63-802 RESTORATION OF LOST BENEFITS 63-802

.1 Entitlement

.11 The CWD shall restore to a household benefits which were lost whenever:

.111 the loss was caused by an administrative error as defined by Section 63-801.22, or;

.112 an administrative disqualification for an intentional Program violation was subsequently reversed as specified in Section 63-805.3, or;

.113 a statement elsewhere in the regulations specifically states that the household is entitled to restoration of lost benefits.

.12 Unless a longer period of time is specified elsewhere in regulations, lost benefits shall be restored for not more than 12 months prior to the earlier of the following dates:

.121 The date the CWD receives a request for restoration from a household; or

.122 The date the CWD is notified or otherwise discovers that a loss to a household has occurred.

.13 The CWD shall restore lost benefits even if the household is currently ineligible for Food Stamp Program participation.

.14 The CWD shall restore to a household benefits which were found by any judicial action to have been wrongfully withheld.

.141 When the judicial action is a review of a state hearing, benefits shall be restored for a period of not more than 12 months prior to the date that the state hearing was initiated, or the dates specified in Section 63-802.12, whichever is the earliest.

CALIFORNIA-DSS-MANUAL-FS

MANUAL LETTER NO. FS-91-03 Effective 3/1/91

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Regulations CORRECTIVE ACTIONS 63-802 (Cont.)

63-802 RESTORATION OF LOST BENEFITS (Continued) 63-802

.142 If the judicial action is the first action the recipient has taken to obtain restoration of lost benefits, then benefits shall be restored for a period of not more than 12 months from the date the judicial action was initiated.

.15 Lost Benefits to Individuals Disqualified for Intentional Program Violation

If the decision which resulted in a disqualification for intentional Program violation is subsequently reversed by a judicial action, that individual is entitled to a restoration of any benefits lost during the months that he/she was disqualified.

.151 The restoration shall not exceed 12 months prior to the date of the CWD's notification of the reversal, except when the individual has participated in an administrative disqualification hearing. The CWD shall consider the individual's prior participation in the administrative disqualification hearing as notification that the household has requested a restoration of lost benefits, and shall restore benefits from the effective date of the notice of action informing the household of the administrative disqualification.

.152 For each month the individual was disqualified, the amount to be restored, if any, shall be determined by comparing the allotment the household received with the allotment the household would have received had the disqualified member been allowed to participate. If the household received a smaller allotment than it should have received, the difference equals the amount to be restored.

.16 Entitlements to Households With Delayed Photo ID Card Replacements

Mutilated or altered photo ID cards shall be replaced as specified in Section 63-504.862 prior to the issuance of coupons. Therefore, if a household's opportunity to participate expires between the time the household requests the photo ID card replacement and the delivery of that card, the CWD shall restore any resulting lost benefits to the household.

CALIFORNIA-DSS-MANUAL-FS

MANUAL LETTER NO. FS-94-02 Effective 2/1/94

Page 460

FOOD STAMP REGULATIONS

63-802 (Cont.) CORRECTIVE ACTIONS Regulations

63-802 RESTORATION OF LOST BENEFITS (Continued) 63-802

.17 Entitlements to Households With Changed Membership

Whenever lost benefits are due a household and the household's membership has changed, the CWD shall restore the lost benefits to the household containing a majority of the individuals who were household members at the time the loss occurred. If the CWD cannot locate or determine the household which contains a majority of household members, the CWD shall restore the lost benefits to the household containing the head of the household at the time the loss occurred.

.2 Method of Restoration

.21 CWDs must reduce any restored benefits owed to a household by the amount of any outstanding claim. This may be done at any time during the claim establishment and collection process. For administrative errors, please see MPP Section 63-801.313, Lopez v. Glickman Court Case.

.22 Regardless of whether a household is currently eligible or ineligible, the CWD shall restore lost benefits to a household by issuing an allotment equal to the amount of benefits that were lost. The amount restored shall be issued in addition to the allotment currently eligible households are entitled to receive. The CWD shall honor reasonable requests by households to restore lost benefits in monthly installments if, for example, the household fears the excess coupons may be stolen, or that the amount to be restored is more than it can use in a reasonable period of time.

.23 Whenever a household entitled to a restoration of lost benefits informs a CWD that it is moving out of the county, benefits shall be restored in a lump sum prior to the move, whenever possible. When benefits cannot be restored prior to the move the CWD shall mail the entitlement in the form of coupons to the household at the new address.

.3 Agency Errors

If the CWD determines that a loss of benefits has occurred and the household is entitled to restoration of those benefits, the CWD shall automatically take action to restore any benefits that were lost. No action by the household is necessary. However, benefits shall not be restored if the benefits were lost more than 12 months prior to the month the loss was discovered by the CWD in the normal course of business, or were lost more than 12 months prior to the month the CWD was notified in writing or orally of a possible loss to a specific household. The CWD shall notify the household of its entitlement, the amount of benefits to be restored, any offsetting that was done, the method of restoration, and the right to appeal through the state hearing process if the household disagrees with any aspect of the proposed lost benefit restoration.

CALIFORNIA-DSS-MANUAL-FS

MANUAL LETTER NO. FS-01-03 Effective 8/10/01

Page 461

FOOD STAMP REGULATIONS

Regulations CORRECTIVE ACTIONS 63-802 (Cont.)

