20 C.F.R. § 404.507

Fault

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Fault as used in without fault (see § 404.506 and 42 CFR 405.355) applies only to the individual. Although the Administration may have been at fault in making the overpayment, that fact does not relieve the overpaid individual or any other individual from whom the Administration seeks to recover the overpayment from liability for repayment if such individual is not without fault. In determining whether an individual is at fault, the Social Security Administration will consider all pertinent circumstances, including the individual's age and intelligence, and any physical, mental, educational, or linguistic limitations (including any lack of facility with the English language) the individual has. Notwithstanding any other provision of this subpart, we will not determine any overpaid individual to be at fault in causing a qualifying overpayment (see § 404.506(b)(1)) unless we determine that the qualifying overpayment made to a beneficiary or a representative payee during the pandemic period (see § 404.501) was the result of fraud or similar fault or involved misuse of benefits by a representative payee (see § 404.2041). What constitutes fault (except for deduction overpayments—see § 404.510) on the part of the overpaid individual or on the part of any other individual from whom the Administration seeks to recover the overpayment depends upon whether the facts show that the incorrect payment to the individual or to a provider of services or other person, or an incorrect payment made under section 1814(e) of the Act, resulted from:

(a) An incorrect statement made by the individual which he knew or should have known to be incorrect; or

(b) Failure to furnish information which he knew or should have known to be material; or

(c) With respect to the overpaid individual only, acceptance of a payment which he either knew or could have been expected to know was incorrect.

[34 FR 14888, Sept. 27, 1969; 34 FR 15646, Oct. 9, 1969, as amended at 44 FR 34942, June 18, 1979; 59 FR 1634, Jan. 12, 1994; 85 FR 52914, Aug. 27, 2020]
Notes of Decisions
Cited in 159 cases (25 in the last 5 years), 1969–2026 · leading case: Leonard ALBALOS, Plaintiff-Appellant, v. Louis S. SULLIVAN, M.D., Sec'y of Health & Human Servs., Defendant-Appellee, 907 F.2d 871 (9th Cir. 1990).
Leonard ALBALOS, Plaintiff-Appellant, v. Louis S. SULLIVAN, M.D., Sec'y of Health & Human Servs., Defendant-Appellee, 907 F.2d 871 (9th Cir. 1990). · cites it 6× “The AU applied 20 C.F.R. § 404.507 in finding that Albalos was “not without fault.”
Califano v. Yamasaki, 442 U.S. 682 (1979). · cites it 2× “20 CFR § 404.507 (1978). For example, a recipient who justifiably relied upon erroneous information from *686 an official source within the Social Security Administration would be “without fault.”
Ermano Valente v. Sec'y of Health & Human Servs., 733 F.2d 1037 (2d Cir. 1984). · cites it 2× “, below, 20 C.F.R. § 404.507 (1983) provides that any fault of SSA in causing overpayments does not relieve the individual of fault.”
Rose v. Comm'r of Soc. Sec., 202 F. Supp. 3d 231 (E.D.N.Y 2016). · cites it 2× “20 C.F.R. § 404.507 (a)-(c). Additionally, the Commissioner must take into account an individual’s “physical, mental, educational, or linguistic limitation[s].”
Anderson v. Sullivan, 914 F.2d 1121 (9th Cir. 1990). · cites it 3× “20 C.F.R. § 404.507 (1989). In making these determinations of fault, the agency “will consider all pertinent circumstances, including his age, intelligence, education, and physical and mental condition.”
Paul Miskey v. Kilolo Kijakazi, 33 F.4th 565 (9th Cir. 2022). · cites it 2× “20 C.F.R. § 404.507 . The evidence cited by the ALJ does not support a finding of fault based on any of those criteria.”
Watson v. Sullivan, 940 F.2d 168 (6th Cir. 1991). · cites it 4× “Title 20 C.F.R. section 404.507 provides in relevant part: What constitutes fault (except for “deduction overpayments” — see § 404.”
Fazeela McCabe v. Comm'r of Soc. Sec., 661 F. App'x 596 (11th Cir. 2016). “20 C.F.R. § 404.507 . Fault can be shown, for example, where the overpayment of benefits results from the claimant’s failure to provide information she knew or should have known was material.”
Wilkening, Traci v. Barnhart, Jo Anne, 139 F. App'x 715 (7th Cir. 2005). · cites it 4× “” 20 C.F.R. § 404.507 . A finding of fault can be based on any of the following: (a) An incorrect statement made by the individual which he knew or should have known to be incorrect; or (b) Failure to furnish information which he knew or should have known to be material; or (c)…”
Herbert C. FOWLER, Plaintiff-Appellant, v. Otis R. BOWEN, Sec'y of Health & Human Servs., Defendant-Appellee, 876 F.2d 1451 (10th Cir. 1989). “20 C.F.R. § 404.507 . The AU must also “consider all pertinent circumstances, including [claimant’s] age, intelligence, education, and physical and mental condition.”
Tefera v. Colvin, 61 F. Supp. 3d 207 (D. Mass. 2014). · cites it 3× “20 C.F.R. §§ 404.507 (a)-(c). “If a claimant fails to establish that [s]he was without fault, analysis of the second prong is unnecessary.”
Gray Panthers v. Richard S. Schweiker, Sec'y of the Dep't of Health & Human Servs., 652 F.2d 146 (D.C. Cir. 1981). “20 CFR § 404.507 (1978). We do not see how these can be evaluated absent personal contact between the recipient and the person who decides his case.”
— 20 C.F.R. § 404.507(c) — 1 case
Morency v. Bowen, 677 F. Supp. 260 (D.N.J. 1988).
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