Temporary Assistance/Case Management Manual

0310.005.00 Claims Referral Procedures and Determination of Date of Discovery

Claim referral procedures vary according to how the potential claim is discovered.

FSD county staff discovers potential overpayment:

  • The eligibility specialist registers the discovery claim referral in CARS on the Discovery Add (OVAD) screen.
  • The date of discovery is the date the FSD county staff discovered there might be an overpayment.

When the Welfare Investigation Unit (WIU), Temporary Assistance Program and Policy Unit, or another source discovers a potential overpayment:

  • The eligibility specialist is notified of the possible overpayment and registers the discovery claim referral in CARS.
  • The date of discovery is the date the eligibility specialist receives the notification of the possible overpayment.

NOTE: If a check or cash payment is either returned, cancelled or expunged off the Electronic Benefit Transfer (EBT) card, an overpayment has not occurred.

Register a discovery claim referral in CARS using the Discovery Add (OVAD) screen to begin the discovery tracking process. Enter the date the potential claim is identified as the date of discovery. A 20-digit discovery identifier is assigned, which includes the 10-digit DCN, the date of discovery (the four-digit year, the month, the day), and a sequence number starting with 01. The sequence number is the number of claim referrals entered with that date of discovery for that specific DCN. Refer to CARS User Guide Registering a Discovery Claim Referral and Establishing a Claim for instructions.

CARS uses the date of discovery to determine that the claim is established in an appropriate time frame. When a claim referral is registered, CARS calculates the due date of the claim. The discovery claim referral must be acted on and the claim established or rejected by the last day of the quarter following the quarter in which the potential claim was discovered. A Weekly Pending Discovery Claim Referral Report (FCLWK500-01) shows three days prior to the end of the quarter as the due date to act on the claim referral for management purposes.

EXAMPLE: The discovery date is August 6, 2008. The discovery claim referral due date is December 27, 2008. The claim must be established or the claim referral must be rejected by December 31, 2008 to be counted as processed timely. Three work days are allowed from the due date to the end of the month to ensure the claim referral is processed timely.