Sample Initial Overpayment Notification Letter - Without Fault

Employee:

EEOICPA Case ID:

EEOICPA Claim ID:

Claimant Name

Address

Dear [Claimant Name]:

The Division of Energy Employees Occupational Illness Compensation (DEEOIC) has made a preliminary finding that you have been overpaid benefits in the amount of [$ ]. The overpayment occurred because:

[Describe reason]

DEEOIC has also made a preliminary finding that you are without fault in creating the overpayment. If you disagree with the fact or the amount of the overpayment, you have a right to submit new evidence.

When a claimant is without fault in creating an overpayment, the law states that DEEOIC may not recover the overpayment if the recovery would defeat the purpose of the Energy Employees Occupational Illness Compensation Program Act (EEOICPA), or the recovery would be against equity and good conscience.

To defeat the purpose of the EEOICPA, it must be found that the claimant requires substantially all current income to meet current ordinary and necessary living expenses and the claimant assets do not exceed a specified amount as determined by DEEOIC from data furnished by the Bureau of Labor Statistics.

It would be against equity and good conscience to recover an overpayment when:

1. A claimant would suffer severe financial hardship in trying to repay the debt; or

2. A claimant, acting on incorrect information from DEEOIC, gives up a verifiably valuable right or changes his or her position for the worse, such as leaving a job which he or she cannot regain; or

3. A claimant, acting on incorrect information from DEEOIC, spends or commits funds in ways which he or she otherwise would not have done, and suffers a financial loss as a result.

ACTIONS YOU MAY TAKE

If you believe that you should receive a waiver instead of repaying the overpayment, you may take any one of the following actions within 30 days of the date of this letter:

1. Request a telephone conference with the DEEOIC National Office; or

2. Request that the DEEOIC National Office issue a final decision based on the written evidence of record.

The DEEOIC staff will address the following issues during the telephone conference or in writing:

a. How the overpayment occurred and the amount;

b. Discuss the criteria for a waiver on collecting the overpayment.

INFORMATION NEEDED TO WAIVE RECOVERY OF THE OVERPAYMENT

If you are seeking a waiver of recovery (whether you choose a phone conference or not) you should send the following to DEEOIC:

1. A detailed explanation of your reasons for seeking waiver;

2. A fully-completed Overpayment Recovery Questionnaire (Form OWCP-20) (copy enclosed); and

3. Supporting documents, to include copies of income tax returns, bank account statements, bills and canceled checks, pay slips, and other records to support income and expenses shown on Form OWCP-20. Do not send originals as they will not be returned.

This information will help us decide whether or not you meet the criteria to waive recovery of the overpayment. If waiver is not granted, the information will be used to decide how to collect the overpayment. We will not try to collect the overpayment until we reach a final decision on your request for waiver.

Also please note that under 20 CFR 30.518, we will deny waiver if you fail to furnish the information requested on the enclosed Form OWCP-20 (or other information we need to address a request for waiver) within 30 days. We will not consider any further request for waiver until the requested information is furnished. Once an overpayment final decision letter is issued, a waiver of recovery of the overpayment is no longer an option.

CONTACTING DEEOIC

If you wish to have a telephone conference, please so state on the attached Response to Initial Overpayment Notice, and send it to the DOL DEEOIC Central Mail Room address noted below the National Office within 30 days. You must also submit a detailed explanation of your reasons for seeking waiver, a fully-completed and signed Form OWCP-20, and supporting documents along with your request. We will then contact you to arrange a convenient time for the conference, allowing enough time for you to prepare. If we do not receive a reply from you within 30 days of the date of this letter, we will issue a final decision based on the information currently on file. Please note that without the required financial information, a waiver of recovery of the overpayment cannot be granted.

If you wish to have a decision made based on the written evidence only, please so state on the attached form and send it to the DOL DEEOIC Central Mail Room within 30 days. (We may still contact you to arrange a telephone conference if the written evidence is not sufficient to make a decision.)

A request for either a conference or a decision on the written evidence, along with any supporting evidence or arguments, should be sent to the following address:

DOL DEEOIC Central Mail Room

PO Box 8306

London, KY 40742-8306

If you agree with the findings of this decision, and you wish to make payment at this time, please send a check to the address shown below. Make the check payable to the “U.S. Department of Labor, OWCP”, notate the case ID, and indicate that it is for an overpayment.

US DEPARTMENT OF LABOR

DEEOIC

PO Box 77247

Washington, DC 20013-7247

If we do not receive a reply from you within 30 days of the date of this letter, a final decision will be issued based on the evidence of record.

If you have any questions about this letter, you may contact me at { } or 202-693-0081.

Sincerely,

{PA name}

Policy Unit

DEEOIC

Enclosures: Overpayment Recovery Questionnaire (Form OWCP-20)

Response to Initial Overpayment Notice

Notice to Customers Making Payment by Check

When you provide a check as payment, you authorize us either to use information from your check to make a one-time electronic fund transfer from your account or to process the payment as a check transaction. When we use information from your check to make an electronic fund transfer, funds may be withdrawn from your account as soon as the same day we receive your payment.

Privacy Act – A Privacy Act Statement required by 5 U.S.C. § 552a(e)(3) stating our authority for soliciting and collecting the information from your check, and explaining the purposes and routine uses which will be made of your check information, is available on internet site at: https://www.pccotc.gov/pccotc/index.htm , or call toll free at 1-866-945-7920 to obtain a copy by mail. Furnishing the check information is voluntary, but a decision not to do so may require you to make payment by some other method.

RESPONSE TO INITIAL OVERPAYMENT NOTICE

EMPLOYEE:

EEOICPA CASE ID:

CLAIMANT:

EEOICPA CLAIM ID:

____ I request a telephone conference with the National Office on the issue of possible waiver of recovery of this overpayment. My supporting financial documents are enclosed.

____ I request that the National Office make a decision based on the written evidence on the issue of possible waiver of recovery of this overpayment. My supporting financial documents are enclosed.

Signature: _____________________________ Date: _________________