We have identified the following overpayment and are in good faith voluntarily refunding all monies collected in error. Explain how overpaid unemployment benefits were spent.When you identify a Medicare overpayment, use the Overpayment Refund Formto submit the voluntary refund. If the DUA says that you were overpaid, you can challenge their decision. You can also challenge the amount of the overpayment. The salary overpayment resulted because . Thank you for completing this Overpayment Refund Notification Form. Thank you for completing this Overpayment Refund Notification Form. Overpayment: How Should I Respond? Dental benefits industry perspective.