TABLE OF CONTENTS

 

 

Paragraph and Subject                Page  Date   Trans. No.

 

Chapter 3-0800 Overpayment Process

 

Table of Contents. . . . . . . .  i    10/09     10-01

1         Purpose and Scope. . . . . . . .  1    10/09     10-01

2  Legislative Authority and. . . .  1    10/09     10-01

   Directives

  3  Definition of Overpayment. . . .  3    10/09     10-01

  4  Notification of Payment. . . . .  3    10/09     10-01

  5  Identifying Overpayments . . . .  4    10/09     10-01

  6  Compensation Paid After

       Claimant’s Death . . . . . . .  5    10/09     10-01

  7  Review and Initial Notification   5    10/09     10-01

  8  Telephone Conferences. . . . . .  7    10/09     10-01

  9  Burden of Proof. . . . . . . . .  10   10/09     10-01

 10  Waiver . . . . . . . . . . . . .  10   10/09     10-01

 11  Overpayment Decisions. . . . . .  17   10/09     10-01

 

Exhibits

 

1   Sample Initial Overpayment

      Notification Letter

      (Without Fault). . . . . . . .        10/09     10-01

 2   Sample Initial Overpayment

       Notification Letter

      (With Fault) . . . . . . . . .        10/09     10-01

 3   Sample Memorandum to File for

       Administrative Write-Off

       of Debt Less Than $2000 . . .        10/09     10-01

 4   Sample Pre-Conference Checklist        10/09     10-01

 5   Sample Memorandum of Conference        10/09     10-01

 6   Sample Conference Letter

       to Claimant. . . . . . . . .         10/09     10-01

 7   OWCP-20 Overpayment Recovery

       Questionnaire. . . . . . . .         10/09     10-01

 8   Sample Final Decision (With

       Fault Preliminary Incorrect)         10/09     10-01

 9   Sample Final Decision (With

       Fault Preliminary Correct)           10/09     10-01

 10  Sample Final Decision (Without

       Fault Waiver Denied) . . . .         10/09     10-01

 

 

1.   Purpose and Scope.  This chapter describes how the Office of Workers’ Compensation Programs (OWCP), through the Division of Energy Employees Occupational Illness Compensation (DEEOIC), identifies, evaluates, provides notification of, waives, issues final decisions regarding, and recovers overpayments under both Parts B and E of the EEOICPA.

 

2.   Legislative Authority and Directives.  The instructions in this part of the procedure manual derive from the following regulations and authority:

 

a.   The Energy Employees Occupational Illness Compensation Program Act (EEOICPA) at 42 U.S.C. 7385j-2 authorizes the Secretary of Labor to recover overpayments because of an error of fact or law, except when an incorrect payment has been made to an individual who is without fault and the adjustment or recovery would defeat the purpose of the Act or would be against equity and good conscience.  With respect to recovery, the EEOICPA authorizes OWCP (as designee of the Secretary of Labor) to recover the overpayment pursuant to regulations prescribed by the Secretary.

 

b.   Public Law 89-508, Federal Claims Collection Act of 1966 (80 Stat. 308), amended by Public Law 900-904 (2000), assigns the Secretary responsibility for the collection of debts arising from the activities of the Department of Labor.  It also provides the authority to compromise, terminate, or suspend collection action on debts not in excess of $100,000 (exclusive of interest, penalties, and administrative costs and after partial payments have been deducted).  In such cases, there must be no indication of fraud, and it must appear that:

 

(1) The debtor is unable to pay the full amount in a reasonable time, as verified through credit reports or other financial information;

 

(2) The Government is unable to collect the debt in full within a reasonable time by enforced collection proceedings;

 

(3) The cost of collecting the debt does not justify the enforced collection of the full amount; or

 

(4) There is significant doubt concerning the Government’s ability to prove its case in court.

 

The Department of Labor Manual Series (DLMS) 6, Chapter 1100, Debt Management, provides that Department of Labor Agency Heads are delegated the authority to compromise, suspend or terminate collection action on debts stemming from program activities not in excess of $100,000, and that Agency Heads may re-delegate this authority to officials in their agencies with approval of the Chief Financial Officer. DLMS6-1111b (1),c (2).

