Element #3:

An injury to the client arising from permitting the department to contradict or repudiate such admission, statement or act. The client experiences either a loss or a detrimental change in their position because the department reverses a decision regarding eligibility. Depending on the specific circumstances of the case, the imposition of a debt that could not be anticipated or avoided by the client may establish injury.

Factors which may be used as evidence of injury:

The client made financial decisions or plans based on a reasonable belief that the benefits they received were correct:

Spent the money on items they would not have otherwise bought and which are not an available resource.

Paid outstanding debts they would not otherwise have paid

Failed to use an available family or community resource due to the receipt of the benefits. Food Banks, help from relatives, the Salvation Army. EXAMPLE: The client receives TANF medical benefits for several months before the department discovers the family is ineligible. The client acted in good faith and is without fault. The family used private medical providers during the period in question based on a reasonable belief that they were entitled to medical assistance. The family did not use the free medical clinic in their town that was available and could have met their medical needs. Injury can be established based on the failure to use an available community resource. When determining injury, the effects of non-cash benefits, such as training and childcare can and should be considered. The appellant and the department must be in agreement regarding the establishment of injury. If the appellant and the department cannot agree on the nature or extent of the injury, the case should go to hearing.