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FOOD AND NUTRITION SERVICES CERTIFICATION CLAIMS Agency Error (AE) Claims

4 Section 810 Change #3 2017 September 20, 2017 EXAMPLE 2: It was reported to Work First on September 29 that there was a change in an additional household member with income. The caseworker discovered at the recertification interview on January 12, that the change had not been made. The ten calendar days for the caseworker to act expired on October 9. The ten working days Adverse Action Notice expired October 22. The change would be keyed October 23. The first month of overissuance is December. Use all other household circumstances as they were originally entered in NC FAST. Add the individual, the changed Work First payment, and the actual income of the additional individual received in November to determine the correct allotment and amount of overissuance.

C. For each month of the overissuance, verify each source of changed income, unless it has been previously verified and not acted on. Use actual income, do not convert.

Use the Division of Employment Security (DES) wage match when actual wages are not available to compute the overissuance when income is reported and not verified or acted upon. Use the gross quarterly income, divided by three months, to obtain the average amount per month. If the employment was less than three months, average the gross amount over the period of time between the start and stop dates of employment.

Determine the initial month of overissuance by contact with the client or employer to obtain the date of first pay. If the client fails or refuses to provide necessary information or the information cannot be obtained from a third party, refer to Section 810.04, B, Client Failure to Cooperate. It is possible that the amount of the claim cannot be determined.

D. Consider any countable income from certain ineligible and all disqualified household members. See Section 260, Whose Income is Counted?

E. Include dependent care expenses as a deduction. Allow the actual amount of dependent care cost the FNS unit is responsible for paying.

F. Count money from means-tested State and federal assistance payments (such as Work First, and SSI) intended for the overissued month even if mailing cycles result in the receipt of two payments in one month and none the next month. For other income, count income in the month received.

EXAMPLE: Supplemental Security Income (SSI) payments are received December 1 and December 31 and none in January due to the January 1 holiday. Count one payment each for December and January.

G. For payments that are mailed, add three calendar days mailing time to the date of the check to determine the month received. Begin counting with the day after the check is mailed, and count days when mail is delivered. If child support is verified through ACTS, the date shown in ACTS is the date the check is written. The check is mailed the next business day.

H. Count the actual amount of Work First, SSI, RSDI, or Veterans Administration (VA) received, even when it represents an erroneous payment.

I. Do not include in the computation any portion of income that was a lump-sum payment unless the lump sum includes the current month’s benefit payment.