Justina Worrell, 47, works part time as a kitchen helper in an Ohio nursing home. She has cerebral palsy, an intellectual disability, and a cardiac condition that required she get an artificial heart valve at age 20.

A year ago, she was earning $862 a month and receiving about $1,065 in monthly Social Security disability benefits when a letter arrived from the federal government. The Social Security Administration had been overpaying her, the letter said, and wanted money back.

Within 30 days, it said, she should mail the government a check or money order.

For $60,175.90.

“Social Security should be to help people, not to destroy them,” said Addie Arnold, Worrell’s aunt and caregiver.

The Social Security Administration is trying to reclaim billions of dollars from many of the nation’s poorest and most vulnerable — payments it sent them but now says they never should have received.

During the 2022 fiscal year, the agency clawed back $4.7 billion of overpayments, while another $21.6 billion remained outstanding, according to a report by SSA’s inspector general.

One consequence is a costly collection effort for the government and a potentially devastating ordeal for the beneficiary.

“We have an overpayment crisis on our hands,” said Rebecca Vallas, a senior fellow at the Century Foundation think tank.

“Overpayments push already struggling beneficiaries even deeper into poverty and hardship, which is directly counterproductive to the goals” of safety-net programs.

The Social Security Administration declined an interview request from KFF Health News and Cox Media Group and would field questions only submitted by email.

The agency declined to say how many people have been asked to repay overpayments.

“We do not report on the number of debtors,” spokesperson Nicole Tiggemann said in a statement.

The agency rejected a May 2022 Freedom of Information Act request for documentation of every overpayment notice sent over several years, and a March 2023 appeal is pending.

Jack Smalligan of the Urban Institute, who has done research on Social Security, estimated that millions of people have received notices saying the agency overpaid them.

Most are on disability, and many cannot afford to repay the government, Smalligan said.

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