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42 U.S.C. § 404Overpayments and underpayments

submitted 91 years ago by ch. 531 to r/title-42-THE-PUBLIC-HEALTH-AND-WELFARE · 2,093 words · no verdicts yet

in plain englishAI-generated · not legal advice

This law tells the Social Security Administration how to fix mistaken payments. If someone got too much money, the government reduces future checks or asks for a refund; if someone got too little, the government pays the difference. People who were not at fault can sometimes get overpayments forgiven, and the law sets rules for who gets a deceased person's unpaid benefits.

(a) Fixing wrong payments (1) If the Commissioner of Social Security finds that someone got more or less than the correct amount, the Commissioner must fix it, following rules the Commissioner writes. (A) Overpayment: The Commissioner can fix an overpayment by lowering the person's future benefits; requiring the person (or their estate) to pay back the extra amount; lowering benefits owed to the estate or to someone else who qualifies on the same earnings record; recovering the money by reducing the person's tax refund (under section 3720A of title 31); or using any mix of these methods. Special rule: if a payment was made because the Department of Defense wrongly reported that a service member died on active duty, that payment does not count as "incorrect" for any month before the Department tells the Commissioner the person is actually alive. (B) Underpayment: The Commissioner must pay the person the balance they are owed. If the person dies before getting the full balance — or before cashing checks that were already correct — the money goes out following the order set in subsection (d) instead. But there is a limit: no back payment can be made for any month a person's benefits are unpaid because of section 402(x)(1) — the rule about certain fugitives and prisoners — or would be unpaid under that rule if the benefits had not already ended for some other reason, until that rule stops applying. This limit does not stop the Commissioner from otherwise withholding, adjusting, or recovering amounts that would normally be taken out of what the person is owed. (2) Special rule for direct deposits after death: If a payment to someone who has died goes out by direct deposit into a joint bank account, and the other person on that account also qualified for a monthly benefit on the same earnings record for the month before the death, then the extra amount is treated as an overpayment to that other person — not to the estate. If a "representative payee" (someone managing benefits for another person) gets an overpayment after the beneficiary's death, that representative payee must repay it, tracked under the payee's own Social Security number. (3) Special rule for foster children: If a State is acting as representative payee for a child in foster care, and an overpayment happens for a month the child is in foster care, the State — not the child — must repay it. (The term "represented minor beneficiary" is defined elsewhere, in subsection (j)(11)(B)(iii), which is not included in this excerpt.) (b) Checking finances before forgiving an overpayment (1) If someone was overpaid but was not at fault, the government will not adjust their future payments or try to recover the money — as long as doing so would either defeat the purpose of Social Security or be unfair. (2) In deciding whether someone was "without fault," the Commissioner must consider any physical, mental, educational, or language limitation the person has — including not speaking English well. (3) To decide whether recovery would "defeat the purpose" of Social Security, the Commissioner can require the person to authorize access to their financial records at any bank or similar institution. This authorization stays valid until either a final decision is made, or the person cancels it in writing. Several technical rules make clear that this kind of authorization satisfies the Right to Financial Privacy Act's requirements without extra paperwork to the bank. The Commissioner must tell the person how long the authorization lasts and what it covers. If someone refuses to give this authorization, or cancels it, the Commissioner can treat that refusal as a reason to decide that recovering the money would not defeat the purpose of Social Security. (c) Government employees are not personally liable No government officer who certifies or pays out benefits is personally liable for money involved in a case, if the recovery is later waived under subsection (b), or if the collection was never completed before everyone whose benefits could be reduced has died. (d) Who gets money owed to someone who died If a person dies before their Social Security payment is finished (including uncashed checks), the money goes, in this order, to whichever category below has someone who qualifies: (1) a surviving spouse who either lived with the deceased when they died, or who qualified for a monthly benefit on the same earnings record for the month before the death; (2) if no spouse qualifies, the deceased's children who qualified for a monthly benefit on the same record for that month, split equally; (3) if no one in (1) or (2) qualifies, the deceased's parents who qualified for a monthly benefit on the same record for that month, split equally; (4) if no one in (1)–(3) qualifies, any surviving spouse, even one who does not meet the special conditions above; (5) if no one in (1)–(4) qualifies, the deceased's children, split equally, even without those special conditions; (6) if no one in (1)–(5) qualifies, the deceased's parents, split equally, even without those special conditions; (7) if no one in (1)–(6) qualifies, the legal representative of the deceased's estate. (e) Supplemental Security Income adjustments If a person's payment is being adjusted because they also get Supplemental Security Income, the rules for that are in a different law — section 1320a–6 of this title. (f) Collecting old unpaid amounts (1) For amounts that are "delinquent" (defined below), the Commissioner can use the same collection tools the government uses generally — specific sections of title 31 and title 5 — as those tools worked right after April 26, 1996. (2) A "delinquent amount" is money that: (A) is more than the correct payment amount; (B) was paid to someone after they turned 18; and (C) the Commissioner decides, by regulation, cannot otherwise be recovered once the person is no longer a Social Security beneficiary. (g) Recovering overpayments across programs If someone was overpaid under Social Security but the government wants to recover it from a different program the Commissioner runs, the rules for that are in section 1320b–17 of this title.
the actual law source: uscode.house.gov ↗public domain
(a) Procedure for adjustment or recovery
(1)

