S.C. Code Regs. § § 47-103

Current through Register Vol. 48, No. 11, November 22, 2024

Section 47-103 - Waiver of Non-Fraudulent or No-Fault Overpayment

Pursuant to South Carolina Code Annotated Section 41-41-40(B)(2), the Department may waive repayment of overpayments if the overpayment was not due to fraud, misrepresentation, or willful dislcosure, was received without fault on the part of the claimant, and recovery of the overpayment would be contrary to equity and good conscience.

1. WAIVER

a. When an overpayment determination is issued, a claimant may request a waiver.

b. A request for waiver by an individual shall be in writing and set forth the grounds for waiver.

c. The Department's denial of a request for waiver of the repayment of an overpayment is an appealable decision.

d. When a waiver of an overpayment has become final, it shall not be re-determined in the absence of fraud, misrepresentation, or willful nondisclosure by the claimant relating to the waiver.

2. FAULT

In determining whether fault exists, the following factors must be considered:

a. whether a statement or representation was made by the individual in connection with a claim for benefits that resulted in the overpayment, and whether the individual knew or should have known that the statement or representation was inaccurate;

b. whether the individual failed or caused another to fail to disclose a material fact, in connection with a claim for benefits that resulted in the overpayment, and whether the individual knew or should have known that the fact was material; and

c. whether the individual knew or could have been expected to know that the individual was not entitled to the benefit payment.

In the event of an affirmative finding on any of the FAULT factors outlined above, the overpayment shall not be waived and further determination of any factors will not be necessary.

3. EQUITY AND GOOD CONSCIENCE

In determining whether recovery of an overpayment is against equity and good conscience for the purpose of deciding whether the overpayment of benefits shall be waived, the Department shall consider the following non-exclusive factors:

a. The extent to which recovery of the overpayment would create an extraordinary financial hardship on the claimant. Extraordinary financial hardship as used herein means the claimant would be unable to provide himself or his immediate family with minimal necessities (e.g., food, shelter, basic utilities) as a result of the Department recovering the overpayment;

b. The nature and cause of the overpayment, including whether Department error contributed to causing the overpayment;

c. Whether the claimant had notice that if a decision to pay benefits was reversed, an overpayment would be created;

d. Whether the claimant detrimentally changed his/her position in reliance upon receipt of benefits; and

e. Any other relevant factor that relates to fairness and good conscience.

S.C. Code Regs. § 47-103

Added by State Register Volume 38, Issue No. 2, eff February 28, 2014.