Avoid Problems in Massachusetts with the Social Security Administration Following a Favorable Decision, Part II

As we discussed in our prior blog entry, there are a number of issues to remain vigilant about following the receipt of a favorable Social Security decision.  As was mentioned, periodic reviews will take place as to whether an individual remains disabled (and thus remaining in consistent and zealous treatment with your providers is important to document how one remains disabled).  Likewise, providing updated records of one’s earnings should you be able to return to work is important so that the Social Security Administration (SSA) can keep track of the extent to which you use up Trial Work Period months.  In this blog entry, we’ll continue our discussion on how the failure to report income and/or assets to SSA following the receipt of a favorable decision can have very serious consequences.

First and foremost, it’s important to remember if you are collecting Supplemental Security Income (SSI) benefits that this is a welfare benefit and that the SSI benefit is based on a claimant’s need: thus, SSA takes into account all resources one has (including resources which may be deemed to have based on their household circumstances).   Thus, if your living circumstances change such that someone moves out or in, or you are now living in someone else’s household, it is important to notify SSA as this may impact the amount of SSI one remains entitled to receive.   If you receive earnings, or other forms of income, this may likewise impact your entitlement to SSI, as will the receipt of certain assets (whether it be a settlement of a personal injury claim or receipt of an inheritance).  The failure to report a change in circumstances can result in monetary penalties, and if found that there has been a purposeful attempt to defraud SSA, the result can be a suspension of one’s benefits.  Likewise, misrepresentations or false statements made for the purpose of defrauding SSA can result in criminal penalties that can involve the imposition of imprisonment.

It is likewise important to understand that the failure to report income or assets for SSI purposes may result in a determination that one has been overpaid, causing SSA to being what is called an overpayment process.   This process can result in SSA’s requiring a claimant to pay back that which has been overpaid in benefits, regardless of a claimant’s financial ability to do so.  If necessary, SSA may undertake a partial or total offset of one’s benefit check. Needless to say, it’s important, if at all possible, to avoid an overpayment process (and the way to do this is to report all resources received in an immediate fashion to SSA).

Assuming one has has been reporting their income in a timely fashion and an overpayment process is initiated, one may be entitled to request what is called a Waiver request of the overpayment.   In order to succeed in receiving a waiver of part are all of an overpayment, it is necessary to show, first, that the overpayment was not caused by the claimant.  Assuming one is able to show that the overpayment was caused through no fault of their own, one would still be required to pay back the overpayment if deemed financially capable of doing so.  A Request for Waiver, assuming the claimant is not found at fault, will require SSA to determine the extent to which the claimant remains capable of makin payment towards the overpayment through their disposable income (that is, through that amount of money that is left over each month after accounting for necessary living expenses).   SSA may under such  circumstances then waive that portion of the overpayment that cannot be made through disposable income in a 36 to 60 month period of time (and, once again, in a circumstance where the overpayment occurred through no fault of the claimant).

Thus, for example, assuming a claimant has failed to report their income for a lengthy period of time, it may result in a determination later on by SSA that the Trial Work Period had been used up and that one, at some point in the past, no longer remained entitled to ongoing benefits.  SSA may then determine that benefits should have been discontinued at some point in the past, and that all such payments made after that point in time were overpaid.  In such circumstances, SSA may refuse to allow for a waiver of an overpayment due  to the fact that the waiver was caused by the claimant’s failure to report their income timely and may, correspondingly, seek repayment of the overpaid amount regardless of an individual’s financial ability do so.

The reporting of any of the above changes in circumstances can take place by phone, mail or in person and, by simply doing so, may allow one to avoid what can be potentially very serious consequences.

If you or a family member are finding yourself struggling to get by as a result of a serious disability and can no longer find a way to earn an income, get the advice you need for an experienced Social Security Attorney who has been handling matters throughout Maine, Massachusetts and New Hampshire for 27 years.  Call the Law Offices of Russell J. Goldsmith at 1-800-773-8622.