Verification Procedure and Opportunity to Contest Clause Samples
The "Verification Procedure and Opportunity to Contest" clause establishes a process for reviewing and confirming the accuracy or validity of certain information, actions, or decisions within an agreement. Typically, this clause outlines the steps a party must follow to verify claims or findings, and provides the other party with a formal opportunity to challenge or dispute the results, often within a specified timeframe. Its core practical function is to ensure fairness and transparency by allowing both parties to address potential errors or disagreements before any final decisions or actions are taken.
Verification Procedure and Opportunity to Contest. A. Verification Procedures SSA will take no adverse action regarding individuals identified through the matching process solely based on information that SSA obtains from the match. SSA will contact the beneficiary or recipient to verify the matching results in accordance with the requirements of the Privacy Act and applicable OMB guidelines. In RSDI cases where discrepant information is produced by SSA alert development, SSA will verify status through the SAVE Program. When necessary, SSA will request or conduct further development if the SAVE Program response and the removal report generated as part of this match are inconsistent with respect to the NH’s current immigration status or if there is some other indication that the removal report is incorrect or does not apply to the NH. In cases where the SAVE Program response or other information immediately available to SSA is sufficient to establish that suspension of RSDI benefits under the removal provisions is not warranted, benefits will continue without further development. The affected individual will have an opportunity to contest the accuracy of the information provided by DHS. SSA will consider the information provided as accurate if the affected individual does not protest within 30 days of receiving notice of the proposed adverse action. SSI recipients who file an appeal within 10 days of receiving the notice will automatically receive payment continuation. SSA will advise the individual that failure to respond within the appropriate timeframes will provide a valid basis for SSA to assume that the information DHS provided is correct.
B. Opportunity to Contest Before taking any adverse action based on the information received from the match, SSA will provide all individuals for whom SSA decides such adverse action is necessary with the following information:
1. SSA has received information from DHS pertaining to the alien’s voluntary absence or deportation/removal from the United States that indicates specified adverse action is necessary.
2. SSA will provide the specific information that indicates the necessity for adverse action to the individual receiving Title XVI SSI payments or Title II RSDI benefits and the effective date of any adjustment or overpayment that may result.
3. The individual has 30 days from the date of the notice to contact SSA and contest the adverse decision. SSI recipients who file an appeal within 10 days of receiving the notice will automatically receive payment continu...
Verification Procedure and Opportunity to Contest. Before making an unfavorable decision on an Extra Help application or redetermination based on the information received from OPM, SSA will provide a written Pre-Decisional Notice (for initial Extra Help applications) to each applicant or Notice of Planned Action (for redeterminations) to each beneficiary when SSA decides such adverse action is necessary. The notice will inform the individual of the match findings and provide the following information:
1. SSA received information from OPM pertaining to receipt of civil service benefit and payment data, which indicates that an adverse action affecting the individual’s eligibility for subsidy assistance is necessary.
2. The individual has a specified number of days (at least 10 days) from the date of the notice to contact SSA to contest the Pre-Decisional Notice or the Notice of Planned Action and submit evidence, if required, to support a decision that SSA should award a full or partial subsidy.
3. Unless the individual notifies SSA within the specified timeframe, SSA will conclude that the data OPM provides is correct and will make the necessary adjustment to the individual’s Extra Help application. SSA will consider failure to respond to the notice sufficient justification for taking the adverse action. SSA will permit further appeals of adverse action as described in applicable instructions and regulations.
Verification Procedure and Opportunity to Contest. A. Verification Procedures
Verification Procedure and Opportunity to Contest. After VA transmits to ED the files of the Veterans whom VA has designated as in receipt of VA disability compensation benefits based on a determination that they have a 100% disabling service-connected disability rating or that they are totally disabled based on an individual unemployability rating and ED matches the VA’s files with ED’s records in NSLDS, ED will contact Borrowers of Title IV Loans and inform them of ED’s TPD discharge process. ED will accept VA’s determination that they have a 100% disabling service-connected disability or that they are totally disabled based on an individual unemployability rating designation in lieu of a VA Statement, and ED will discharge the Borrowers Title IV Loans no earlier than 61 days after ED has notified a Borrower, unless the Borrower chooses to have their Title IV Loans discharged earlier or chooses to opt out of the TPD discharge, thereby simplifying the TPD discharge process for the Borrower. If VA does not identify a Borrower as in receipt of VA disability compensation benefits based on a determination that the Borrower has a 100% disabling service-connected disability or that the Borrower is totally disabled based on an individual unemployability rating, the Borrower still will have the option to submit a TPD discharge application and provide the required physician’s certification in order to determine his or her eligibility for a TPD discharge.
Verification Procedure and Opportunity to Contest. A. Beneficiaries of Individual Unemployability
1. Verification Procedures VA will independently verify all income information to determine the validity or applicability of the information obtained through this matching program prior to the termination, denial, suspension, or reduction of any benefits. VA will independently verify all wage and self-employment income with the payer or the beneficiary.