 

c.   Public Law 97-365, Debt Collection Act of 1982, amended several statutes, including the Federal Claims Collection Act of 1966. The Debt Collection Act authorizes Federal agencies to collect certain charges on outstanding debts, to use salary offset or administrative offset to collect claims and to use the services of private collection agencies.(Note: The Federal Claims Collection Act of 1966 as amended by the Debt Collection Act of 1982 has been codified as 31 USC 900-904.)

 

d.   Public Law 104-134, Debt Collection Improvement Act of 1996 also amended several statutes, including the Debt Collection Act of 1982.  The Debt Collection Improvement Act provides that any non-tax debt or claim owed to the United States that has been delinquent for a period of 180 days be turned over to the Secretary of the Treasury, who will determine whether to collect or terminate collection actions on the debt or claim.

 

e.   31 CFR Parts 900-904 (Federal Claims Collection Standards) describes standards for the collection and compromise of debts, termination of agency collection, and referral of civil claims to the Department of Justice.  In particular, 31 CFR 902.1(b) and 903.1(b) provide that the Department of Justice has the exclusive  authority to compromise, suspend or terminate claims in excess of $100,000, exclusive of interest, penalties and administrative costs. Consequently, even if OWCP believes that compromise, suspension or termination of recovery of such a debt is appropriate, the matter must be referred to the Department of Justice, through the Department of the Treasury, for determination.

 

f.   31 CFR Part 285 includes the provisions for transferring delinquent debt to the Department of the Treasury.

 

g.   In a case involving criminal fraud on the part of the debtor or any other party having an interest in the claim, instructions regarding compromise, suspension or termination of recovery do not apply.  As provided by 31 CFR 900.3(a), only the Department of Justice has authority to compromise, suspend or terminate collection action on such claims.

 

h.   In cases referred to the Office of the Inspector General or the U.S. Attorney for reasons other than collection of the debt, the OIG should be advised before collection action is initiated in order to evaluate whether collection action would jeopardize an ongoing investigation or a legal action in progress.

 

3.   Definition of Overpayment.  An overpayment is any amount of compensation paid under 42 U.S.C. §§ 7384s, 7384t, 7384u, 7385s-2 or 7385s-3 to a recipient that, at the time of payment, is paid where no amount is payable or where payment exceeds the correct amount of compensation determined by DEEOIC.

 

4.   Notification of Payment.  DEEOIC provides claimants with narrative descriptions of benefits paid or payable.  Claimants who receive compensation payments are required to sign an acceptance of payment form.  Payments made by check clearly indicate the reason for payment.  Payments made by Electronic Funds Transfer (EFT) appear on the claimant’s financial institution statement listing the amount and date of payment.  Such advice is considered due notice of payment absent affirmative evidence to the contrary.  The claimant is responsible for notifying DEEOIC of any discrepancy between the amount paid and the amount stated as paid on a check or bank statement.

 

5.   Identifying Overpayments.  Aside from the requirement that the claimant inform DEEOIC of any overpayment that he or she discovers, the primary responsibility to identify overpayments rests with claims staff.  The Final Adjudication Branch (FAB) must issue a final decision with respect to eligibility before the overpayment is officially identified.

 

a.   Initial Screening.  Claims staff initially screen for overpayments, which occur for various reasons, such as:

    

(1) A claimant was paid compensation in error.  This might result from a final decision overturning an award of compensation.  A final decision should not overturn a previous award of compensation based on a change in policy, if payment was made based on a policy that is now obsolete.

 

(2) The required tort offset or coordination with state workers’ compensation benefits was either improperly applied or never applied.

 

(3) A lump sum award requires adjustment because additional eligible survivors emerge after payment, resulting in overpayments to the original eligible payees.

 

(4) Medical reimbursements to claimants in excess of actual medical bills result in overpayments.

