The following are definitions of terms used throughout this memorandum.

• Discovery claim referrals are "registered" in the Claims Accounting and Restitution System (CARS) the date a potential overpayment is identified. 

• These discovery claim referrals will "pend" until staff determine whether an overpayment/claim exists. 

• The "date of discovery", the date county staff become aware of a possible overpayment, is entered for each discovery claim referral. 

• The "due date" is calculated by CARS for each discovery claim referral. 

• The "date established" for the claim is the date the demand letter is generated.  CARS will automatically generate a demand letter that is mailed the next business day after the worker enters all information necessary to establish the claim.

• any adult member of the household, age 18 or over, when the overpayment or trafficking occurred, even if this individual is no longer in the household; 

• a sponsor of an immigrant household member if the sponsor is at fault; and/or 

• a person connected to the household, such as an authorized representative, who actually traffics or otherwise causes an overpayment or trafficking.

CARS is changed to add screens that allow us to track timely processing of claim referrals and to associate all responsible household members to an established claim.  The new screens work with the existing screens.  Minor changes made to existing screens are discussed in a separate memorandum.

REGISTERING A CLAIM

All food stamp discovery claim referrals must have the date of discovery entered.  The date of discovery is the date county staff become aware of a possible overpayment.  The discovery claim referral is registered in CARS the same day it is discovered. 

EXAMPLE 1:  The caseworker, Joe Shmoe, discovers a possible overpayment for the D'Arcy household on August 6, 2001.  Workers in this particular county are responsible for their own claims.  Joe registers the discovery claim referral in CARS on August 6, using his/her own user ID (SHMOZ00) and his supervisor's user ID.  The date of discovery is August 6, 2001.

EXAMPLE 2:  Jane Doe, discovers a possible overpayment for the Biafra household on September 12, 2001.  Jane Doe registers the discovery claim referral in CARS on September 12 without verifying eligibility information. Jane enters her own user ID (DOEZAZ) and the user ID of the supervisor of the claims worker/unit.  The claims worker/unit is notified of the discovery claim referral on September 13.  The date of discovery is September 12, 2001, the day the possible overpayment is discovered.  The claims worker who receives the claim referral changes the user ID to his/her own.

DUE DATE

Once a discovery claim referral is registered, CARS calculates the due date for the claim.  Discovery claim referrals must have a claim established or the referral rejected by the third to last working day of the quarter following the quarter of the date of discovery.

EXAMPLE:  The discovery date is August 6, 2001.  The discovery claim referral due date is December 27, 2001.  The claim must be established or the claim referral must be rejected by December 27, 2001.

REJECTING CLAIM REFERRALS

Claim referrals may be rejected for any of the following reasons: 

• no overpayment exists,
• there was insufficient information to determine if an overpayment exists,
• there were duplicate referrals,
• DFS is unable to locate the client, or
• the overpayment is less than the threshold:
• the overpayment is less than $125 and the case is not active, or
• the overpayment is less than $125 and the overpayment was not discovered in a quality control review.

The demand letters now include overpayment information for each month of overpayment.  Included is the amount of benefits the household received each month of the claim period, the amount the household was eligible to receive each month, and the overpayment amount for each month.  A screen is developed to capture this information.  The layout is similar to the claim worksheet, form IM-86.  It is no longer a requirement to complete form IM-86 on food stamp claims.  Continue to use FBCA as applicable.

CLAIM MEMBERS

The following individuals are now responsible for repaying a claim established after 08/06/01.  Do not add new responsible individuals to claims established prior to 08/06/01.

• any adult member of the household, age 18 or over, when the overpayment or trafficking occurs, even if this individual is no longer in the household;

• a sponsor of an immigrant household member if the sponsor is at fault; and/or

• a person connected to the household, such as an authorized representative, who actually traffics or otherwise causes an overpayment or trafficking.

NOTE:  An authorized representative is not responsible to repay an Agency Error claim.

Collections will only be made against one household for a single claim when responsible claim members reside in multiple households, in the following order:

• active head of household,

• other active household members, by descending age (oldest members to youngest),

• active non-household members, by descending age,

• inactive head of household,

• other inactive household members, by descending age, and

• inactive non-household members, by descending age.

Once all the information necessary to establish a claim has been entered in CARS, worker involvement in the claim establishment process is complete.  CARS will automatically generate a demand letter to be sent the next working day.  The date the letter is generated is considered the date of establishment.