2. Opportunity to Contest Sixty days before taking any adverse action based on the information received from the match, VA will notify each beneficiary of any adverse information uncovered and give him or her opportunity to explain the circumstances prior to making a final eligibility determination or adjustment to current benefits. VA will provide all the beneficiaries for whom VA decides adverse action is necessary with the following information:
a. That VA has received information that indicates an adverse action is necessary.
b. That the beneficiary has 60 days to contest the adverse action.
B. Pension and Dependency and Indemnity Compensation Consistent with OMB guidance, published at 54 Fed. Reg. 25818, 25827 (June 19, 1989), VA will combine the independent verification and notice requirements for VA applicants and beneficiaries into a single step, as explained in paragraphs b and c below. VA expects that compressing these two steps will reduce the overpayments and under- payments created by delays in processing the match. Records of payments reported as being made by any component of the Department of Treasury, including interest on Federal tax refunds, do not require separate verification. While such reports are considered verified upon receipt by VA, they are return information subject to all of the use and disclosure restrictions provided in IRC Section 6103, IRS Publication 1075, Tax Information Security Guidelines for Federal, State, and Local Agencies, and this agreement.
Verification Procedure and Opportunity to Contest. Once SSA identifies a borrower who is receiving SSI or SSDI disability payments as having a disability status of MINE, ED will contact borrowers of Title IV Loans and inform those individuals of the TPD discharge process. ED will accept SSA’s MINE determination in lieu of requiring the borrower to submit SSA’s award letter with a MINE designation. ED will discharge the borrowers Title IV Loans no earlier than 61 days after ED has notified a borrower, unless the borrower chooses to have their Title IV Loans discharged earlier or chooses to opt out of the TPD discharge, thereby simplifying the TPD discharge process for the borrower. Due to a recent change in tax law, federal student loan amounts that are discharged due to TPD are not considered to be income for federal tax purposes. However, some states consider loan amounts that are discharged due to TPD as income, meaning that a borrower may be taxed on the amount of the discharge. If the borrower receives a TPD discharge, the borrower should contact their state tax revenue office or a tax professional before filing their state tax return to find out how much the borrower could owe to the state as a result of the discharge. If a borrower is not identified by SSA as having a MINE status, the borrower still will have the option to submit a TPD loan discharge application and provide the required physician’s certification in order to determine his or her eligibility for a TPD.
Verification Procedure and Opportunity to Contest. A. Verification Procedures: ED may not suspend, terminate, reduce, or make a final denial of any financial assistance or payment under Title IV of the HEA to an applicant for Title IV, HEA program assistance, or take other adverse action against such applicant, if as a result of information produced by this matching program ED determines that such applicant is ineligible for Title IV, HEA program assistance until such time as such applicant is given notice of the adverse findings and the proposed adverse action based on those findings. ED will provide such applicant with a description of procedures for contesting those findings in advance of the proposed adverse action and with an opportunity to provide the eligible institution with an accurate SSN, proof of U.S. citizenship, or both. Such applicant will have at least 30 days from the date of the notice to provide clear and convincing evidence of the accuracy of such applicant’s SSN, proof of such applicant’s U.S. citizenship, or both. ED’s notification process is highly automated and requires compression of the verification and the notice and wait procedures because such applicants serve as the best source for verifying the matched data and it is not possible to intervene until after an output document has been issued. Indeed, OMB’s “Final Guidance Interpreting the Provisions of Public Law (Pub. L.) 100-503, the Computer Matching and Privacy Protection Act of 1988” anticipates such a situation when it states: “[i]t would be of dubious utility to apply the verification requirements equally to all matches and argue that a match that results in an adverse consequence of the loss of, for example, a tuition assistance payment should receive the same due process procedures as one that results in the loss of an Aid to Families with Dependent Children (AFDC) payment or Food Stamp eligibility.” 54 Fed. Reg. 25818, 25827 (June 19, 1989). This OMB guidance also recognizes that “[i]n many cases, the individual record subject is the best source for determining a finding’s validity, and he or she should be contacted where practicable.” Id. Under the matching program, such applicant records are matched at the time such applicant has, at a minimum, initiated an application for Title IV, HEA program assistance. Examples of an unsuccessful match include, but are not limited to, when such applicant’s name, DOB, or reported SSN is not found, the student is not a U.S. citizen, or the SSN matches that of a deceased person in t...
Verification Procedure and Opportunity to Contest. A. Verification Procedures SSA will take no adverse action regarding individuals identified through the matching process without first conducting verification procedures. SSA will also contact the beneficiary or recipient in accordance with Section XVI of this Agreement to verify discrepant information obtained through the matching results in accordance with the requirements of the Privacy Act and applicable OMB guidelines. In both RSDI and SSI cases, the affected individual will have an opportunity to contest the accuracy of the information provided by DHS as described below.
