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West Virginia Income Maintenance Manual Chapter 10

West Virginia Income Maintenance Manual Page 29 Chapter 10 The Case Maintenance Process

10.4.5.C Time Limits for Restoring Benefits Benefits are not restored for more than 12 months prior to the earliest of the events: • The date the Worker received a request from the AG for restoration of benefits; • The date the Worker is notified or otherwise discovers that a loss has occurred; or • The date any judicial action determined that benefits were wrongfully withheld as follows: o If the judicial action is the first action the recipient has taken to obtain restoration of lost benefits, benefits are restored for a period of not more than 12 months from the date court action is initiated. o If the judicial action is a review of the DOHS’s action, benefits are restored for the period of not more than 12 months from the date the DOHS received a request for restoration. When no request for restoration was received, benefits are restored for not more than a period of 12 months from the date the Fair Hearing was requested by the client. AGs eligible for restoration of benefits due to uncapped shelter deductions and/or excess medical deductions because of the presence of an SSI recipient are not subject to the time limits listed above. Benefits may be restored the month following the first month SSI benefits are paid or the original date of application for SNAP benefits, whichever is later. When the restoration of benefits is due to the decision of a fair hearing, legal ruling, or appeal, benefits must be restored within 10 days of the Department receiving the decision. Benefits restored due to a reversal of an Administrative Disqualification Hearing (ADH) are restored for a period not to exceed 12 months prior to the date of notification, which is determined as follows: • If a member of the AG participated in the ADH and contested the DOHS’s position, the date of notification is the date the ADH was held. • When the DOHS’s position was not contested at the ADH, the date of notification is the date the court decision is received. Restoring Benefits Example 1: The client tells the Worker on July 14, 2014, that he believes his benefit amount is incorrect due to failure of the Worker to allow the client a deduction for reported medical expenses. On August 10, the Worker discovers that an error was made in the birth date of one of the AG members when the case was approved, and a medical deduction should have been allowed since February 2013. The Worker takes action to update the eligibility system effective August 2014. Benefits are restored for July 2013