Whenever the Commissioner of Social Security finds that more or less than the correct amount of payment has been made to any person under this subchapter, proper adjustment or recovery shall be made, under regulations prescribed by the Commissioner of Social Security, as follows:

(A)

With respect to payment to a person of more than the correct amount, the Commissioner of Social Security shall decrease any payment under this subchapter to which such overpaid person is entitled, or shall require such overpaid person or his estate to refund the amount in excess of the correct amount, or shall decrease any payment under this subchapter payable to his estate or to any other person on the basis of the wages and self-employment income which were the basis of the payments to such overpaid person, or shall obtain recovery by means of reduction in tax refunds based on notice to the Secretary of the Treasury as permitted under section 3720A of title 31, or shall apply any combination of the foregoing. A payment made under this subchapter on the basis of an erroneous report of death by the Department of Defense of an individual in the line of duty while he is a member of the uniformed services (as defined in section 410(m) of this title) on active duty (as defined in section 410(l) of this title) shall not be considered an incorrect payment for any month prior to the month such Department notifies the Commissioner of Social Security that such individual is alive.

(B)
(i)

Subject to clause (ii), with respect to payment to a person of less than the correct amount, the Commissioner of Social Security shall make payment of the balance of the amount due such underpaid person, or, if such person dies before payments are completed or before negotiating one or more checks representing correct payments, disposition of the amount due shall be made in accordance with subsection (d).

(ii)

No payment shall be made under this subparagraph to any person during any period for which monthly insurance benefits of such person—

(I)

are subject to nonpayment by reason of section 402(x)(1) of this title, or

(II)

in the case of a person whose monthly insurance benefits have terminated for a reason other than death, would be subject to nonpayment by reason of section 402(x)(1) of this title but for the termination of such benefits,

until section 402(x)(1) of this title no longer applies, or would no longer apply in the case of benefits that have terminated.

(iii)

Nothing in clause (ii) shall be construed to limit the Commissioner’s authority to withhold amounts, make adjustments, or recover amounts due under this subchapter, subchapter VIII or subchapter XVI that would be deducted from a payment that would otherwise be payable to such person but for such clause.

(2)

Notwithstanding any other provision of this section, when any payment of more than the correct amount is made to or on behalf of an individual who has died, and such payment—

(A)

is made by direct deposit to a financial institution;

(B)

is credited by the financial institution to a joint account of the deceased individual and another person; and

(C)

such other person was entitled to a monthly benefit on the basis of the same wages and self-employment income as the deceased individual for the month preceding the month in which the deceased individual died,

the amount of such payment in excess of the correct amount shall be treated as a payment of more than the correct amount to such other person. If any payment of more than the correct amount is made to a representative payee on behalf of an individual after the individual’s death, the representative payee shall be liable for the repayment of the overpayment, and the Commissioner of Social Security shall establish an overpayment control record under the social security account number of the representative payee.

(3)
(A)

When any payment of more than the correct amount is made on behalf of an individual who is a represented minor beneficiary for a month in which such individual is in foster care under the responsibility of a State and the State is the representative payee of such individual, the State shall be liable for the repayment of the overpayment, and there shall be no adjustment of payments to, or recovery by the United States from, such individual.

(B)

For purposes of this paragraph, the term “represented minor beneficiary” has the meaning given such term in subsection (j)(11)(B)(iii).1

(b) Access to financial information for old-age, survivors, and disability insurance waivers
(1)

In any case in which more than the correct amount of payment has been made, there shall be no adjustment of payments to, or recovery by the United States from, any person who is without fault if such adjustment or recovery would defeat the purpose of this subchapter or would be against equity and good conscience.

(2)

In making for purposes of this subsection any determination of whether any individual is without fault, the Commissioner of Social Security shall specifically take into account any physical, mental, educational, or linguistic limitation such individual may have (including any lack of facility with the English language).

(3)
(A)

In making for purposes of this subsection any determination of whether such adjustment or recovery would defeat the purpose of this subchapter, the Commissioner of Social Security shall require an individual to provide authorization for the Commissioner to obtain (subject to the cost reimbursement requirements of section 1115(a) of the Right to Financial Privacy Act [12 U.S.C. 3415]) from any financial institution (within the meaning of section 1101(1) of such Act [12 U.S.C. 3401(1)]) any financial record (within the meaning of section 1101(2) of such Act [12 U.S.C. 3401(2)]) held by the institution with respect to such individual whenever the Commissioner determines the record is needed in connection with a determination with respect to such adjustment or recovery.

