SAMPLE MEMORANDUM OF CONFERENCE

MEMORANDUM OF CONFERENCE

DATE:

NAME OF EMPLOYEE:

NAME OF CLAIMANT:

CASE ID:

CONFERENCE DATE:

PARTICIPANTS: { Name } , Claimant

{ Name } , Policy Analyst, DEEOIC

PREPARED BY: {Analyst’s name}

This memorandum summarizes the telephone conference held to discuss the {$ } overpayment in the claim filed by {Claimant’s name} under Part {B and/or E} of the Energy Employees Occupational Illness Compensation Program Act (EEOICPA or Act).

PURPOSE OF TELEPHONE CONFERENCE:

In response to an overpayment notice, {Claimant’s name} requested a telephone conference to discuss the findings pertaining to the overpayment in {his / her} claim, including a request for waiver of recovery of the overpayment.

BACKGROUND:

{Describe the background of the claim and how the overpayment was determined.}

When an overpayment occurs in a claim, the DEEOIC is required to take the appropriate action to recover the overpaid benefits. The DEEOIC sent {Claimant’s name} a notice informing {him / her} of the overpayment. The notice also informed {him / her} of the preliminary finding that {he / she} was {insert fault finding} in causing the overpayment. {If at fault, insert why this finding was made.}

In response to the notice, {Claimant’s name} requested a telephone conference and requested a waiver of recovery. {Claimant’s name} submitted an Overpayment Recovery Questionnaire and {insert documentation submitted}.

PRE-CONFERENCE CALL:

On {date}, {Analyst’s name} telephoned {Claimant’s name} to schedule a telephone conference. {Claimant’s name} was informed that the purpose of the conference was to give {him / her} the opportunity to discuss the criteria for granting a waiver of recovery of the overpayment. The telephone conference was scheduled for {date}.

OVERPAYMENT TELEPHONE CONFERENCE:

The telephone conference was held on {date} with {Analyst’s name}, who advised {Claimant’s name} that the purpose of the conference was to give {him / her} the opportunity to provide information to support the request for a waiver of recovery of the overpayment.

{Insert in detail what claimant stated during the conference}

{Analyst’s name} explained the criteria for granting a waiver of recovery of the overpayment. A waiver can be granted if a claimant is not at fault in causing the overpayment, and that it would be a financial hardship and defeat the purpose of the EEOICPA, or it would be against equity and good conscience if required to repay the money.

{If waiver request is based on financial hardship, list type and amount of income, expenses, and assets.}

{Claimant’s name} stated that the monthly income, expenses, and assets include the following:

Monthly Income:

{Identify each income source} $

Monthly Expenses:

{Identify each monthly expense} $

Countable Assets:

(Identify each countable asset $

and value)

-OR-

{If waiver request is based on against equity and good conscience, describe the basis for that request and documentation submitted to support it.}

{Analyst’s name} informed {Claimant’s name} that if a waiver is granted based on “against equity and good conscious,” financial information is not taken into consideration. Therefore, {his / her} complete financial information was not being requested at this time.

CONCLUSION:

{Analyst’s name} informed {Claimant’s name} that {he / she} would prepare and send a memorandum summarizing the telephone conference. If {he / she} had any comments regarding the memorandum, {he / she} should send the comments in writing to {Analyst’s name}. The information in the case file will be reviewed, and a final decision regarding the overpayment will be sent to {him / her}. {Claimant’s name} stated that {he / she} did not have any further statements, and the telephone conference was concluded.