1142.010.00 Claims Process – DSS Manuals

IM-58 October 09, 2024 ; IM-102 December 12, 2023 ; IM-14 February 2, 2022 ; IM-50 May 15, 2020 ; IM-40 May 28, 2008 ; IM-142 December 2, 2005

The Program Integrity Unit (PIU) will register and track all possible overpayments in the Claims Accounting and Restitution System (CARS). This possible overpayment is called a “discovery claim referral”. The PIU will refer to the CARS User guide Registering a Discovery Claim Referral and Establishing a Claim for instructions.

The PIU will reject the discovery claim referral if it is determined there is:

no overpayment

the claim is less than the threshold, or

the claim period does not fall within the time-frame/look-back period.

This allows another worker or reviewer to see that the claim has already been explored. The PIU will refer to CARS User guide Rejecting a Discovery Claim Referral for instructions.

Thresholds for referring and establishing a claim are applied according to whether the household is active or inactive at the time the claim is discovered, unless the potential overpayment is identified through the process of completing a quality control review or there is a suspected program violation.

Thresholds for Establishing Claims Participating Households Non-participating Households AE IHE SPV/IPV AE IHE SPV/IPV $325 $325 $0 $600 $600 $0

Note : All claims are established that are identified by a Quality Control (QC) review.

Claims are established subject to look-back periods defined below:

Administrative Error (AE) claims may be calculated back no more than twelve months including the month of discovery. see 1142.015.05 Administrative Error

Inadvertent Household Error (IHE) claims may be calculated back no more than twenty-four months including the month of discovery. see 1142.015.10 Inadvertent Household Error

Suspected Program Violation (SPV) and Intentional Program Violation (IPV) claims may be calculated back for a period up to seventy-two-months including the month of discovery. see 1142.015.10.05 Suspected Program Violation see 1142.015.15 Intentional Program Violation

Once it is determined that an overpayment exists, a claim is established in CARS listing the responsible household members.

CARS generates a demand letter to the household the day the claim is established. (see 1142.045.00 Demand Letters )

The household is given the opportunity to request a hearing (see 1142.050.00 Claims Hearings ) and choose a repayment agreement (see 1142.055.10 Repayment Agreement ).

Claims in which an intentional program violation is suspected are referred to the Welfare Investigation Unit (WIU) for investigation as SPVs. WIU may accept the claim for investigation or follow the current handoff process in place to pursue an Administrative Disqualification Hearing (ADH).

Note : FSD staff will not refer claims known to be AE or IHE to WIU for investigation.

All AE and IHE claims will be considered for compromise when contacted by the household. If a hearing is not requested, 30 days after the claim is established, SNAP benefits of any person responsible for the claim may be reduced to repay the claim, unless the debtor has made a repayment agreement and is making agreed payments.

The billing process begins 30 days from the date the claim is established, or 30 days from the hearing decision if a fair hearing is requested.

Any claim that is delinquent for 180 days or more may be referred to the Treasury Offset Program (TOP) for collection (see 1142.055.15.25 Treasury Offset Program ).

Expunged SNAP benefits may be used to repay the claim.