 

b.   Referral to National Office (NO).  Once an overpayment is identified, the matter is referred to the District Office Chief of Operations (COP) or FAB Manager for transfer to the NO.

 

The Claims Examiner (CE) identifying the overpayment prepares a memorandum identifying and evaluating the overpayment for review by and signature of the COP/Manager.  In the memorandum, the CE describes the circumstances of the overpayment.

 

If the COP/Manager agrees that an overpayment exists, the file is transferred to the Chief of Policies, Regulations, and Procedures Unit (PRPU), where it is assigned to a Policy Analyst (PA).

 

6.   Compensation Paid After Claimant’s Death.  No overpayment is declared when compensation is paid by EFT for direct deposit to the decedent's bank account.

 

     a.   Standard Form 1184.  When the NO discovers that compensation has been paid after the death of the claimant, and the payment is not returned, the Fiscal Officer immediately notifies the Department of the Treasury of the erroneous payment by completing the electronic Standard Form 1184 (Unavailable Check Cancellation), available at http://contacts.gsa.gov/webforms.nsf/0/A7422A589D29E2E1852570BC004ADC27/$file/sf1184_e.pdf, indicating the claimant's name and date of death in the appropriate boxes on the form.

 

b.   Time Limitations.  The Department of the Treasury has a twelve-month time limit from the date of the EFT to initiate recovery of the improper payment.  Therefore, the PA acts promptly upon learning that a payment was issued after the date of the claimant's death. Once the Department of the Treasury has been advised of the erroneous payment, the PA monitors the case for receipt of the payments.

 

c.    Recoupment.  The Department of the Treasury recoups the money from the bank which received the EFT and restores the funds to DEEOIC.  If for any reason the Department of the Treasury cannot recoup the erroneous payment, DEEOIC has no redress against the bank and the PA simply drafts a memorandum to the case file concerning the matter.

 

7.   Review and Initial Notification.  The PA reviews the overpayment memorandum and all available evidence to verify the existence of an overpayment, then calculates the exact amount of the overpayment.  The PA creates and maintains an accounts receivable log in a spreadsheet to be stored on the shared drive to record overpayments and their disposition over time.  The PA tracks overpayments separately by district office. 

 

Once the overpayment is established, the PA determines whether the claimant bears any fault in the creation of the overpayment.

 

a.              Determination of Fault. The PA’s determination of fault depends on the circumstances surrounding the overpayment. The claimant must show good faith and exercise a high degree of care in reporting events which may affect entitlement to or the amount of benefits. Degree of care may vary with the complexity of circumstances and a claimant’s capacity to realize an overpayment has occurred.  While this is not an exhaustive list, the following can be construed as fault in creating an overpayment:

 

(1)  Claimant made an incorrect statement as to a material fact he or she knew or should have known to be incorrect.

 

(2)  Claimant failed to provide information he or she knew or should have known to be material in nature.

 

(3)  Claimant accepted payment that he or she knew or should have known to be incorrect.

 

b.              Initial Notification.  After making a determination of fault, the PA generates a letter bearing the Unit Chief’s (UC) signature informing the claimant that an overpayment exists.  Initial notification is required before DEEOIC can take any final action to recover an overpayment or adjust benefits. 

 

Exhibit 1 is a sample initial overpayment notification letter used when the claimant is without fault.  Exhibit 2 is a sample initial overpayment notification letter used when the claimant is with fault. [However, in situations warranting administrative write-off (see paragraph 7c below), no overpayment notification is sent to the claimant.]  The notification letter serves to:

 

(1)  Notify the claimant that an overpayment exists and the exact amount of the overpayment.

 

(2)  Provide the result of the preliminary finding of fault.

 

(3)  Advise the claimant of his or her rights. The claimant has 30 days following the date of the overpayment notification letter to invoke the rights to:

 

(a)  Inspect and copy DEEOIC records relating to the overpayment.

 

(b)  Present written evidence challenging existence or amount of the overpayment.

 

(c)  Request a telephone conference.

 

(d)  Challenge any finding of fault.

