Claims against CE and BBCE households are only established when the claim can be calculated based on changed net adjusted income and/or household size. Other issues unrelated to net income or household size such as resources do not result in overpayment claims.

An overpayment must be pursued and processed in the following expedite situations:

1. If a household is certified under expedited service, and it is later discovered that the household intentionally misrepresented their circumstances.

2. If a household inadvertently provides incorrect information at expedited intake.

3. If an agency-caused error causes an overpayment when processing an expedited application. These errors include but are not limited to:

   1. Not verifying anticipated new income.

   2. Not verifying a stated job-end.

   3. Not verifying out of state benefits.

   4. Not verifying a stated lack of income.

   5. Any other administrative error.

       

Group homes are liable for repayment of agency and participant-caused overpayments when representatives of the group home act as authorized representatives. Residents of drug/alcohol treatment and rehabilitation programs are required to designate the drug/alcohol treatment, rehabilitation, or mental health center as authorized representatives. Drug/alcohol treatment, rehabilitation, and mental health centers are liable for repayment of agency and participant-caused overpayments. The household’s benefits must not be reduced to repay the overpayment.

The State where duplicate benefits were authorized is the State that establishes the claim. This is the State that issues benefits AFTER another State has already issued benefits for the same month.

1. Agency-Caused Errors

2. participant-Caused Errors

3. Intentional Program Violation (IPV)

When a household was over issued benefits, the eligibility worker must determine if the error was agency or participant caused.

An error is considered an agency-caused error if caused by:

1. An eligibility worker’s action or failure to act on known information.

2. An eligibility staff member incorrectly applying policy.

3. An eligibility staff member’s action which results in an incorrect CE/BBCE determination, and the claim can be calculated based on a change Information that is different from what is currently used to determine eligibility and/or benefits. in net income and/or household size; or,

4. The Social Security Administration (SSA) failed to take an action that resulted in the household incorrectly being determined categorically eligible Any household in which all members receive or are authorized to receive TANF and/or SSI. These households are income and asset eligible..

Agency-caused errors include but are not limited to:

1. The eligibility worker failed to act timely on a reported change.

2. A computation error was made, or policy was applied incorrectly.

3. A change in the SNAP allotment The total value of SNAP benefits a household is authorized to receive. was not made after changing the TANF cash grant.

Note:If the eligibility worker could have known information at application, recertification, or when adding a household member via an interface but does not query or does not correctly query the other interfaces, it is considered an agency caused error.

An error is considered a participant-caused error when the household failed to report, provide information, or provided incorrect information. The eligibility worker must determine if the household inadvertently or intentionally caused the error. Errors caused because of one of the following are considered inadvertent participant-caused errors:

 

1. A misunderstanding or unintended error on the part of the household.

2. A misunderstanding or unintended error on the part of a CE/BBCE eligible household provided the claim can be calculated based on a change in net income and/or household size.

3. Unintentionally failed to provide correct or complete information.

4. Unintentionally failed to report changes in household circumstances; or,

5. Received continued benefits pending the outcome of a Fair Hearing and the decision determined the household was ineligible Not qualified to receive benefits because of not meeting one or more of the specified nonfinancial or financial requirements of eligibility. or received an over issuance.

Intentional Program Violations include, but are not limited to, those claims in which a participant intentionally:

1. Makes a false or misleading statement.

2. Misrepresents, conceals, or withholds facts; or,

3. Commits any act that constitutes a violation of the Food Stamp Act or regulations, or any state statute relating to the use, presentation, transfer, acquisition, receipt, or possession of SNAP benefits.

Overpayments determined to be a participant-caused error must be evaluated for Intentional Program Violations (IPVs). Eligibility workers determine if an IPV occurred. participant errors must have a narrative documenting whether an IPV referral has been completed. The narrative must include justification to substantiate this decision. If an IPV is not being pursued the narrative must include justification to substantiate this decision. Narrative must be entered at the point of discovery, throughout the investigation and when the claim is established.

participants are informed about their rights and responsibilities and their reporting requirements. Therefore, the household cannot simply state they did not understand their reporting requirements, forgot to report changes, or unintentionally caused the error. For the error to be considered an ‘inadvertent’ participant error, substantiated circumstances must be documented that confirm the error was inadvertent; examples include, but are not limited to:

1. participant has a documented mental condition that causes comprehension or memory problems.

2. Income was reported untimely, but the participant relocated to a domestic violence shelter during the reporting time frames, causing the untimely reporting.

All possible IPV disqualifications are referred to the Legal Advisory Unit even when an overpayment is not established. All participant-caused over issuance claims are initially established as inadvertent participant-caused errors.

