An SBP recipient is overpaid if he is not eligible for benefits he receives.
NOTE: An SBP recipient is not considered overpaid because of visual acuity unless:
The CAO decides from the evidence that the person knew he was visually not eligible and did not report it promptly, or
The CAO fails to suspend and/or stop SBP after learning that the person does not meet the visual requirement
An SBP recipient is underpaid if he was eligible for a higher benefit than he received. He is entitled to a corrective payment.
The CAO finds whether there was an overpayment by comparing the blind person’s total net income (including the SBP payment) with $4,260 at the end of the fiscal year. See the PA 21-BI.
If the total net income, including the SBP payment, is more than $4,260, the SBP recipient has been overpaid by the amount over the $4,260.
The SBP recipient must make restitution for any overpayment of $1 or more, unless the overpayment is because of administrative error. Administrative error is when:
The CAO did not get, interpret or correctly apply the facts of the blind person’s situation
The blind person fulfilled reporting requirements to the best of his ability, and
The blind person could not have been expected to know that he was overpaid
If an overpayment occurs for reasons other than administrative error, and the blind person qualifies for SBP, he can make restitution in one of these two ways:
Paying back the entire overpayment amount in one payment
NOTE: The CAO must send an Overpayment Referral (OIG 189) to OIG and continue to grant SBP. If the blind person fails to repay in a lump sum after choosing to do so, the CAO will reduce or suspend the SBP to recover the overpayment.
Suspending or reducing the SBP payment until the overpayment is repaid
NOTE: The reduction or suspension may not go beyond the last day of the fiscal year after the year of the overpayment. If the overpayment has not been completely repaid by then, or if SBP stops before the end of this period, the CAO must make an overpayment referral for the remaining overpayment amount.
The CAO will complete an OIG 189 when:
The SBP recipient was overpaid while benefits were discontinued
The overpayment is discovered more than one fiscal year after the overpayment
More than one fiscal year has passed since the end of the fiscal year of the overpayment and SBP has resumed
Full restitution was not reached by suspending or reducing the SBP payment
See Chapter 910, Overpayment Recovery, for OFAIR overpayment rules.
At the end of the fiscal year, the CAO finds whether there was an underpayment by comparing the blind person’s total net income, including the SBP payment, with $4,260.
If the total net income, including the SBP payment, is less than $4,260, the CAO authorizes a one-time issuance for the difference, unless the difference is less than $1.
If the blind person did not qualify for SBP for reasons other than income during any month in the fiscal year, or if he received a nursing home care payment during any month, the CAO must subtract $100 for each of these months when calculating the underpayment amount.
Example: Mr. M received SBP payments of $47 per month based on the computation done when he applied on April 3. When the CAO performed the fiscal year computation, it found that Mr. M's total net income was $3,924. However, for the month of August, he was ineligible because his resources were greater than $7,500 in value. Calculate the underpayment as follows:
|
Maximum SBP limit: |
$4,260 |
Reviewed July 30, 2013