 

(e)  Request waiver of recovery of the overpayment.

 

The filing date of the claimant’s challenge to the overpayment is determined by the postmark date, the date the request is received in the office, or the Resource Center, whichever is the earliest determinable date.

 

c.   Administrative Write-Off.  If the amount of the overpayment is equal to or less than $2,500, the PA recommends administrative write-off, regardless of the claimant’s fault, since the cost of recovery action will exceed the expected recovery amount.  The PA prepares a brief memorandum to the UC describing the reasons for recommending termination of collection actions.

 

Once the UC approves an administrative write-off, the PA creates an accounts receivable record of the overpayment in the accounts receivable spreadsheet. The overpayment is then cancelled without giving any notice of the overpayment to the overpaid party, and no final decision is issued.  Exhibit 3 is a sample memorandum to file for this process.

 

8.   Telephone Conferences.  When requested by the claimant, the PA holds a telephone conference within 30 days of the date of the overpayment notification letter.  The PA also holds telephone conferences in cases where the financial data in the file is not clear or adequate to make a decision about waiver or repayment.

    

a.   Pre-conference Call. The PA holds a pre-conference call to give the claimant a clear picture of the purpose and process of the conference and the obligations of all parties, and to schedule a time for the call.  The PA:

 

(1)  Explains the issues that will be addressed during the conference call (i.e., income, expenses, assets, transfer of assets, and liabilities).  If a preliminary finding of "with fault" was issued, the PA explains how the decision was made and its implications, and invites the claimant to provide any information that could affect the preliminary determination;

 

(2)  Describes the criteria used to make key decisions in the case (i.e., with fault finding, criteria for waiver, interest charges);

 

(3)  Describes the evidence the claimant needs to collect in preparation for the conference call;

 

(4)  Gives the claimant a chance to ask questions;

 

(5)  Determines the best time for the conference; and

 

(6)  Prepares the pre-conference checklist (Exhibit 4), which verifies that the conference agenda items were discussed.

 

b.   During the Conference Call.  The PA:

 

          (1)  Identifies him- or herself;

 

          (2)  References the pre-conference call;

 

          (3)  States the purpose of the call;

 

(4)  Advises the claimant that he or she will be taking notes and for that reason there will be periodic pauses while he or she is writing;

 

          (5)  Describes the specific focus of the call;

 

(6)  Obtains the claimant’s acknowledgement that he or she understands what the conference issues are and what the conference is about;

 

(7)         Listens carefully to what is being said;

 

(8)         Probes responses that are too general or not credible, or which conflict with other statements given or the evidence of file;

 

(9)         Takes notes complete enough to capture the necessary information; and

 

(10) Confirms the accuracy of the statements recorded by reading them back to the participant(s) for confirmation.

 

     c.   After the Conference.  The PA: 

 

(1)         Prepares a neutral Memorandum of Conference, without findings, describing what transpired during the conference.  (See Exhibit 5 for a sample Memorandum of Conference.)  The language of the memorandum must be clear and non-technical.  A sound Memorandum of Conference should:

 

(a)  Identify and describe the issues that were discussed during the conference;

 

(b)  Identify the PA who conducted the conference and who participated in the conference;

 

(c)  Describe the position of DEEOIC and the claimant coming into the conference;

 

(d)  Describe the explanation provided in the conference that is relevant to the issue;

 

(e)  Describe what was said in the conference that is relevant to the issue;

 

(f)  Describe the method used to confirm the accuracy of the information collected in the conference that is recorded in the Memorandum of Conference; and

 

(g)  Describe any agreements reached in the conference.

 

(2)  Sends the Memorandum of Conference to the conference participant(s) for review and comments.  Exhibit 6 is a sample letter to the claimant.  Fifteen days from the date of the conversation, should be allowed for comments.  After receipt of any comments, the PA makes findings on the issues for resolution and documents these findings in the final letter decision.

