Complete this form if any of the following applies: You think that you are not at fault for the overpayment and you cannot afford to pay the money back. Class members with appeals of suspensions, denials, or overpayments that were pending on October 24, 2006 or later also may get back payments.If you were overpaid, you will receive a written notice in the mail. The salary overpayment resulted because . Write a letter to the Social Security Administration. Tell them how much you can afford to pay each month. If we can't waive collection, we may use this form to decide how you should repay the money. Please answer the questions on this form as completely as you can. We have identified the following overpayment and are in good faith voluntarily refunding all monies collected in error. I'm a social security disability attorney and today I'd like to talk to you about what you need to do to request a waiver of overpayment of benefits.