63-802 RESTORATION OF LOST BENEFITS (Continued) 63-802

.4 Disputed Benefits

.41 If the CWD determines that a household is entitled to restoration of lost benefits, but the household does not agree with the amount to be restored as calculated by the CWD or any other action taken by the CWD to restore lost benefits, the household may request a state hearing within 90 days of the date the household is notified of its restoration of lost benefits. If a state hearing is requested prior to or during the time lost benefits are being restored, the household shall receive the lost benefits as determined by the CWD pending the results of the state hearing. If the state hearing decision is favorable to the household, the CWD shall restore the lost benefits in accordance with that decision.

.42 If a household believes it is entitled to restoration of lost benefits but the CWD, after reviewing the case file does not agree, the household has 90 days from the date of the CWD determination to request a state hearing. The CWD shall restore lost benefits to the household only if the state hearing decision is favorable to the household. Benefits lost more than 12 months prior to the date the CWD was initially informed of the household's possible entitlement to lost benefits shall not be restored.

.5 Computing the Benefit to be Restored

After correcting the loss for future months and excluding those months for which benefits may have been lost prior to the 12-month time limit, the CWD shall calculate the amount to be restored.

.51 If the household was eligible but received an incorrect allotment, the loss of benefits shall be calculated only for those months the household participated. However, if a household did not have an opportunity to participate because of an incorrect delay, denial, or termination of benefits, the months affected by the loss shall be calculated as follows:

.511 If an eligible household's application was erroneously denied, the month the loss initially occurred shall be the month of application, or for an eligible household filing a timely reapplication, the month following the expiration of its certification period.

.512 If an eligible household's application was delayed, the months for which benefits may be lost shall be calculated in accordance with procedures in Section 63-301.4.

CALIFORNIA-DSS-MANUAL-FS

MANUAL LETTER NO. FS-90-01 Issued 7/1/90

Page 462

FOOD STAMP REGULATIONS

63-802 (Cont.) CORRECTIVE ACTIONS Regulations

63-802 RESTORATION OF LOST BENEFITS (Continued) 63-802

.513 If the household's benefits were erroneously terminated, the month the loss initially occurred shall be the first month benefits were not received as a result of the erroneous action.

.514 After computing the date the loss initially occurred, the loss shall be calculated for each month subsequent to that date until either the first month the error is corrected or the first month the household is found ineligible.

.52 For each month affected by the loss, the CWD shall determine if the household was actually eligible. In cases where there is no information in the household's case file to document that the household was actually eligible, the CWD shall advise the household of what information must be provided to determine eligibility for these months. For each month the household cannot provide the necessary information to demonstrate its eligibility, the household shall be considered ineligible.

.53 For the months the household was eligible, the CWD shall calculate the allotment the household should have received. If the household received a smaller allotment than it was eligible to receive, the difference between the actual and correct allotments equals the amount to be restored.

.54 If a claim against a household is unpaid, suspended or terminated as provided in Section 63-801.5, the amount to be restored shall be offset against the amount due on the claim before the balance, if any, is restored to the household.

.541 When a household is certified and receives an initial allotment, this initial allotment shall not be reduced to offset claims even if the allotment is paid retroactively.

.542 If a change in household composition occurs, the CWD shall offset the amount of the claim against restored benefits in accordance with Sections 63-801.313 and 63-801.323. This action may be taken against any or all households which contain a member who was an adult member of the original household at the time the overissuance occurred (see Section 63-801.1).

(a) The CWD shall not collect more than the amount of the claim under any circumstances.

HANDBOOK BEGINS HERE

The California Department of Social Services and the CWDs are permanently enjoined by court order in Lopez v. Glickman from applying that part of 63-802.54 regarding the offset of administrative error claims. CWDs shall not offset the amount of an administrative error claim against any amount of lost benefits which have not yet been restored to the household.

HANDBOOK ENDS HERE

CALIFORNIA-DSS-MANUAL-FS

MANUAL LETTER NO. FS-00-03 Effective 2/16/00

Page 463

FOOD STAMP REGULATIONS

Regulations CORRECTIVE ACTIONS 63-803

63-802 RESTORATION OF LOST BENEFITS (Continued) 63-802

.55 Since coupon books with values of $1, $3, or $5 cannot be issued, restorations made in allotments of $1, $3, and $5 shall be rounded to $2, $4, and $6 respectively.

.6 Accounting Procedures

Each CWD shall be responsible for maintaining an accounting system for documenting a household's entitlement to restoration of lost benefits and for recording the balance of lost benefits that shall be restored to the household. Each CWD shall at a minimum, document how the amount to be restored was calculated and the reason lost benefits must be restored. The accounting system shall be designed to readily identify those situations where a claim against a household can be used to offset the amount to be restored.

NOTE: Authority cited: Sections 10554 and 18904, Welfare and Institutions Code. Reference: 54 Federal Register 30, Table of Redesignations (Part 274), p. 6991, 7 CFR 273.17(a)(1); 7 CFR 273.17(d)(4); 7 CFR 273.18(f); and Sections 10554 and 18904, Welfare and Institutions Code.