 

9.  Burden of Proof.  DEEOIC has the right to require that the overpaid claimant submit whatever financial information the PA deems necessary to determine whether to waive recovery of an overpayment.  Form OWCP-20 financial questionnaire (Exhibit 7) is designed to obtain financial information.  Extensive documentation of assets and expenses in support of the statements made on the OWCP-20 are required.  The burden rests solely on the overpaid claimant to establish the grounds for a waiver.

 

10.  Waiver.  DEEOIC may waive recovery of all or part of an overpayment.  (See paragraph 10(b)(2)(b)(Example 2) for further explanation of a partial waiver.)  A determination to waive recovery of an overpayment is based on the PA’s review of any documentation or argument submitted by the claimant within 30 days after the initial notification letter is issued, evidence obtained during the telephone conference, or evidence received within a timely period after the claimant’s receipt of the Memorandum of Conference.

 

The burden of proof rests with the claimant to prove the conditions necessary to grant a waiver.  DEEOIC requires the claimant to submit information specified on Form OWCP-20 and supporting documentation.  If this information is not submitted within 30 days of the request, waiver will be denied until such time as the requestor documentation is furnished.  Where it is determined that the overpaid claimant is not at fault in the creation of the overpayment, repayment will still be sought unless adjustment or recovery either would defeat the purpose of the Act or would be against equity and good conscience.

 

     a.   Recovery Would Defeat the Purpose of the EEOICPA.

Where it is found that recovery will defeat the purpose of the EEOICPA, no recovery will be sought.  To defeat the purpose of the EEOICPA, it must be found that the claimant requires substantially all current income to meet current ordinary and necessary living expenses and that the claimant’s assets do not exceed a specified amount as determined by DEEOIC from data furnished by the Bureau of Labor Statistics (BLS). 

 

When a claimant exceeds the limit for either disposable current income or assets, a basis exists for establishing a reasonable repayment schedule over a reasonable, specified period of time.  It is the claimant’s burden to show otherwise by submitting evidence that recovery of the overpayment would cause hardship of a nature sufficient to justify waiver.

 

(1)  The PA determines the claimant’s income based upon documents submitted.  An individual's total income includes any funds which may reasonably be considered available for his or her use, regardless of the source.  A spouse's income will not be considered available to the claimant unless the spouse was living in the household both at the time the overpayment was incurred and at the time waiver is considered.  Income to be considered includes, but is not limited to:

 

(a) Government benefits.

 

(b) Wages and self-employment income.

 

(c) Regular payments (rent or pension).

 

(d) Investment income and alimony or child support payments.

 

(2)  The PA reviews claimed ordinary living expenses. It is the claimant’s burden to show that such expenses are reasonable and necessary. An individual is deemed to need substantially all of his or her current income to meet current ordinary and necessary living expenses if monthly income does not exceed monthly expenses by more than $50. The following can be considered as ordinary and necessary living expenses:

 

(a) Food, clothing, household and personal hygiene supplies, rent, mortgage payments, property taxes, utilities (e.g., electricity, gas, fuel, telephone, water), insurance (e.g., vehicle—one or two allowable, life, accident, and health), expenses for one or two vehicles (e.g., loan payments with the date each will be paid off, gas, oil, maintenance), transportation expenses not included under vehicle expenses, and creditor payments (e.g., credit card debt or other debt made in monthly installments).

 

(b) Medical, hospitalization and similar expenses not reimbursed by insurance or other sources.

 

(c) Church and charitable contributions made on a regular basis.  This does not include large one-time gifts made after receipt of the preliminary notice of the overpayment.

 

(d) Miscellaneous expenses (e.g., haircuts, newspapers) not to exceed $50 per month.

 

A finding that a type of expense is ordinary and necessary does not mean that the amount is ordinary and necessary.  The burden is on the claimant to show that the expenses are reasonable and needed for a legitimate purpose.

 

If the PA determines that the amount of certain expenses is not ordinary and necessary, particularly regarding significant expenses for food, clothing, and vehicles, the PA must state in writing the reasons for the finding. The finding must be supported by rationale, which may include reference to recognized research data (such as current statistics from BLS) that show that the claimant’s expenses exceed the average or range of expenses for the general population relevant to the claimant’s circumstances.

