9011.4 Computing the Amount to be Restored

After correcting the loss for future months and excluding those months for which benefits may have been lost prior to the twelve month time limit, calculate the amount to be restored as follows: 1. If the household was eligible but received an incorrect allotment, the loss of benefits will be calculated only for those months the household participated. If the loss was caused by an incorrect delay, denial, or termination of benefits, calculate the months affected by the loss as follows: a. If an eligible household's application was erroneously denied, calculate the loss beginning with the month of application. For an eligible household filing a timely re-application, calculate the loss beginning with the month following the expiration of its certification period. b. If an eligible household's application is delayed, calculate the months for which benefits may have been lost in accordance with the procedures in DSSM 9040. c. If a household's benefits were erroneously terminated, the month the loss initially occurred will be the first month in which benefits were not received as a result of the erroneous action. d. After computing the date the loss initially occurred, calculate the loss 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. 2. For each month affected by the loss, 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, 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 will be considered ineligible. 3. For the months the household was eligible, calculate the allotment it 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. 4. If a claim against a household is unpaid or held in suspense as provided in DSSM 7005, the amount to be restored will be offset against the amount due on the claim before the balance, if any, is restored to the household. At the point in time when the household is certified and receives an initial allotment, the initial allotment will not be reduced to offset claims, even if the initial allotment is paid retroactively. Audit and Recovery Management Services processes all claim determinations. Consequently, benefits will not be restored to any household until ARMS advises the DSS via Form 106, of any off-setting that is required due to outstanding claims. The procedure for effecting benefit restorations is found in DSSM 7002.1.