EXAMPLE:  Information is entered to establish a claim on 12/28/01.  The letter is generated in the overnight batch process prior to midnight.  12/28/01 is the date the claim is considered established.  The next business day the letter could be mailed is 12/31/01.

DISCOVERY IDENTIFIER

As soon as a discovery claim referral is registered, it will be assigned a 20-digit Discovery Identifier(ID).  This Discovery ID consists of ten digits for the DCN (the DCN is preceded by two zeros in anticipation of the ten-digit DCN to be used for FAMIS), the eight-digit discovery date (YYYYMMDD), and a two-digit sequence number.  This will allow staff to enter more than one claim referral per case with the same discovery date.

EXAMPLE:  A discovery claim referral registered for DCN 12345678 with a discovery date of August 10, 2001, will have the Discovery ID 00123456782001081001.  A second discovery claim referral registered for the same DCN and the same discovery date will have the Discovery ID 0123456782001081002.

To allow multiple food stamp claims to be established (the date the demand letter is generated) on the same day for a DCN, CARS will assign the claim indicator letter "I" for the first claim established and a successive letter for subsequent claims (J, K, L, etc.).  If only one food stamp claim is established on a given day, the claim indicator letter is "I".  The claim indicator assignment is based only on the DCN and the date of claim establishment.  It is completely independent of the Discovery ID.

CLAIM IDENTIFIER

At the point the claim is established, CARS assigns a claim identifier, consisting of the claim indicator, DCN, space, program, space, date of establishment. 

EXAMPLE:  Two claims for DCN 12345678 are established (demand letters are generated) on September 22, 2001.  Both claims are program 12.  The first claim established has the claim identifier I12345678 12 092201 and the second claim established has the claim identifier J12345678 12 092201.

NOTE:  The claim indicator is displayed after the program code in the "PGM" column on OVCS.  The claim indicator is only displayed on OVCS if it is other than "I".  A blank space after the program code indicates that the claim indicator is an "I".

The method of accessing other CARS screens has not changed.  They require only an "I" before the DCN.  These other screens either display information regarding all claims for a given DCN regardless of the identifier or program, or they allow the user to cycle through the screens to view specific claims.

EXAMPLE:  The claims worker determines a member associated to a claim needs to be added.  The worker needs to access OVMA.  To find the claim identifier, view a list of all the claims for DCN 12345678.  Type OVCS I12345678.  Locate the claim that is to be changed.  After determining the claim identifier, to change claim information on a claim with program 12, claim indicator "J", and date established 09-22-01, overtype the tran ID with OVCA J12345678 12 092201.

Four reports are used to monitor claim referrals to ensure the time frames are met.  If more than 10% of the claim referrals are delinquent, a backlog exists and a corrective action plan will be required. 

• Daily Incomplete Pending Claim Registration Report (Report Number FCLDY500-01):  This report is generated if insufficient information is entered in CARS and a demand letter cannot be generated.  The report is produced daily.  It is sent to the worker and the supervisor.  Initially the report is printed centrally and mailed to the county office.  The report will be available on S020 within a short time.  A copy of the report is attached.

• Weekly Pending Discovery Claim Referral Report (Report Number FCLWK500-01):  Each worker receives a weekly report showing claim referrals assigned to him/her.  Each management unit receives reports showing all claim referrals within that unit.  The report displays the claim referral due date and indicates delinquent claim referrals.  Initially the report is printed centrally and mailed to the county office.  The report will be available on S020 within a short time.  A copy of the report is attached.

• Delinquent Discovery Claim Referrals Report (Report Number FCLQT500-01):  This quarterly report shows all delinquent claim referrals for each worker.  It indicates the number of delinquent referrals versus the total number of referrals, providing the percentage of referrals delinquent.  The report is to be used as a management tool to ensure claim referrals are processed in a timely manner.  Further details regarding this report and a copy of it will be sent at a later date.

• Discovery Claim Activity Report (Report Number FCLMT500-01):  This monthly report shows claim referrals registered, claim referrals rejected, and claims established for each worker.  It includes the date of discovery, due date, and date established.  Further details regarding this report and a copy of it will be sent at a later date.

The old Food Stamp Manual Chapter IX Section VII (Claims) is currently being revised.  It will be available on the Intranet Food Stamp Manual when it is completed.  The Claims section of the Forms Manual is also being revised.

• Discuss this memorandum with all appropriate staff.

• Follow the new food stamp claim policy effective 08/06/01.

• Refer to the procedures memorandum for instructions to enter food stamp claims information in CARS.