 

The PA evaluates only the minimum periodic payment as determined by the creditor.  The minimum amount is verified by copies of the claimant’s monthly billing(s) for consumer debt.

 

(3)  An individual’s assets should not exceed the resource base of $5,500 for an individual or $9,200 for an individual with a spouse or one dependent, plus $1,100 for each additional dependent, based on information from BLS. A spouse's assets will not be considered available to the claimant unless the spouse was living in the household both at the time the overpayment was incurred and at the time waiver is considered. 

    

(a)  Liquid assets may include (but are not limited to) cash, the value of stocks, bonds, savings accounts, mutual funds, and certificates of deposit.

 

(b)  Non-liquid assets may include (but are not limited to) the fair market value of an owner’s equity in property such as a camper, boat, second home and furnishing/supplies, vehicle(s) (i.e., any vehicles above the two allowed per immediate family), and jewelry.

 

Assets do not include the value of household furniture (primary residence), clothing, one or two vehicles, a home which the person maintains as the principal family domicile, or income-producing property, if the income from such property has been included in income.

 

b.   Recovery Would Violate Equity and Good Conscience.  If the claimant is not entitled to waiver under the “defeat the purpose of the EEOICPA” clause, the PA considers the “against equity and good conscience” clause.  Even if the claimant does not raise the “equity and good conscience” reason in the claim for waiver, the PA addresses this issue in the waiver memorandum. 

 

The PA reviews all pertinent financial information to determine if recovery of the overpayment will violate the concept of “equity and good conscience.”  This clause is divided into two parts, financial hardship and relinquishing a valuable right.  To demonstrate such a violation it must be established that either:

 

(1) Recovery will cause the claimant to experience severe financial hardship.  The PA evaluates financial records and compares income with expenses similar to the review conducted under paragraph 10(a) to determine if repayment will cause severe financial hardship.

 

Recovery will be found to be “against equity and good conscience” when an individual who was not entitled to benefits would experience severe financial hardship in attempting to repay the debt.  The criteria to be applied in making this determination are the same as those stated above in paragraph 10(a).

 

(2) The claimant has relinquished a valuable right or changed position for the worse.  The PA must review pertinent financial and other evidence to determine either of the following:

 

(a) Based chiefly or solely on notification of payment, the claimant relinquished a verifiably valuable right and such right cannot be regained (e.g., left a job that cannot be regained, sold a business, retired, or other major life-changing financial decisions).  When a claimant gives up a valuable right, his or her current ability to repay is not taken into consideration, as the forfeiture of the right is in itself the grounds for waiver.

 

Example:  After being advised of entitlement to compensation, the claimant resigned his job and withdrew his contributions to his retirement fund, under the assumption that he was entitled to a lump sum award of $150,000.  Three years later it was discovered that his award was erroneous.  The claimant had lost his retention rights, was unable to get his old job back, and could not secure other employment.  Recovery of any of the overpayment would be “against equity and good conscience” in this situation because the individual gave up a valuable right.

 

(b)  A decision was made resulting in a loss that verifiably worsened the claimant’s condition, and such decision would not have been made but for the receipt of benefits. The claimant must show that if required to repay the overpayment, he or she would be in a worse position after repayment than would have been the case if the benefits had never been received in the first place.

 

Converting the overpayment into a different form, such as food, consumer goods, real estate, etc., from which the claimant derived some benefit, is not considered a loss. Converting the overpayment into a different form for the benefit of another person, such as a child or relative, may be considered as a loss if the claimant retains no ownership interest in the proceeds and has no ability to reclaim the proceeds.

 

Example 1:  A claimant received a lump sum award.  Later the entire award is declared to be an overpayment.  The claimant contends that he has changed his position for the worse, as he used the entire award to make a down payment on a larger home.  The claimant has not met his burden in showing that he changed his position for the worse, since he has not established that he suffered any loss.  He has simply converted the money into a different form.  Conversion of a liquid asset into real or tangible property does not constitute a loss.

