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West Virginia Income Maintenance Manual Chapter 10

West Virginia Income Maintenance Manual Page 3 Chapter 10 The Case Maintenance Process

o Individuals in the community and other Department of Human Services (DOHS) employees may report information to the DOHS that has a bearing on the client's eligibility. The report may be in the form of a complaint about the client or a claim that he is receiving benefits fraudulently. If the reported information would have no effect on eligibility for the specific program, this must be explained to the individual providing the information, without confirming that the client receives such benefits or revealing any case information. The nature of the complaint must be recorded in the case record, but not the name of the complainant. If the reported information is true and would have a bearing on eligibility or the benefit level, the Worker must contact the client to confirm the information, keeping in mind the assistance group’s (AG’s) reporting requirements. Verification may be requested, if appropriate. The Worker must not take action, or indicate he is taking action, until the complaint is substantiated. When the complaint involves allegations of fraud, the Worker must determine if there is reason to believe the client committed fraud. If so, and the amount is $500 or more, the Worker must make a referral to Investigations and Fraud Management (IFM). See Chapter 11. Reporting Example 1: A woman calls to report her neighbor’s oldest son moved out of the home and the neighbor has purchased a new vehicle. After reviewing the case, the Worker finds that the AG is receiving SNAP benefits only and is not required to report changes except when the AG’s income exceeds 130% Federal Poverty Level (FPL). The Worker thanks the caller for her information and explains that countable assets and reporting requirements differ among programs. The information is noted in case comments and explored at the next scheduled redetermination. • Information from other offices or bureaus within the DOHS. • Data system matches and case maintenance functions. Each program has specific reports and other case maintenance functions. See program-specific information. The following information provides procedural instructions for case actions common to all programs. 10.2.1.A County Transfers When a client moves to another county, eligibility system action is taken immediately to change the address and transfer the case. The eligibility system notifies the local office in the client's new location electronically of the case name, case number, new address, effective date of the transfer, and any other pertinent information the new county of residence needs before receipt