(B)

Notwithstanding section 1104(a)(1) of the Right to Financial Privacy Act [12 U.S.C. 3404(a)(1)], an authorization provided by an individual pursuant this paragraph shall remain effective until the earlier of—

(i)

the rendering of a final decision on whether adjustment or recovery would defeat the purpose of this subchapter; or

(ii)

the express revocation by the individual of the authorization, in a written notification to the Commissioner.

(C)
(i)

An authorization obtained by the Commissioner of Social Security pursuant 2 this paragraph shall be considered to meet the requirements of the Right to Financial Privacy Act [12 U.S.C. 3401 et seq.] for purposes of section 1103(a) of such Act [12 U.S.C. 3403(a)], and need not be furnished to the financial institution, notwithstanding section 1104(a) of such Act [12 U.S.C. 3404(a)].

(ii)

The certification requirements of section 1103(b) of the Right to Financial Privacy Act [12 U.S.C. 3403(b)] shall not apply to requests by the Commissioner of Social Security pursuant to an authorization provided under this paragraph.

(iii)

A request by the Commissioner pursuant to an authorization provided under this paragraph is deemed to meet the requirements of section 1104(a)(3) of the Right to Financial Privacy Act [12 U.S.C. 3404(a)(3)] and the flush language of section 1102 of such Act [12 U.S.C. 3402].

(D)

The Commissioner shall inform any person who provides authorization pursuant to this paragraph of the duration and scope of the authorization.

(E)

If an individual refuses to provide, or revokes, any authorization for the Commissioner of Social Security to obtain from any financial institution any financial record, the Commissioner may, on that basis, determine that adjustment or recovery would not defeat the purpose of this subchapter.

(c) Nonliability of certifying and disbursing officers

No certifying or disbursing officer shall be held liable for any amount certified or paid by him to any person where the adjustment or recovery of such amount is waived under subsection (b), or where adjustment under subsection (a) is not completed prior to the death of all persons against whose benefits deductions are authorized.

(d) Payment to survivors or heirs when eligible person is deceased

If an individual dies before any payment due him under this subchapter is completed, payment of the amount due (including the amount of any unnegotiated checks) shall be made—

(1)

to the person, if any, who is determined by the Commissioner of Social Security to be the surviving spouse of the deceased individual and who either (i) was living in the same household with the deceased at the time of his death or (ii) was, for the month in which the deceased individual died, entitled to a monthly benefit on the basis of the same wages and self-employment income as was the deceased individual;

(2)

if there is no person who meets the requirements of paragraph (1), or if the person who meets such requirements dies before the payment due him under this subchapter is completed, to the child or children, if any, of the deceased individual who were, for the month in which the deceased individual died, entitled to monthly benefits on the basis of the same wages and self-employment income as was the deceased individual (and, in case there is more than one such child, in equal parts to each such child);

(3)

if there is no person who meets the requirements of paragraph (1) or (2), or if each person who meets such requirements dies before the payment due him under this subchapter is completed, to the parent or parents, if any, of the deceased individual who were, for the month in which the deceased individual died, entitled to monthly benefits on the basis of the same wages and self-employment income as was the deceased individual (and, in case there is more than one such parent, in equal parts to each such parent);

(4)

if there is no person who meets the requirements of paragraph (1), (2), or (3), or if each person who meets such requirements dies before the payment due him under this subchapter is completed, to the person, if any, determined by the Commissioner of Social Security to be the surviving spouse of the deceased individual;

(5)

if there is no person who meets the requirements of paragraph (1), (2), (3), or (4), or if each person who meets such requirements dies before the payment due him under this subchapter is completed, to the person or persons, if any, determined by the Commissioner of Social Security to be the child or children of the deceased individual (and, in case there is more than one such child, in equal parts to each such child);

(6)

if there is no person who meets the requirements of paragraph (1), (2), (3), (4), or (5), or if each person who meets such requirements dies before the payment due him under this subchapter is completed, to the parent or parents, if any, of the deceased individual (and, in case there is more than one such parent, in equal parts to each such parent); or

(7)

if there is no person who meets the requirements of paragraph (1), (2), (3), (4), (5), or (6), or if each person who meets such requirements dies before the payment due him under this subchapter is completed, to the legal representative of the estate of the deceased individual, if any.

(e) Adjustments due to supplemental security income payments

For payments which are adjusted by reason of payment of benefits under the supplemental security income program established by subchapter XVI, see section 1320a–6 of this title.

