Opinion ID: 328764
Heading Depth: 1
Heading Rank: 1

Heading: recoupment procedure

Text: 2 Section 204(a) of the Act directs the Secretary to recover overpayments of social security benefits through recoupment of future benefit payments. Section 204(b), however, requires the Secretary to waive recoupment under certain circumstances. It provides that there shall be no recoupment where the overpaid beneficiary is without fault 2 and the recoupment either would defeat the purpose of Title II of the Act 3 or would be against equity and good conscience. 4 Pursuant to these statutory directives, the Secretary has promulgated regulations providing for a four-step process of administrative review: an initial determination that there has been an overpayment and that there is no basis for waiver of recovery (20 C.F.R. § 404.905); a reconsideration of that initial determination upon request by the recipient (Id. § 404.914); an administrative hearing de novo before an administrative law judge (Id. § 404.917); and review by the Appeals Council of the Social Security Administration (Id. § 404.945). Judicial review is then available, under section 205(g) of the Act, 42 U.S.C. § 405(g), to claimants who have exhausted their administrative remedies. 3 While a claimant thus has a right to a full evidentiary hearing at the third step in the administrative process, such a hearing is not available until after the recoupment process has begun. When a claimant is notified of the initial adverse determination and of his right to seek reconsideration, he is given thirty days in which to submit, in writing, his reasons why he disagrees with the determination that he has been overpaid or why he seeks a waiver under section 204(b) of the Act. Once such a request for reconsideration or waiver has been filed, even if the thirty days has expired, the recoupment procedure is automatically deferred until such reconsideration is completed. 5 If the Secretary adheres to his initial determination, the claimant is so notified and benefits begin to be withheld. At that time, the claimant is notified of his right to seek an administrative hearing de novo, with the right to present oral testimony and to cross-examine witnesses. A request for an oral hearing, unlike a request for reconsideration, will not toll recoupment. While the record is not entirely clear, it appears that there is usually a delay of several months from the time benefits are first withheld to the time a claimant is able to obtain an oral hearing.