 

Example 2:  A claimant is notified that he is entitled to $30,000.  Upon receipt of the money, the claimant signs a lease to rent a larger apartment and pays a $2,000 security deposit.  He places the remainder of the award in a savings account.  Before the claimant moves in, he is notified that the entire award is an overpayment.  As a result, the claimant fails to make the first month’s rent, forfeits the security deposit, and does not move to the new apartment.

 

Since the claimant would not have entered into the lease to rent the apartment but for his receipt of benefits, it would be inequitable to recoup the entire $30,000 overpayment.  The claimant clearly suffered a $2,000 loss and repayment would put him in a worse position than if he had not received the initial award.

 

Given that the claimant suffered a $2,000 loss, and not a $30,000 loss, a partial waiver is a legitimate action is this case.  The claimant does not have the money to rent a larger apartment and had no intention of doing so until he received his award.  Thus, the claimant relied on DEEOIC’s action and it would be inequitable to recover that part of the overpayment to the extent of his reliance.  It would not be inequitable to recover that part of the overpayment that the claimant deposited in the bank.  However, if the claimant were faced with additional expenditures arising out of the lease, those expenses would also be deducted from the

 

Example 3:  Suppose a claimant receives a $150,000 award and loaned a relative $25,000 to buy a house before he received notice of an overpayment.  Since the claimant has not suffered a loss, equity and good conscience do not require waiving of this $25,000.

 

However, it would be inequitable to tell the claimant to recall the loan at once (further, the terms may not allow such action), and it would not be inequitable to count the $25,000 as currently available assets.  Thus, the interest the claimant receives on the loan as well as any sum he may receive on the principal should be considered income when determining the claimant’s ability to repay the overpayment.

 

11.  Overpayment Decisions.  After weighing all the evidence and considering all the circumstances surrounding the overpayment, the PA drafts an overpayment decision.  The decision outlines his or her findings and whether recovery is to be pursued.  The UC reviews, signs, and issues the overpayment decision to the claimant.  Authority to issue overpayment decisions rests solely with the PPRU.  As noted above, overpayment decisions are not issued where an overpayment is administratively terminated.

 

a.   First Demand Letter.  Where the overpayment decision holds that a collectible overpayment (debt) exists, the overpayment decision serves as the first demand letter.  In the overpayment decision, the PA outlines the facts surrounding the overpayment, provides a rationale as to why the overpayment is recoverable, and informs the claimant of the exact amount owed and the collection strategy to be used (i.e., monthly payment, collection from future entitlement).

 

The decision advises the claimant that referral to the Department of the Treasury or the Department of Justice is possible and includes the due process requirements outlined by the Department of the Treasury.  The decision advises the claimant that he or she has 30 days from the date of issuance of the overpayment decision to resolve the recoverable debt.  Exhibits 8, 9, and 10 are samples of final letter decisions.

 

b.   Issuing Waiver.  If the PA determines that a waiver is warranted, the overpayment decision definitively waives the full amount of the overpayment in question.  No further action is required on the part of the overpaid claimant or the PA, other than updating the spreadsheet.  (See Exhibit 8, option 1.)

 

(1)  Where it is determined that the claimant is at fault in the creation of the overpayment, no waiver may be granted and recovery will proceed as outlined in this chapter.

 

 

Exhibit 1: Sample Initial Overpayment Notification Letter (Without Fault)

Exhibit 2: Sample Initial Overpayment Notification Letter (With Fault)

Exhibit 3: Sample Memorandum to File for Administrative Write-Off of Debt Less Than $2000

Exhibit 4: Sample Pre-Conference Checklist

Exhibit 5: Sample Memorandum of Conference

Exhibit 6: Sample Conference Letter to Claimant

Exhibit 7: OWCP-20 Overpayment Recovery Questionnaire

Exhibit 8: Sample Final Decision (With Fault Preliminary Incorrect)

Exhibit 9: Sample Final Decision (With Fault Preliminary Correct)

Exhibit 10: Sample Final Decision (Without Fault Waiver Denied)