1142.035.00 Computing the Amount of the Claim

IM-40 May 28, 2008; IM-142 December 2, 2005

The amount of the claim is computed by determining the number of months of an overpayment and the amount of overpayment for each month. Whether an overpayment occurred is impacted by the EU change reporting requirements. Do not consider an overpayment has been made if the EU was not required to report the change in circumstances.

The first month of overpayment is determined by applying the change reporting rules that would have applied to the case situation if all facts and figures required to be reported had been reported to the agency within the proper time frames.

If the overpayment occurred because incorrect information was given or an incorrect determination was made at the time of an application or reapplication, the first month benefits were overpaid is the beginning month of the certification period.

EXAMPLE: Mr. B applies for Food Stamp benefits on 8/5/2004, and is approved for 08/2004 issuance. He does not report SSI income he has been receiving since 2001. SDX is received by the county office on 10/3/2004. The claim for overissuance when the SSI income is budgeted begins with 08/2004 because the income was not reported at application.

If the EU reports the change timely and action is required, but the worker fails to act on the change, the first month of overpayment is the first month the agency should have made the change effective. If the notice of adverse action was required but was not sent, the agency shall assume that the maximum advance notice period, if applicable, would have expired without the EU requesting a fair hearing.

EXAMPLE: Mrs. J applies for Food Stamp benefits on 8/5/2004 and reports all income. On August 26, 2004, Mrs. J reports she began a new job on August 25, 2004 and her income exceeds 130% of the poverty level. The worker does not act on the reported change. Mrs. J reapplies for Food Stamp benefits on January 18, 2005, and the worker discovers she is ineligible for Food Stamp benefits. The claim is done as an agency error beginning October 2004.