When the eligibility worker discovers information not reported according to the participant’s reporting requirements, a request for information notice is sent requiring the household to submit information/verification Third-party information or documentation used to establish the accuracy of statements. within 10 days of the notice. This notice must stipulate specific information being requested.

If the household refuses to provide the required information/verification (e.g., actual wage amounts) the case must be closed (advance notice must be provided). The participant may be required to respond to the request in writing or over the telephone, but not in person. The eligibility worker should attempt to obtain the information from the source (e.g., employer).

If the information/verification cannot be obtained, a narrative marked as “high importance” is entered stating there is an outstanding claim issue and include specifically what information/verification is needed to determine the claim amount. If the case is closed and the household later reapplies, it must cooperate by providing information necessary to calculate the claim. The new application is denied if the household continues to refuse to cooperate with providing verification of actual income during the overpayment period.

Exception: If the household is unable to obtain the information/verification due to no fault of their own, the new application can be approved, and benefits are not pended for the information/verification. The eligibility worker must narrate why the information could not be obtained.

 

For agency-caused and inadvertent participant-caused errors, a claim must be established for any over issuance not to exceed 12 months retroactively from the month of discovery.

For IPV errors, a claim must be established back to the month the IPV act occurred. Amounts that occurred more than six years prior to the eligibility worker becoming aware of the overpayment are not included.

The eligibility worker must establish a claim and send both the notice of claim by the end of the quarter following the quarter that the overpayment is first identified. A quarter is identified as January - March, April - June, July – September, and October - December. Therefore, an error discovered in February must have a claim established by the end of June

Exception: Case corrections for Quality Control reviews, Management Evaluation reviews, and National Directory of New Hire (NDNH) cases must be completed based on each review’s correction procedures.

 

Note: All claims must be established even if they are not established timely.

 

A Supervisor must review all overpayment claims for accuracy and timeliness of the claim. The overpayment claim must be approved by the supervisor and this approval must be documented in a narrative.

The first month of overpayment is determined according to the household’s reporting requirements. Prompt action must be taken on the change, allowing for 10-day advance notice A notice that must be sent to a household at least 10 days before the effective date of an action that reduces, suspends, or terminates a household’s benefit.. All required unreported changes and changes that are not reported timely must be evaluated for a possible IPV disqualification.

If the income was not reported timely, earned income Employee payments received in cash for wages, tips, commissions, or net profit from self-employment activities; the Gross Income is before deductions for personal or employment expenses or garnishments. Net Income is after deductions for personal or employment expenses or garnishments. disregards cannot be allowed on the portion that was not reported/verified timely.

For Change Reporters: when an error is discovered, request verification of actual element(s) that caused the error to calculate the overpayment.

For Simplified Reporters: the amount of the claim is based on the corrected circumstances that should have been used at certification, Simplified Report, recertification or when a change was reported/discovered that required action.

If more than one past month is being re-evaluated, all overpayment months are totaled into one overpayment claim. If some of the months reworked result in an under issuance, the restoration should only be authorized if the error was agency caused.

When the initial allotment is issued untimely, but within 60 days of application, it can’t be reduced to offset an existing overpayment.

If an overpayment claim has not yet been established and there is also an under issuance that needs to be authorized, both actions must be taken. If there is an open overpayment claim for months prior to the underpayment A benefit issued to a household, whenever a loss was caused by worker error, when an IPV disqualification is later reversed, or when specifically required by federal regulations. month, the entire restoration is applied to the oldest outstanding claim up to the total amount needed to satisfy the overpayment claim.

If a household is entitled to a supplement Additional benefits issued for the current month to compensate for an under issuance. and there is an open overpayment claim for months prior to the under-issuance month, the amount recouped will be $10.00 or 10% of the supplement, whichever is greater, up to the outstanding overpayment amount. Households determined to have committed an IPV must have an allotment reduction of $20.00 or 20% whichever is greater.

If the Administrative Law Judge does not agree with an overpayment amount, the Fair Hearing Representative is notified. The Fair Hearing Representative will request that the eligibility worker recalculates the claim; the Fair Hearing approves it and notice is sent to the household.

1. Lump Sum Payment Earned or unearned income received on a non-recurring (one-time) basis. It is considered as a resource in the month received. – the household may make a cash or SNAP payment for the entire claim amount. The household should not be required to liquidate all its resources to make this lump sum payment.

2. Installment Payment – If the household is unable to repay with a lump sum, payments may be accepted in regular installments or a partial payment and regular installments for the balance.

