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Page | 313 which verification sources are used. For situations in which specific verifications may not be obtained, the next most reliable source/verification is used.

All requests for substantiation must be made as soon as possible, but within 30 days of the date the potential overpayment is discovered.  If substantiation cannot be started within 30 days, the process must still be completed (it will be a late determination).

Tracking of the substantiation process will be completed for federal reporting; therefore, it is imperative the date of potential overpayment and the date substantiation is initiated are listed on the hard copy (DSS-EA-894) and automated overpayment referral (RECO).

The date the final documentation is received verifying that an overpayment has occurred, is defined as the substantiation date. In cases of SPVs that have been determined to be IPVs, the date of substantiation is the date of the final court order, signed waiver, or final order from the court is received. The claim is calculated when the EABS completes their sections of the DSS-EA-894. The DSS-EA-894 and the SPEC-C-RECO and supporting documents for the claim are required to be transmitted to the Office of Recoveries and Fraud Investigation (ORFI) within 120 days from the completed substantiation date.

B. Claim Referral to ORFI

The overpayment report, DSS-EA-894, and automated referral (RECO) is the process used to transmit overpayments to ORFI to establish liability for the loss to the program. The overpayment report must contain a summary of the facts and circumstances supporting the overpayment amount, including the:  Date of discovery of potential overpayment  Date the substantiation process is started  Date the final substantiation was received.

Failure to complete any of the required dates will result in the DSS-EA-894 report being returned for completion. Additionally, RECO has on-line edits to require completion of each date field. The summary section on the 894 must also contain an explanation on how claim identification was determined (why the claim was identified as a suspected program violation (SPV), inadvertent household error (IHE), or agency error (AER).

If the referral is not made to ORFI within 120 days, the overpayment is considered overdue. Time frames will be tracked; therefore, it is very important that the substantiation date is listed on both the DSS-EA-894 and RECO.

Example: The employer refuses or fails to release actual amounts of each pay check. The quarterly amount reported to the Department of Labor and Regulation (DLR) may be used by averaging the gross amount over the entire 3 months or, if the employment is less than 3 months, over the start and/or stop dates of employment. Important: Overpayment reports must still be completed and referred to ORFI even when the 120 day time frame are not met