The salary overpayment resulted because . 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.To ask for waiver, fill out the Request for Waiver Form and send it to Social Security. Medical records must be received within fourteen (14) calendar days of the date of the. Medical Record Request Letter. The good news is that you have some options. The first is to appeal the overpayment with a request for reconsideration. In the event I leave employment with this agency, I authorize the overpayment balance to be deducted from my final payroll payment or terminal leave cashout.