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West Virginia Income Maintenance Manual Chapter 11

West Virginia Income Maintenance Manual

Page 35 Chapter 11 Benefit Repayment

The important elements constituting an offense under this statute are that any false representation was willfully made or that any other device to obtain assistance was a misrepresentation. A willfully false statement is one that is deliberately given, with the intent that it be accepted as true, and with the knowledge that it is false. It is an essential element in a misrepresentation charge that the client knew his statement was false. The misrepresentation must be of an existing fact and cannot be said to be willfully false if it is merely an expression of opinion. Likewise, it is not essential that an affirmative representation be made. Misrepresentation may also be the suppression of what is true, as well as in the representation of what is false. 11.6.2 REFERRAL CRITERIA The following guidelines assist the Worker in determining whether or not a referral is made to the CIU. No referral is made in the following situations: • The misrepresentation period ended more than two years ago. Referral Example: A case was last certified in December 1994. An overpayment occurred due to a false statement but was not discovered until November 1998. The case is not referred for fraud investigation but is referred for repayment as detailed in Sections 11.2 and 11.3. • Pertinent sections of the application form (e.g., income, assets, potential resources, employment) were not properly completed by the Worker. • The Rights and Responsibilities form was not signed. • The application form was not signed. • Correct information affecting eligibility was reported, but the agency did not take appropriate action. • The total amount is less than $500. Repayment procedures should be followed instead. See Sections 11.2 and 11.3. • The Worker believes the client is not mentally capable of understanding his responsibilities to report changes. • The client is seriously ill, blind, or is suffering from a terminal illness.