Page 1102

West Virginia Income Maintenance Manual Chapter 11

West Virginia Income Maintenance Manual

Page 17 Chapter 11 Benefit Repayment

11.3.2 PROCEDURES FOR ESTABLISHING CASH ASSISTANCE CLAIMS The following actions are taken by the IFM Worker in establishing a claim against the AG. The IFM Worker: • Accept all referrals related to potential cash assistance overpayments • Review the case record • Obtain third-party verifications to support the allegations • Identify the month(s) for which the claim is established • Classify the claim as agency or client error • Use policy that was in effect at the time of the error to determine the amount of the overpayment • Notify the AG of the overpayment • Initiate and monitor collection activity on the claim 11.3.3 IDENTIFYING THE MONTH(S) FOR WHICH CLAIMS ARE ESTABLISHED When a client fails to report changes timely according to Section 10.5.2, and the change would have decreased benefits, a claim is established. Failure to Take Prompt Action and Computation Error below are used when the overpayment is not contested in a Fair Hearing. If a Fair Hearing is held, the Hearing Officer’s decision is final. NOTE: Claims are NOT established for excess benefits received solely because of the 13-day advance notice period. NOTE: If either of the following conditions exist, see the fraud referral process in Section 11.6: • The amount of cash assistance due to client misrepresentation is greater than $500. • The cash assistance overpayment, in combination with other overissued benefits of other programs due to client misrepresentation, is greater than $500.

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Page 1102

Official source

West Virginia Income Maintenance Manual Chapter 11

West Virginia Income Maintenance Manual

Page 17 Chapter 11 Benefit Repayment

11.3.2 PROCEDURES FOR ESTABLISHING CASH ASSISTANCE CLAIMS The following actions are taken by the IFM Worker in establishing a claim against the AG. The IFM Worker: • Accept all referrals related to potential cash assistance overpayments • Review the case record • Obtain third-party verifications to support the allegations • Identify the month(s) for which the claim is established • Classify the claim as agency or client error • Use policy that was in effect at the time of the error to determine the amount of the overpayment • Notify the AG of the overpayment • Initiate and monitor collection activity on the claim 11.3.3 IDENTIFYING THE MONTH(S) FOR WHICH CLAIMS ARE ESTABLISHED When a client fails to report changes timely according to Section 10.5.2, and the change would have decreased benefits, a claim is established. Failure to Take Prompt Action and Computation Error below are used when the overpayment is not contested in a Fair Hearing. If a Fair Hearing is held, the Hearing Officer’s decision is final. NOTE: Claims are NOT established for excess benefits received solely because of the 13-day advance notice period. NOTE: If either of the following conditions exist, see the fraud referral process in Section 11.6: • The amount of cash assistance due to client misrepresentation is greater than $500. • The cash assistance overpayment, in combination with other overissued benefits of other programs due to client misrepresentation, is greater than $500.