3. Allotment Reduction – This method is automatically used for all households still receiving SNAP benefits. Recipient households may choose lump sum or installment payments in addition to allotment reduction. The allotment reduction is $10.00 or 10% of the current allotment, whichever is greater. Households determined to have committed an IPV must have an allotment reduction of $20.00 or 20% whichever is greater. The household can elect to have a higher dollar amount (not percent) deducted. Allotment reductions for households with outstanding claims who reapply for assistance will begin with the first FULL month’s allotment. SNAP benefits not accessed in 274 days are expunged and no longer available to the household. If there is an outstanding overpayment, the benefits are applied towards the overpayment prior to being expunged. Expungement Any benefits in an EBT account that has not been used within 274 days from the last date of activity on the EBT account are expunged and no longer available to the household. A notice will be sent to the household informing them of the expungement 30 days prior to benefits being expunged. is completed by the State SNAP Policy Office

4. Treasury Offset Program (TOP) - Accounts that are delinquent for 90 days or more will be referred to TOP or the Department of Revenue for collection. Funds that can be recouped include federal salaries, income tax returns, Social Security benefits, and any warrants issued through the State Department of Revenue. Concerns regarding collections are to be referred to the State SNAP Policy Office.

5. Offset Debt with Electronic Benefit Balance – SNAP participants may request the eligibility staff member to apply funds toward repayment of an overpayment claim from their North Dakota EBT account. To remove funds from the EBT account:

   1. A household must be allowed to pay a claim using benefits from its EBT account. If the household is currently participating in the program, allotment reduction is automatic. The worker must explain to the household that choosing repayment from its EBT account in addition to allotment reduction or an EBT benefit greater than allotment reduction is strictly voluntary. Written authorization A system-initiated approval which generates a benefit. must be obtained from the participant which specifies the amount. The Repayment Agreement (this is attached to the Notice of Claim) can be used. This information must be submitted to the State Office.

       

   Note: participants should contact EBT Card A North Dakota Department of Health and Human Services debit card issued to access SNAP benefits from EBT accounts. Customer Service for the balance in their account prior to completing the form to ensure there is the amount of benefits in the account that they want to use for repayment.

    

The State SNAP Program Office may compromise or reduce an overpayment claim or any portion of an overpayment claim if it is determined that the household’s economic circumstances will prevent repayment of the overpayment claim within three years. Compromises are determined per program. TANF and SNAP overpayment claims cannot be combined when determining compromise.

Compromise will only be considered for:

1. Agency caused error claims; and,

2. Inadvertent household caused error claims.

Compromises will not be considered for:

1. Suspected/Established Intentional Program Violation Claims.

2. Claims due to receiving continued benefits pending a Fair Hearing; and, Court ordered restitutions.

If a household’s circumstances indicate that a compromise is appropriate, please send the state office the following information:

1. The household’s current earned and/or unearned income

2. The household’s current shelter expenses

3. The household’s current medical expenses if elderly or disabled A member of a household who meets one of the following criteria: 1.Eligible to receive SSI benefits, including presumptive SSI payments, or is eligible as a 1619B under SSI criteria. 2.Is determined disabled by SSA and in receipt of disability payments. 3.Is a recipient of disability related medical assistance under Medicaid (Title XIX of the Social Security Act). Eligibility to receive these benefits must be based on disability or blindness criteria, which is at least as stringent as SSI regulations. 4.Is in receipt of disability retirement benefits from a government agency because of a disability considered permanent under Social Security disability criteria. 5.Is a veteran with a service connected or non-service connected disability. 6.Is a veteran considered by the VA in need of regular aid and attendance or permanently house bound under Title 38 of the United States Code. 7.Is a surviving spouse of a veteran and considered by the VA in need of regular aid and attendance or permanently house bound or a surviving child of a veteran and considered by the VA as permanently incapable of self-support under Title 38 of the United States Code. 8.Is a surviving spouse or surviving child of a veteran and considered by the VA entitled to compensation for a service-connected death or pension benefits for a non-service-connected death under Title 38 of the United States Code and has a disability considered permanent. Entitled refers to a surviving spouse and surviving children who are receiving the compensation or pension benefits stated or have been approved for such payments but are not yet receiving them. 9.Is in receipt of a Railroad Retirement disability annuity and has been determined to qualify for Medicare. 10.Is in receipt of SSI optional or mandatory supplementation. (North Dakota does not have SSI optional or mandatory supplementation. However, someone moving to North Dakota may have received this benefit from another state.) 11. Is in receipt of disability-based State general assistance benefits, provided that the eligibility to receive any of these benefits is based upon disability or blindness criteria established by the state they receive the benefit from, which are at least as stringent as those used under SSI regulations. (North Dakota does not have disability-based State general assistance benefits. However, someone moving to North Dakota may have received this benefit from another state.)

4. Representative payee fees