the child turns 18. It is not uncommon for a child to qualify as a child, but not as an adult, even with the exact same condition and symptoms. The rules are not the same. So is this an age 18 CDR Cessation case? How old is the daughter now? Does the father also qualify for disability benefits because of his mental disabilities? If the daughter was already age 18, SSA should not have accepted an appeal submitted by the father of the adult. SSA found her not disabled. She was 18. Father no longer matters. She should have filed the appeal and filed to be her own payee and filed for payment continuation and managed her own incorrect payments.

How did he spend the money that was received? Does he have records? Does he have his own income or was the SSI supporting the entire family? How much did the daughter get in spending money? If he had income and she was under age 18, did he report it to SSI and was it used in computing the SSI?

Was the daughter under medical care for her conditions? Was she in special education or therapy or counseling? Did she take medication for her disabling condition? SSA decided she got better, so she must have been diagnosed with a condition that would improve with treatment. What was she diagnosed with and how did she get better? Did the father submit the CDR timely or did SSA have to threaten to stop the checks? Did she attend Consultative Exams scheduled by DDS and or OHO? Did she and the father submit missing records that DDS couldn't find? Did the father and the daughter both attend the recon conference and the OHO hearing? Did she testify? How hard did the father and the daughter work at proving she was disabled and how much did they contribute to the delay?

At the time of the cessation three years ago, was there any unpaid balance on an older overpayment due to unreported income of the parent? That would be a different waiver discussion.

 

[needshelp576]

Thank you for your thorough answer Janke. I will answer your questions to the best of my ability:

1. Daughter was 16 at the time of the appeal. By your conditions, she was a minor, age 16, at the start of the appeal but an adult, age 19, at the end. Therefore, part of the payments occurred while she was a minor and another part an adult.

1.5. The father does qualify for disability benefits due to his mental disabilities.

2. Dad has his own income. Daughter received the full amount of SSI. All of his income was reported to SSI for the calculation.

3. All of the money went towards special therapy for the daughter's disability. She takes medication and does ballet to suppress condition. She was diagnosed with rheumatoid arthritis. This is a chronic disease, so without those interventions, it severely attacks her joints.

4. There was no recon conference, but there was a hearing. Through an extremely slow wait, it finally happened after 3 years. The father and daughter both attended, and the daughter did testify. The only thing that contributed to the payment delay was when the father starting the appeal.

5. At the time of cessation three years ago, there was no unpaid balance.

Based on this information, does the fault lie with SSA?

 

[Janke]

She has a good case for waiver. Both should complete separate waiver requests. He is asking to be relieved of liability since he was not at fault and he spent the funds on her. Both are asking that it be waived because they acted in good faith by following the rules and not adding to the delay.

She lost the hearing and the cessation was upheld? She does have an illness than can be debilitating, but maybe it is not bad currently. Did she appeal further, file a new claim or is she working? If the appeal is still pending at a higher level, then SSA should not be sending bills requesting repayment since the issue is still open.