B. Opportunity to Contest Before taking any adverse action based on the information received from the match, SSA will provide all individuals for whom SSA decides such adverse action is necessary with the following information. SSA will provide this information in English or Spanish with alternative options available for the blind or visually impaired consistent with Section XVI of this Agreement.
1. SSA has received information from DHS pertaining to the noncitizen’s voluntary absence or removal from the United States that indicates specified adverse action is necessary.
2. SSA will provide information that indicates the necessity for an adverse action to the individual receiving Title XVI payments or Title II benefits and the effective date of any adjustment or overpayment that may result. • Notice language for absences related to Title XVI.4 • Notice language for absences related to Title II.5 6
3. The individual has 60 days from the date of the notice to contact SSA and contest the adverse decision. SSI recipients who file an appeal within 10 days of receiving the notice will automatically receive payment continuation.
4. Unless the individual notifies SSA within the time period specified, SSA will conclude that the data provided by DHS is correct and will make the necessary adjustment to the individual's RSDI or SSI benefits. To ensure SSA does not act without verification, the agency also has a policy in place for incorrect, missing or questioning removal data even if the individual does not contest.7 The N03 or N23 policy would apply for Title XVI recipients, as Claims Specialists would have a high level of confidence in the third-party report via this Agreement.8
Verification Procedure and Opportunity to Contest. A. In the event of a match under this program, SSA will follow the verification procedures described below (in accordance with SSA operating procedures):
1. SSA will generate a savings security alert for each individual for whom Fiscal Service reports a total redemption amount that equals or exceeds $1,000.
2. SSA will contact each individual for whom SSA generates an alert to confirm ownership.
3. If the individual confirms ownership, SSA will determine whether the individual remains eligible for SSI.
4. If the individual denies ownership, SSA will question the individual to determine whether the security was purchased as a gift using his or her (the applicant’s or recipient’s) SSN in the registration.
5. If all attempts to resolve the issue of ownership fail, SSA will obtain a signed authorization from the individual for release of Fiscal Service’s records and will contact Fiscal Service through the parallel SSA field office in Minneapolis, Minnesota. SSA will advise other field offices not to contact Fiscal Service directly nor refer individuals to Fiscal Service. Additionally, SSA will ensure that:
a. The authorization form sent to Fiscal Service bears the individual’s signature. Fiscal Service will accept photocopies.
b. Where a representative payee signs an authorization, SSA will review the records involved and annotate the authorization to indicate whether the signer is authorized to consent to the release of information on behalf of the individual.
c. When the individual is deceased, SSA will review the records involved and annotate the authorization to indicate whether the individual is deceased and the signer is a qualified person legally entitled to the information requested.
6. If Fiscal Service’s records indicate that the individual’s name appears on the security, Fiscal Service will provide a copy of the record. SSA will attempt to verify the retroactive security values and will determine the individual’s retroactive and continued eligibility.
7. If the individual’s name is not on Fiscal Service’s records, Fiscal Service will indicate that it has no record for the individual. SSA will take no further action with respect to security ownership.
8. SSA will not release copies of the savings security alert to individuals unless Fiscal Service or the SSI recipient has verified ownership.
B. Before taking any adverse action to deny, reduce, suspend, or terminate an individual’s SSI payment based on the information received from the match, SSA will...
Verification Procedure and Opportunity to Contest. A. Verification Procedure OPM will take no adverse action regarding retirees, survivors, and other annuitants identified through the matching process solely based on information that OPM obtains from the match. OPM will contact the retirees, survivors, and other annuitants to verify the matching results in accordance with requirements of the Privacy Act and applicable OMB guidelines and as described in subsection B of this section. The affected retirees, survivors, and other annuitants will have an opportunity to contest the accuracy of the information SSA provided. OPM will consider the information SSA provided as accurate if the affected retirees, survivors, and other annuitants do not protest within 30 days after receiving notice of the proposed adverse action. OPM will advise the retirees, survivors, and other annuitants that failure to respond within 30 days will provide a valid basis for OPM to assume that the information SSA provided is correct.
B. Opportunity to Contest Before taking any adverse action based on the information received from the match, OPM will provide all the retirees, survivors, and other annuitants for whom OPM decides
1. OPM will advise the individual that OPM received information from SSA that indicates an adverse action affecting the annuitant’s CSRS or FERS annuity is necessary;
2. OPM will advise the individual of the effective date of any adjustment or overpayment that may result;
3. OPM will advise the individual that retirees, survivors, and other annuitants have 30 days to contest any adverse decision; and that
4. Unless the retirees, survivors, and other annuitants respond to contest the proposed adverse action in the required 30-day time period, OPM will conclude that the information SSA provided is correct, and will make the necessary adjustment to the retirees, survivors, and annuitants payment.