SSA realizes that if you get cash public assistance, you can’t afford to repay. This can include Supplemental Security Income (SSI), VA benefits and Reach Up. (Food stamps, Medicaid, unemployment and workers’ compensation are not considered cash public assistance.)
If you get cash public assistance, fill out the waiver request form through question 12 and then sign, date and submit the form.
If you do not get cash public assistance, you need fill out the whole form. List all of your living expenses. If all of your monthly income is needed for your expenses and you have no other bank accounts or other resources, SSA should find that you don’t have the ability to pay back the overpayment.
Some expenses that people forget to list are: over-the-counter medicines or vitamins; pet care; snow removal; lawn service; cleaning products, personal care and other non-food grocery items; haircuts; newspapers and magazines; birthday and holiday gifts; entertainment; dry cleaning; cable TV and internet service.
Tip: To get a monthly amount for expenses you don’t have every month, add up the total you pay in one year. Divide the total by 12. Use that amount for your monthly expense. For example, you pay $24 for snow removal 10 times. That’s $240. $240 divided by 12 = $20 monthly.
Tell SSA about things you don’t have because you can’t pay for them. For example, your washing machine is broken, but you can’t afford to have it fixed or buy a new one.
If you have money in a bank, you should explain why the money can’t be used to repay the overpayment. Use the section called “Remarks” on the last page of the form. For example, you need the money to pay bills that you owe, or you are saving money to buy new dentures or a washing machine, or you need it for your property taxes.