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West Virginia Income Maintenance Manual Chapter 11
West Virginia Income Maintenance Manual
Page 34 Chapter 11 Benefit Repayment
11.6 REFERRALS TO THE CRIMINAL INVESTIGATIONS UNIT (CIU) 11.6.1 DEFINITION OF WELFARE FRAUD The principle statute dealing with obtaining welfare assistance through misrepresentation is Section 4, Article 5, Chapter 9, of the Code of West Virginia, 1936 as amended: “Any person who obtains or attempts to obtain, or aids or abets an applicant or recipient in obtaining or attempting to obtain, by means of a willfully false statement or misrepresentation or by impersonation or any other fraudulent device: • Any class of welfare assistance to which the applicant or recipient is not entitled; or • Any class of welfare assistance in excess of that to which the applicant or recipient is justly entitled shall upon conviction be punished as follows: o If the aggregate value of all funds or other benefits obtained or attempted to be obtained shall be less than five hundred dollars, the person so convicted shall be guilty of a misdemeanor and shall be fined not more than one thousand dollars or confined to jail not exceeding one year; or o If the aggregate value of all funds or other benefits obtained or attempted to be obtained shall exceed five hundred dollars, the person so convicted shall be guilty of a felony and shall be fined not more than five thousand dollars or confined in the penitentiary not less than one year nor more than five years.” NOTE: Workers must never accuse the client or insinuate to him that he is guilty of fraud or any criminal activity, and must never imply a threat of criminal action to obtain repayment. NOTE: When an agency employee believes that an overpayment of benefits is $500 or greater due to an alleged fraudulent act (e.g., intentional false statement or deliberate client misrepresentation), the case is referred to the Criminal Investigations Unit (CIU) for evaluation, investigation, and referral for prosecution if warranted. Employees in this unit are known as Criminal Investigators (CIs). The overpayment can be in one program of assistance or programs may be combined to reach the $500 threshold.