(f) Collection of delinquent amounts
(1)

With respect to any deliquent 3 amount, the Commissioner of Social Security may use the collection practices described in sections 3711(f), 3716, 3717, and 3718 of title 31 and in section 5514 of title 5, all as in effect immediately after April 26, 1996.

(2)

For purposes of paragraph (1), the term “delinquent amount” means an amount—

(A)

in excess of the correct amount of payment under this subchapter;

(B)

paid to a person after such person has attained 18 years of age; and

(C)

determined by the Commissioner of Social Security, under regulations, to be otherwise unrecoverable under this section after such person ceases to be a beneficiary under this subchapter.

(g) Cross-program recovery of overpayments

For provisions relating to the cross-program recovery of overpayments made under programs administered by the Commissioner of Social Security, see section 1320b–17 of this title.

Source credit: (Aug. 14, 1935, ch. 531, title II, § 204, 49 Stat. 624; Aug. 10, 1939, ch. 666, title II, § 201, 53 Stat. 1362, 1368; Aug. 28, 1950, ch. 809, title I, § 109(b)(1), 64 Stat. 523; Sept. 1, 1954, ch. 1206, title I, § 111(a), 68 Stat. 1085; Pub. L. 89–97, title III, § 329, July 30, 1965, 79 Stat. 401; Pub. L. 90–248, title I, §§ 152, 153(a), 154(a), Jan. 2, 1968, 81 Stat. 860, 861; Pub. L. 96–265, title V, § 501(b), June 9, 1980, 94 Stat. 470; Pub. L. 99–272, title XII, § 12113(a), Apr. 7, 1986, 100 Stat. 288; Pub. L. 101–239, title X, § 10305(b), Dec. 19, 1989, 103 Stat. 2483; Pub. L. 101–508, title V, § 5129(a), Nov. 5, 1990, 104 Stat. 1388–287; Pub. L. 103–296, title I, § 107(a)(4), Aug. 15, 1994, 108 Stat. 1478; Pub. L. 103–387, § 5(a), Oct. 22, 1994, 108 Stat. 4077; Pub. L. 104–134, title III, § 31001(z)(2)(A), Apr. 26, 1996, 110 Stat. 1321–379; Pub. L. 104–316, title I, § 115(g)(2)(E), Oct. 19, 1996, 110 Stat. 3835; Pub. L. 105–306, § 8(b)(1), Oct. 28, 1998, 112 Stat. 2929; Pub. L. 106–169, title II, §§ 201(a), 203(c), Dec. 14, 1999, 113 Stat. 1831, 1832; Pub. L. 108–203, title II, § 210(b)(1), Mar. 2, 2004, 118 Stat. 517; Pub. L. 111–115, § 2(a), Dec. 15, 2009, 123 Stat. 3029; Pub. L. 114–74, title VIII, § 834(a), Nov. 2, 2015, 129 Stat. 614; Pub. L. 115–165, title I, § 104(a), Apr. 13, 2018, 132 Stat. 1263.)

history & why it existsrecord from the source credit
  • 1935Enacted · Act of Aug. 14, 1935, ch. 531 · 49 Stat. 624
  • 1939Amended · Act of Aug. 10, 1939, ch. 666 · 53 Stat. 1362, 1368
  • 1950Amended · Act of Aug. 28, 1950, ch. 809 · 64 Stat. 523
  • 1954Amended · Act of Sept. 1, 1954, ch. 1206 · 68 Stat. 1085
  • 1965Amended · Pub. L. 89-97 · 79 Stat. 401
  • 1968Amended · Pub. L. 90-248 · 81 Stat. 860, 861
  • 1980Amended · Pub. L. 96-265 · 94 Stat. 470
  • 1986Amended · Pub. L. 99-272 · 100 Stat. 288
  • 1989Amended · Pub. L. 101-239 · 103 Stat. 2483
  • 1990Amended · Pub. L. 101-508 · 104 Stat. 1388
  • 1994Amended · Pub. L. 103-296 · 108 Stat. 1478
  • 1994Amended · Pub. L. 103-387 · 108 Stat. 4077
  • 1996Amended · Pub. L. 104-134 · 110 Stat. 1321
  • 1996Amended · Pub. L. 104-316 · 110 Stat. 3835
  • 1998Amended · Pub. L. 105-306 · 112 Stat. 2929
  • 1999Amended · Pub. L. 106-169 · 113 Stat. 1831, 1832
  • 2004Amended · Pub. L. 108-203 · 118 Stat. 517
  • 2009Amended · Pub. L. 111-115 · 123 Stat. 3029
  • 2015Amended · Pub. L. 114-74 · 129 Stat. 614
  • 2018Amended · Pub. L. 115-165 · 132 Stat. 1263

A history note hasn’t been published yet. The record shows enactment by ch. 531 on 1935-08-14.

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