The amount of the claim is computed by determining the number of months of overpayment and the amount of overpayment for each month.
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, the first month benefits were overpaid is the beginning month of benefits.EXAMPLE: Mr. B applies for Temporary Assistance benefits on 8/5/2008 and is approved for 08/2008 issuance. He does not report Social Security income he has been receiving since 2007. SDX is received by the county office on 10/3/2008. The claim for over issuance when the Social Security income is budgeted begins with 08/2008 because the income was not reported at application.
- If the EU does not report the change within ten (10) days and action can not be taken to close or reduce the grant the next month, the overpayment is effective the month of the maximum advance notice period, if applicable. This is the month the adverse action notice would have expired without the EU requesting a fair hearing.EXAMPLE: Ms. B. is currently receiving Temporary Assistance. On 09-11-08 she became employed, and did not report this change until she reapplied for food stamps on 01-21-09. Taking into account the 10-10-10 rule, Ms. B. should have reported employment by 09-21-08. The eligibility specialist completes a budget by 10-01-08 and sends an adverse action to reduce Temporary Assistance benefits. The adverse action expires on 10-11-08 and action could have been taken to affect November, 2008 Temporary Assistance benefits. The overpayment begins with November, 2008 Temporary Assistance benefits.
- If the EU reports a change within the ten (10) day reporting time frame and the eligibility specialist has a Waiver of 10-Day Advance Notice (IM-80A) signed but does not take action to affect the grant for the month following the month the IM-80A was signed, the overpayment begins with the month following the month the IM-80A was signed.EXAMPLE: Ms. P. signs an IM-80A at the local FSD office on 9-22-08. The eligibility specialist fails to enter a Worker Initiated Closing (WICL) in the month of September, 2008 to close the TA case effective for October, 2008. The overpayment begins with the October, 2008 Temporary Assistance benefits.
- If the EU reports the change timely and action is required, but the eligibility specialist 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: Ms. J applies and was approved for Temporary Assistance benefits on 8/5/08 and reports no income. On 8-26-08, Ms. J reports she began a new job on 8-25-08 and her income exceeds 185% of the poverty level. The eligibility specialist does not act on the reported change. A reinvestigation was completed on Ms. J 1-18-09, and the eligibility specialist discovers she is ineligible for Temporary Assistance benefits. The overpayment begins with October 2008 Temporary Assistance benefits.
The eligibility factors and budget process in effect during the period of the claim are used in determining the amount of overpayment.